By Melinda Gaddy, Ph.D.
A SMART Recovery group member at VA Eastern Kansas Health Care System (Dwight D. Eisenhower Veterans Affairs (VA) Medical Center) stated during their first meeting back after a period of absence from SMART, “The ABCs are so annoying, but they really do work.” We had just finished setting our agenda for the meeting. I believe the individual was speaking not only to a group member newer to SMART, but also to themselves as they settled into a chair, ready to begin again in applying SMART’s well-researched tools to their life circumstances: recently released from the hospital and solemnly resolved to do what was needed to rebuild. I appreciated the statement for a number of reasons. It helped other group members to get focused and ready to dive into the ABC tool, it conveyed hope, and it was a great example of just how good Veterans are at telling it like it is. Opinions and experiences can be offered without need for a “polite filter” since meaningful bonds are formed quickly among Veterans in recovery. This makes facilitating SMART Recovery groups within the VA an incredibly dynamic and rewarding experience.
In recent decades, VA has become increasingly focused on providing military Veterans in the United States with evidence-based treatment programs and recovery tools. This is just as true regarding recovery from a substance use disorder as it is for recovery from PTSD. It is required, in fact, that VA care for Veterans with substance use disorders “must be provided consistent with evidence-based treatment…” (Department of Veterans Affairs, 2012, pg. 8). SMART Recovery is not yet included on the VA’s official list of evidence-based treatments for substance use disorder, yet it certainly fits the spirit of this mandate and evidence is mounting daily. Over 40 face-to-face meetings are currently offered nationwide in VA medical centers and VA-affiliated facilities, with meetings available within both inpatient and outpatient treatment settings. According to the full meeting list online (see reference list for link), Pennsylvania currently has the greatest number of VA-affiliated SMART Recovery meetings statewide, coming in at 8, with Missouri and Minnesota offering 7 meetings each. SMART Recovery Board of Directors voted in July, 2014, to establish a Veterans Administration Committee to help further increase the accessibility of SMART Recovery for Veterans in the VA healthcare system (Waite, 2014). With the efforts of this committee in addition to the VA’s commitment to evidence-based treatment, the number of VA-affiliated meetings offered to American Veterans is sure to continue growing.
On the Leavenworth, Kansas VA Medical Center campus, staff have offered officially recognized SMART Recovery meetings since 2011 as part of the care provided in the Addiction Treatment Program. Beginning at that time with one weekly meeting, staff currently conduct three meetings each week: a daytime group, an evening group, and a group for women Veterans. All three are closed to Veterans enrolled in the local VA system, all are attended by both outpatient and inpatient group members, and each is run by a different staff member who has completed the SMART Facilitator Training. Two of these facilitators, Troy Elliott and Matt Atwood are, themselves, military Veterans. The chief of our program, Dr. Jenny Rosinski, says, “Our Veteran clients immediately responded very positively to the SMART Recovery approach and material. An average of 40 Veterans attend SMART Recovery within our program each week. Staff and Veterans alike report that they find the SMART Recovery groups helpful, rewarding, and empowering, and SMART Recovery is often cited as one of the highlights of our program.”
SMART Facilitator and VA Addiction Therapist, Troy Elliott, as a Veteran, offers a unique perspective on Veteran care and the use of SMART with Veteran populations, “Veterans of the United States Military have proven their ability to persevere under the harshest conditions. They’re extensively trained to develop skills and attributes that will allow them to excel in the most stressful environments imaginable. Unfortunately, the skills that allow soldiers to effectively navigate the modern battlefield often don’t translate well to civilian life. For example, soldiers are trained to suppress and control their emotions while enduring dangerous, shocking or traumatic events.” VA providers are sensitive to the ways military training can make Veterans vulnerable to a range of mental health concerns, including struggles with addictive behavior. Mr. Elliott adds, “Thankfully, SMART Recovery meetings are offering many of our Nation’s Veterans an environment where both their military experiences and their addictive behaviors can be understood and addressed. The SMART Recovery approach to dealing with habitual behaviors seems to resonate with individuals from all branches of service.”
Veterans at the Dwight D. Eisenhower VA Medical Center have enjoyed the opportunity to gain new skills and training in SMART. A Veteran during a recent SMART Recovery meeting stated, “I like the way SMART teaches me to respond to my addiction. I’ve been to a lot of other meetings, and am always told I’ll never be anything but an addict. I refuse to accept that. I learned in the Army that I can adapt and overcome in any situation. And, I like that SMART has the tools to help me be the person I know I can be.” Another Veteran recently stated, “These meetings are the only place where I can talk about this… I look forward to coming here because I know you understand.” Being a Veteran and getting support from other Veterans is of great importance to our clientele, and serving Veterans and providing care that supports recovery is the primary mission of our staff. SMART Recovery offers Veterans empowering, recovery-oriented care in an environment imbued with the unique comradery of the military, an environment that allows them to truly tell it like it is and apply new tools to help them to make healthy changes, further adjust to civilian life, and build a life worth living.
Department of Veterans Affairs (March 7, 2012). VHA Handbook 1160.04: VHA Programs for
Veterans with Substance Use Disorders (SUD). Washington DC: Author.