Consultation – The future of SMART Recovery UK

26th April to June 11th 2010

Introduction and background

SMART Recovery is owned by a not for profit organisation based in the USA, which has licensed the
materials and rights to develop the program within the UK to a local charity set up for the purpose,
SMART Recovery UK.

Over the last five years, SMART Recovery has developed in a rather ad-hoc way within this country,
with different groups and organisations making progress, but pulling in very different directions. The
Board believes that SMART Recovery has not yet fulfilled its potential and needs a more focussed and
coherent approach.

This document sets out the ‘thinking so far’ in our work toward a new strategic plan and business
model that we expect to publish within the next two months. We are seeking feedback and comment
from a wide range of stakeholders.

Overview
The Board believes that the heart and soul of SMART Recovery is the Peer facilitated meeting. The
number one objective and measure of success for the organisation should be the growth in availability
and quality of these meetings. With the right approach, we should aim for rapid growth over the next
few years, to the benefit of many tens of thousands of people.

One option is to try and grow the organisation entirely from within the Peer network, using donations
and small grants to fund materials, publicity and training. On reflection, we do not believe this would
achieve the rapid increase in meeting availability that we think can be achieved.

Furthermore, some of the ways that SMART Recovery has been used within professional services are
impressive and have the potential to help the wider network grow. We therefore propose a
partnership with the professional treatment sector.

To grow the organisation, there is an urgent need for more training capacity, stronger central
administration, investment in materials and capacity to liaise with national bodies. The Board believe
that a sustainable revenue stream is needed to cover such costs, and relying on meeting donations is
unrealistic. An additional benefit of partnership with the professional sector is access to the modest
financial resources that the organisation needs to grow.
SMART Recovery Meetings Network
Most SMART Recovery meetings will take place out in the Community and led by Peer facilitators.
They will welcome members who have never been in treatment, as well as people introduced by
provider agencies.

A key priority is to increase the availability of facilitator training. We will develop a new standard
training pack and agree the minimum amount / quality of training required by new facilitators. In the
short term it is proposed that we ‘accredit’ a minimum of six trainers to run these courses and work
with them on the new training pack.

It is proposed to have regionally based training mentors who will mentor, train and problem solve with
the facilitators of meetings and act as go betweens to the national organisation. These will initially be
volunteers, though we should consider paid positions if the organisation grew to the point that this
became desirable and realistic.

The organisation will also seek to supply facilitators with leaflets and publicity materials to promote
their meeting, as well as build the community of facilitators using online tools, telephone conferences
and (when resources permit) an annual conference.

Provider Partnerships
The Board believes that treatment providers have an important role to play in supporting the
development SMART Recovery, though this needs careful thinking through. The proposed model is to
encourage providers to include some elements of SMART Recovery into their treatment programmes,
under license and in accordance with several principles. This approach would solve some important
problems for providers as well as leverage the capacity of the treatment system to help build the
SMART Recovery network.

Learning from existing Partnership work

A great deal of valuable work has been carried out within Addaction and the Alcohol Concern pilots on
how treatment providers can partner effectively with SMART Recovery. The following factors seemed
to be associated with success in creating standalone meetings out of these partnerships.

a) Where the provider offered encouragement, logistical and emotional support to the Facilitator,
but did not interfere or try to take ownership of the meetings.
b) Where staff were actively involved in promoting the meeting to their clients, with a named
champion taking the lead.
c) Where clients were exposed to SMART tools in advance of attending meetings.
d) Where Peer facilitators learned through a combination of participation, co-facilitation and
 training.
e) Addaction found it worked best where meetings initially co-facilitated by staff but quickly
transitioned to being Peer led. Alcohol Concern tended to work with Peer facilitators from the
start.

One of the criticisms levelled at existing partnerships centres on professionals not ‘letting go’ of
meetings and subjugating the peer support model to becoming merely an adjunct to treatment. We
understand this as a risk; though believe this to be very much the exception rather than the rule in
current partnership work and existing partners have themselves stressed the need for a model that
‘floats meetings free’. The board is therefore seeking a model that captures the opportunities of
partnership, whilst mitigating these risks.

Proposed partnership model

The following is a ‘first stab’ attempt at defining how providers would integrate and support SMART
Recovery. A central aim is to engage the support of treatment providers in building a national network
of free – standing SMART Recovery groups.

1. The treatment provider operates under a license agreement with SMART Recovery UK to use
the name, brand and tools as described below.

2. The license to use SMART Recovery would be for a period of three years, renewable if agreed
by both parties. There would be a standard cost associated with this license. A secondary level
license fee would vary depending on the number of services using SMART Recovery within the
organisation.

3. The provider would put one or more members of staff forward for training to become ‘SMART
Recovery Champions’ for their service.

4. The provider would introduce elements of SMART Recovery into their programme, allowing
clients to be ‘coached’ in the core principles and tools of SMART Recovery during their
treatment episode. This could be delivered one to one by the ‘SMART Recovery champion’ or
by re-working the main treatment package to include elements of SMART.

5. All clients working toward abstinence should have SMART Recovery built into their treatment
plan, with attendance at meetings scheduled to start before discharge. The service should ‘line
up’ clients to use SR as their primary source of aftercare.

6. The provider would, if they run a predominantly abstinence oriented programme, run some
SMART Recovery groups within the treatment centre. These would be closed groups, available
only to clients of that treatment centre. These groups may be facilitated by centre staff, though
 it would be preferable for a peer to facilitate or co-facilitate. Peer facilitation may be more
realistic in longer treatment programmes. These ‘within service’ meetings must be explicitly
framed as a transitional step out to the network meetings.

7. There is a debate within the SMART Recovery movement whether the meetings should ever be
called SMART Recovery if the meeting is not run by volunteers. One suggestion is to use the
same methods, but describe this as ‘SMART Recovery Therapy’ when delivered by professional
paid staff as part of a treatment programme.

8. The treatment centre should encourage interested clients to become facilitators. They will help
arrange training (via SRUK) for a small number each year and provide support for the facilitator
to set up meetings external to the treatment centre. These must be open meetings. Although
co-facilitation by treatment service staff is acceptable in the short term, the transition to peer
facilitation and operational independence should be a priority.

9. The treatment centre might provide some ongoing but long-arm support to the meeting, but
only with the consent of the facilitator and members of that meeting. The meeting is not
‘owned’ by the treatment centre, but might be supported to help the meeting flourish. For
example, the provider might help with room bookings or promote the meeting to local GP’s to
encourage direct referral.

Benefits to treatment providers

Partnership with SMART Recovery is attractive to providers because the tools will enhance their
treatment programme and provide their clients with a robust source of aftercare long after they have
left treatment. Association with the SMART Recovery brand will also be of value to providers,
demonstrating their active commitment to Recovery beyond the walls of treatment.

SRUK will create a ‘Partnership pack’ for providers, explaining various models of how to integrate SR
within their programmes, the license and sample wording to include in tender documents.

Benefits to Commissioners
SMART Recovery provides a straightforward way for Commissioners to ‘Commission for Recovery’ and
build aftercare capacity at minimal cost.

By encouraging or requiring providers to partner with SMART Recovery, Commissioners will quickly
develop a network of free-standing SMART Recovery groups in their local area. This will provide much
needed aftercare capacity, as well as an alternative to treatment for some people with more moderate
problems. As the SMART Recovery network is run largely by volunteers (to be backed up by a small
central team) the impact on treatment budgets is tiny. SMART Recovery can sit alongside other
Recovery groups and mutual aid organisations; SMART Recovery has wide appeal but does not claim to
be for everyone.

To help Commissioners rollout SR in their local area, we will produce a ‘Commissioner Information
pack’ with standard wordings that can be inserted directly into Invitations to Tender.

Governance and copyright

SRUK is a registered charity overseen by the Board of trustees. The relationship with the mother
organisation in the USA is defined in a license agreement that assigns all rights to SMART Recovery
within the UK.

SRUK intends to widen the board of trustees. In the first year we expect to have a SR Peer facilitator on
the board and will seek other mechanisms to make sure members have a strong say in the running of
the organisation. Over time we expect to further increase the proportion of Trustees that have come
through the Peer membership. At the present time there is also urgency in finding one or more
appropriate trustees located in England.

It is proposed to create an ‘advisory group’ consisting of academics and other experts who can offer
insights to help the organisation develop. This body would probably not actually meet, other than via
perhaps twice annual telephone conferences. The main purpose would be to help the board on
thematic and technical issues for which the board did not have sufficient expertise.

Consultation Process
The Consultation on future of SMART Recovery in the UK will last for approximately six weeks. We
hope to collate feedback during this period and possibly produce further documents for discussion, so
please do not wait until the end of this period before sending feedback. In appendix A are some
suggested questions, though welcome any feedback you think we need.

• We have set up an online questionnaire to collate consultation feedback. http://bit.ly/dsbKDL

• You could alternatively email your responses directly to Richard Phillips, who is coordinating
this consultation on behalf of the Trustees. richard@drugsandalcohol.net

• We are planning to hold two or three Consultation meetings, likely to be London, Manchester
and Scotland.

• See website for link to an online video presentation of the key issues in the consultation.

• Please see www.smartrecovery.org.uk for more details.

Richard Phillips
On behalf of the SMART Recovery UK Board
Appendix A – Suggested Consultation Questions
We welcome comments on any issues relating to the future direction of SMART Recovery in the UK;
though offer the following questions as a starting point. The following questions are included on our
online Questionnaire which is the preferred way of responding as it makes compiling results much
easier.

Existing network members and Facilitators

How did you first come across SMART Recovery? If you are a facilitator, do you think you had adequate
experience / training before running meetings?

Please describe the relationship with local treatment providers. Does this help your meeting flourish?
What could be better?

What do you think of the proposed partnership with Provider organisations? What are your hopes and
fears if we followed this path?

Service Providers

Do you think SMART Recovery has something to offer your clients and your organisation?

Given the model described above, how likely would you be to enter into a partnership with SMART
Recovery? What would make you more likely to do this, what would make you less likely?

If you were to Partner with SR, does the branding of meetings within your services concern you. Eg.
Would calling these ‘Smart Connect’ or ‘Smart Recovery Therapy’ be helpful, problematic or neutral?

Service Commissioners

Do you think SMART Recovery has something to offer your local population?

Given the model described above, how likely would you be to insert SR partnership into ITT’s. What
would make you more likely to do this, what would make you less likely?

What information would you like to see in a ‘Commissioner Information Pack’?

Second Tier / Policy / Government

Is there any advice you can offer the Board on how to promote and position SMART Recovery to
provide maximum benefit in the UK. (Please leave contact details if you would like to discuss this
personally)

What do you think of the proposed partnership model with providers and Commissioners?