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59-436: Meetings of SMART participants are held throughout the week, both in person and online. These meetings, which tend to run from 60 to 90 minutes each, are confidential, free, and guided by trained facilitators. Facilitators can be volunteers or professionals. Participants in various stages of recovery, or simply curious about pursuing recovery, share lessons and challenges from their own journeys, while exploring, through discussion,

118-437: A 50% lower incidence rate in a patient group aged 75 or older. Another depression study found a neutral effect compared to personal, social, and health education, and usual school provision, and included a comment on potential for increased depression scores from people who have received CBT due to greater self recognition and acknowledgement of existing symptoms of depression and negative thinking styles. A further study also saw

177-739: A Participant Handbook and other related publications. The following organizations recognize SMART Recovery. United States American Academy of Family Physicians National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIAA is an agency of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services . National Institute on Drug Abuse (NIDA) Substance Abuse and Mental Health Services Administration (SAMHSA) United Kingdom Public Health England National Institute of Health and Care Excellence (NICE) Recovery Orientated Drug Treatment Expert Group (RODT) Advisory Council on

236-567: A certifying board in family medicine on February 8, 1969. The AAFP was founded in 1947 as the American Academy of General Practice. The organization's name was changed on October 3, 1971, to "more accurately reflect the changing nature of primary health care". The mission of the AAFP is to improve the health of patients, families and communities by serving the needs of members with professionalism and creativity. To fulfill its mission,

295-436: A constructive alternative. At the same time as Eysenck's work, B. F. Skinner and his associates were beginning to have an impact with their work on operant conditioning . Skinner's work was referred to as radical behaviorism and avoided anything related to cognition. However, Julian Rotter in 1954 and Albert Bandura in 1969 contributed to behavior therapy with their works on social learning theory by demonstrating

354-602: A greater longevity in therapeutic outcomes. In a study with anxiety, CBT and ACT improved similarly across all outcomes from pre- to post-treatment. However, during a 12-month follow-up, ACT proved to be more effective, showing that it is a highly viable lasting treatment model for anxiety disorders. Computerized CBT (CCBT) has been proven to be effective by randomized controlled and other trials in treating depression and anxiety disorders, including children. Some research has found similar effectiveness to an intervention of informational websites and weekly telephone calls. CCBT

413-434: A negative schema of the world in childhood and adolescence as an effect of stressful life events, and the negative schema is activated later in life when the person encounters similar situations. Beck also described a negative cognitive triad . The cognitive triad is made up of the depressed individual's negative evaluations of themselves, the world, and the future. Beck suggested that these negative evaluations derive from

472-517: A neutral result. A meta-study of the Coping with Depression course, a cognitive behavioral intervention delivered by a psychoeducational method, saw a 38% reduction in risk of major depression. Many studies show CBT, combined with pharmacotherapy, is effective in improving depressive symptoms, mania severity and psychosocial functioning with mild to moderate effects, and that it is better than medication alone. INSERM 's 2004 review found that CBT

531-475: A non-fearful reaction in feared situations. A combination of glucocorticoids and exposure therapy may be a better-improved treatment for treating people with anxiety disorders. For anxiety disorders, use of CBT with people at risk has significantly reduced the number of episodes of generalized anxiety disorder and other anxiety symptoms, and also given significant improvements in explanatory style, hopelessness, and dysfunctional attitudes. In another study, 3% of

590-426: A normal part of the change cycle and if handled well, can serve as a learning experience in overcoming an addiction. SMART Recovery meetings are free for all wishing to attend and are intended to be informational as well as supportive. Over 1500 weekly group meetings led by volunteer facilitators are held worldwide. In addition, the organization provides online resources and support to the volunteers and those attending

649-414: A particular action. A basic concept in some CBT treatments used in anxiety disorders is in vivo exposure . CBT-exposure therapy refers to the direct confrontation of feared objects, activities, or situations by a patient. For example, a woman with PTSD who fears the location where she was assaulted may be assisted by her therapist in going to that location and directly confronting those fears. Likewise,

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708-478: A person with a social anxiety disorder who fears public speaking may be instructed to directly confront those fears by giving a speech. This "two-factor" model is often credited to O. Hobart Mowrer . Through exposure to the stimulus, this harmful conditioning can be "unlearned" (referred to as extinction and habituation ). CBT for children with phobias is normally delivered over multiple sessions, but one-session treatment has been shown to be equally effective and

767-456: A suite of scientifically grounded psychology tools and techniques. The SMART approach is built on the belief that freedom from substance use disorders and behavioral addictions fundamentally requires the exercise of personal choice. The SMART model is built on psychological tools of cognitive behavioral therapy and motivational interviewing. SMART was initially developed by medical professionals seeking more effective methods to treat patients. At

826-497: A variety of childhood disorders, including depressive disorders and various anxiety disorders. CBT has shown to be the most effective intervention for people exposed to adverse childhood experiences in the form of abuse or neglect. Criticism of CBT sometimes focuses on implementations (such as the UK IAPT ) which may result initially in low quality therapy being offered by poorly trained practitioners. However, evidence supports

885-421: Is a common form of talk therapy based on the combination of the basic principles from behavioral and cognitive psychology . It is different from other approaches to psychotherapy , such as the psychoanalytic approach, where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a "problem-focused" and "action-oriented" form of therapy, meaning it

944-574: Is also effective as part of treatment plans in the adjustment, depression, and anxiety associated with fibromyalgia , and as part of the treatment after spinal cord injuries . In children or adolescents, CBT is an effective part of treatment plans for anxiety disorders, body dysmorphic disorder, depression and suicidality , eating disorders and obesity , obsessive–compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), tic disorders , trichotillomania , and other repetitive behavior disorders. CBT has also been used to help improve

1003-885: Is also evidence that using CBT to treat children and adolescents with anxiety disorders was probably more effective (short term) than wait list or no treatment and more effective than attention control treatment approaches. Results from a 2018 systematic review found a high strength of evidence that CBT-exposure therapy can reduce PTSD symptoms and lead to the loss of a PTSD diagnosis. CBT has also been shown to be effective for post-traumatic stress disorder in very young children (3 to 6 years of age). A Cochrane review found low quality evidence that CBT may be more effective than other psychotherapies in reducing symptoms of posttraumatic stress disorder in children and adolescents. A systematic review of CBT in depression and anxiety disorders concluded that "CBT delivered in primary care, especially including computer- or Internet-based self-help programs,

1062-605: Is an effective therapy for several mental disorders, including bipolar disorder. This included schizophrenia, depression , bipolar disorder , panic disorder , post-traumatic stress , anxiety disorders, bulimia , anorexia , personality disorders and alcohol dependency . In long-term psychoses , CBT is used to complement medication and is adapted to meet individual needs. Interventions particularly related to these conditions include exploring reality testing, changing delusions and hallucinations, examining factors which precipitate relapse, and managing relapses. Meta-analyses confirm

1121-470: Is biased towards negative interpretations. Beck's theory rests on the aspect of cognitive behavioral therapy known as schemata . Schemata are the mental maps used to integrate new information into memories and to organize existing information in the mind. An example of a schema would be a person hearing the word "dog" and picturing different versions of the animal that they have grouped together in their mind. According to this theory, depressed people acquire

1180-464: Is cheaper. CBT-SP, an adaptation of CBT for suicide prevention (SP), was specifically designed for treating youths who are severely depressed and who have recently attempted suicide within the past 90 days, and was found to be effective, feasible, and acceptable. Acceptance and commitment therapy (ACT) is a specialist branch of CBT (sometimes referred to as contextual CBT ). ACT uses mindfulness and acceptance interventions and has been found to have

1239-480: Is most effective when combined with medication for treating mental disorders, such as major depressive disorder . CBT is recommended as the first line of treatment for the majority of psychological disorders in children and adolescents, including aggression and conduct disorder . Researchers have found that other bona fide therapeutic interventions were equally effective for treating certain conditions in adults. Along with interpersonal psychotherapy (IPT), CBT

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1298-428: Is potentially more effective than usual care and could be delivered effectively by primary care therapists." Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression. One etiological theory of depression is Aaron T. Beck 's cognitive theory of depression. His theory states that depressed people think the way they do because their thinking

1357-492: Is recommended in treatment guidelines as a psychosocial treatment of choice. The prevailing body of research consistently indicates that maintaining a faith or belief system generally contributes positively to mental well-being. Religious institutions have proactively established charities, such as the Samaritans , to address mental health issues. Cognitive behavioral therapy has undergone scrutiny as studies investigating

1416-758: Is used to treat specific problems related to a diagnosed mental disorder . The therapist's role is to assist the client in finding and practicing effective strategies to address the identified goals and to alleviate symptoms of the disorder. CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of many psychological disorders and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms. When compared to psychoactive medications , review studies have found CBT alone to be as effective for treating less severe forms of depression, and borderline personality disorder . Some research suggests that CBT

1475-784: The 12 steps that make up the basis of the various "Anonymous" self-help groups (e.g., Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc.) and is generally listed as an "Alternative to AA" or an "Alternative to the 12 Steps." SMART Recovery believes that each individual finds their own path to recovery. Though listed as an "alternative," it is also suggested as a possible "supplement" to 12-step programs in SMART Recovery's main program publication, The SMART Recovery Handbook . SMART Recovery recognizes that participants may be in one or more of various stages of change and that different exercises may be helpful at different stages. Side event: Relapse – Although not inevitable, relapses are

1534-406: The "second wave" of CBT, which emphasized cognitive factors. Although the early behavioral approaches were successful in many so-called neurotic disorders , they had little success in treating depression . Behaviorism was also losing popularity due to the cognitive revolution . The therapeutic approaches of Albert Ellis and Aaron T. Beck gained popularity among behavior therapists, despite

1593-674: The "third wave" of CBT. The most prominent therapies of this third wave are dialectical behavior therapy and acceptance and commitment therapy . Despite the increasing popularity of third-wave treatment approaches, reviews of studies reveal there may be no difference in the effectiveness compared with non-third wave CBT for the treatment of depression. In adults, CBT has been shown to be an effective part of treatment plans for anxiety disorders , body dysmorphic disorder , depression , eating disorders , chronic low back pain , personality disorders , psychosis , schizophrenia , substance use disorders , and bipolar disorder. It

1652-438: The 4-Point Program, in the process of recovery: Building Motivation, Coping with Urges, Problem Solving, and Lifestyle Balance. The "SMART Toolbox" is a collection of various MET, CBT, and REBT methods, or "tools," which address the 4 Points. SMART Recovery can be used as a stand-alone primary recovery support program for those seeking help recovering from addictions, but does not insist on being exclusive. The program does not use

1711-461: The AAFP's strategic objectives include: The AAFP also provides patients with free educational resources on its consumer health site. The AAFP is governed by a Congress of Delegates composed of two delegates from each of its 55 constituent chapters, as well as from resident and student groups, new physicians, and the special constituencies (women, minorities, international medical graduates, and LGBTQs). The Congress meets annually immediately prior to

1770-864: The LBGTQIA+ communities, young adults and family and friends of people engaged in or trying to achieve independence from addictive and problematic behaviors. SMART Recovery is based on scientific knowledge and is intended to evolve as scientific knowledge evolves. The program uses principles of motivational interviewing , found in motivational enhancement therapy (MET), and techniques taken from rational emotive behavior therapy (REBT), and cognitive-behavioral therapy (CBT), as well as scientifically validated research on treatment. The SMART Recovery Program and meetings are congenial to participants who choose to use appropriately-prescribed medications, including opioid-agonist medications, as part of their recovery programs. The organization's program emphasizes four areas, called

1829-695: The Misuse of Drugs (ACMD) Australia Lifeline (crisis support service) Turning Point Alcohol and Drug Centre Cognitive behavioral therapy Cognitive behavioral therapy ( CBT ) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions (such as thoughts, beliefs, and attitudes) and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it

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1888-642: The United States, the United Kingdom, and South Africa. Their inspiration was by the behaviorist learning theory of Ivan Pavlov , John B. Watson , and Clark L. Hull . In Britain, Joseph Wolpe , who applied the findings of animal experiments to his method of systematic desensitization , applied behavioral research to the treatment of neurotic disorders. Wolpe's therapeutic efforts were precursors to today's fear reduction techniques. British psychologist Hans Eysenck presented behavior therapy as

1947-411: The best-documented efficacy for treatment of major depressive disorder . A 2001 meta-analysis comparing CBT and psychodynamic psychotherapy suggested the approaches were equally effective in the short term for depression. In contrast, a 2013 meta-analysis suggested that CBT, interpersonal therapy , and problem-solving therapy outperformed psychodynamic psychotherapy and behavioral activation in

2006-515: The classical general practitioner . It is headquartered in Leawood, Kansas . AAFP is one of the largest medical organizations in the United States, with 136,700 members in 50 U.S. states and territories, in addition to international members. The AAFP was instrumental in establishing family medicine as medicine's 20th primary specialty. The AMA's Council on Medical Education and the independent American Board of Medical Specialties granted approval to

2065-411: The culprits of emotional distress. It was from this hypothesis that Beck developed cognitive therapy , and called these thoughts "automatic thoughts". He first published his new methodology in 1967, and his first treatment manual in 1979. Beck has been referred to as "the father of cognitive behavioral therapy". It was these two therapies, rational emotive therapy, and cognitive therapy, that started

2124-413: The degree to which an individual's sense of control is either internal or external. An internal locus of control exists when an individual views an outcome of a particular action as being reliant on themselves and their personal attributes whereas an external locus of control exists when an individual views other's or some outside, intangible force such as luck or fate as being responsible for the outcome of

2183-593: The development of CBT was John Stuart Mill through his creation of Associationism , a predecessor of classical conditioning and behavioral theory. The modern roots of CBT can be traced to the development of behavior therapy in the early 20th century, the development of cognitive therapy in the 1960s, and the subsequent merging of the two. Groundbreaking work of behaviorism began with John B. Watson and Rosalie Rayner 's studies of conditioning in 1920. Behaviorally-centered therapeutic approaches appeared as early as 1924 with Mary Cover Jones ' work dedicated to

2242-474: The earlier behaviorist rejection of mentalistic concepts like thoughts and cognitions. Both of these systems included behavioral elements and interventions, with the primary focus being on problems in the present. In initial studies, cognitive therapy was often contrasted with behavioral treatments to see which was most effective. During the 1980s and 1990s, cognitive and behavioral techniques were merged into cognitive behavioral therapy. Pivotal to this merging

2301-613: The effectiveness of metacognitive training (MCT) for the improvement of positive symptoms (e.g., delusions). For people at risk of psychosis , in 2014 the UK National Institute for Health and Care Excellence (NICE) recommended preventive CBT. INSERM 's 2004 review found that CBT is an effective therapy for several mental disorders, including schizophrenia. A Cochrane review reported CBT had "no effect on long‐term risk of relapse" and no additional effect above standard care. A 2015 systematic review investigated

2360-717: The effectiveness of CBT for anxiety and depression. Evidence suggests that the addition of hypnotherapy as an adjunct to CBT improves treatment efficacy for a variety of clinical issues. The United Kingdom's National Institute for Health and Care Excellence (NICE) recommends CBT in the treatment plans for a number of mental health difficulties, including PTSD, OCD, bulimia nervosa , and clinical depression . Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. The American Psychiatric Association Practice Guidelines (April 2000) indicated that, among psychotherapeutic approaches, cognitive behavioral therapy and interpersonal psychotherapy had

2419-489: The effects of CBT compared with other psychosocial therapies for people with schizophrenia and determined that there is no clear advantage over other, often less expensive, interventions but acknowledged that better quality evidence is needed before firm conclusions can be drawn. American Academy of Family Physicians The American Academy of Family Physicians ( AAFP ) was founded in 1947 to promote and maintain high-quality standards for family medicine , an offshoot of

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2478-600: The effects of cognition on learning and behavior modification. The work of Claire Weekes in dealing with anxiety disorders in the 1960s is also seen as a prototype of behavior therapy. The emphasis on behavioral factors has been described as the "first wave" of CBT. One of the first therapists to address cognition in psychotherapy was Alfred Adler , notably with his idea of basic mistakes and how they contributed to creation of unhealthy behavioral and life goals. Abraham Low believed that someone's thoughts were best changed by changing their actions. Adler and Low influenced

2537-490: The group receiving the CBT intervention developed generalized anxiety disorder by 12 months postintervention compared with 14% in the control group. Individuals with subthreshold levels of panic disorder significantly benefitted from use of CBT. Use of CBT was found to significantly reduce social anxiety prevalence. For depressive disorders, a stepped-care intervention (watchful waiting, CBT and medication if appropriate) achieved

2596-513: The groups and one or more daily online meetings. Meetings are also held in correctional facilities in many states, including: Arizona, California, Florida, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Vermont, Virginia, Washington, and Wisconsin. A 2018 longitudinal study compared the self-reported success of SMART Recovery, LifeRing Secular Recovery , Women for Sobriety , and Alcoholics Anonymous . After normalizing for income and other demographic factors,

2655-816: The impact of religious belief and practices have gained prominence. Numerous randomized controlled trials have explored the correlation of CBT within diverse religious frameworks, including Judaism , Taoism , and predominantly, Christianity . Principles originating from Buddhism have significantly impacted the evolution of various new forms of CBT, including dialectical behavior therapy , mindfulness-based cognitive therapy , spirituality-based CBT, and compassion-focused therapy . Precursors of certain fundamental aspects of CBT have been identified in various ancient philosophical traditions, particularly Stoicism . Stoic philosophers, particularly Epictetus , believed logic could be used to identify and discard false beliefs that lead to destructive emotions, which has influenced

2714-612: The negative schemata and cognitive biases of the person. According to this theory, depressed people have views such as "I never do a good job", "It is impossible to have a good day", and "things will never get better". A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema. Beck further proposed that depressed people often have the following cognitive biases: arbitrary inference , selective abstraction , overgeneralization, magnification, and minimization . These cognitive biases are quick to make negative, generalized, and personal inferences of

2773-655: The same time, SMART acknowledges that certain individuals can benefit from a blend of approaches, and does not discourage people from using other methods whilst attending SMART meetings. SMART endeavors to be inclusive for all participants. The organization's methods and meetings are congenial to participants who choose treatment with appropriately prescribed medications. SMART recognizes some participants may be seeking to regulate behaviors whilst others may choose abstinence. Throughout its global network of affiliates can be found both large scale SMART Recovery meetings and specific meetings tailored to prison inmates, military personnel,

2832-417: The self, thus fueling the negative schema. On the other hand, a positive cognitive triad relates to a person's positive evaluations of themself, the world, and the future. More specifically, a positive cognitive triad requires self-esteem when viewing oneself and hope for the future. A person with a positive cognitive triad has a positive schema used for viewing themself in addition to a positive schema for

2891-412: The study saw that SMART Recovery fared worse across the outcomes of alcohol abstinence, alcohol drinking problems, and total abstinence, compared to Alcoholics Anonymous. However, after normalizing for treatment goal, SMART Recovery members who pursued abstinence did as well across all three factors as members of AA. In other words, among AA members and members of SMART Recovery who wanted to abstain, there

2950-403: The treatment of depression. According to a 2004 review by INSERM of three methods, cognitive behavioral therapy was either proven or presumed to be an effective therapy on several mental disorders . This included depression , panic disorder , post-traumatic stress , and other anxiety disorders. CBT has been shown to be effective in the treatment of adults with anxiety disorders. There

3009-464: The unlearning of fears in children. These were the antecedents of the development of Joseph Wolpe 's behavioral therapy in the 1950s. It was the work of Wolpe and Watson, which was based on Ivan Pavlov 's work on learning and conditioning, that influenced Hans Eysenck and Arnold Lazarus to develop new behavioral therapy techniques based on classical conditioning . During the 1950s and 1960s, behavioral therapy became widely used by researchers in

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3068-470: The way modern cognitive-behavioral therapists identify cognitive distortions that contribute to depression and anxiety. Aaron T. Beck 's original treatment manual for depression states, "The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers". Another example of Stoic influence on cognitive theorists is Epictetus on Albert Ellis . A key philosophical figure who influenced

3127-475: The work of Albert Ellis , who developed the earliest cognitive-based psychotherapy called rational emotive behavioral therapy , or REBT. The first version of REBT was announced to the public in 1956. In the late 1950s, Aaron T. Beck was conducting free association sessions in his psychoanalytic practice. During these sessions, Beck noticed that thoughts were not as unconscious as Freud had previously theorized, and that certain types of thinking may be

3186-510: The world and for the future. Cognitive behavioral research suggests a positive cognitive triad bolsters resilience , or the ability to cope with stressful events. Increased levels of resilience is associated with greater resistance to depression . Another major theoretical approach to cognitive behavioral therapy treatment is the concept of Locus of Control outlined in Julian Rotter's Social Learning Theory . Locus of control refers to

3245-752: Was established. SRI is the governing body for the global SMART Recovery community. SRI is overseen by a Board of international Directors mostly drawn from national SMART Recovery organizations. It receives advice from the SMART Recovery Global Research Committee. SMART affiliates in individual countries maintain their own governance structures as independent entities that are licensed to use the SMART Recovery intellectual property by SMART Recovery International. Specific program offerings can differ among these entities. SMART Recovery relies on funding from voluntary donations, philanthropy and grants. SMART Recovery also offers for sale

3304-413: Was found to be equally effective as face-to-face CBT in adolescent anxiety. Studies have provided evidence that when examining animals and humans, that glucocorticoids may lead to a more successful extinction learning during exposure therapy for anxiety disorders. For instance, glucocorticoids can prevent aversive learning episodes from being retrieved and heighten reinforcement of memory traces creating

3363-495: Was no significant difference in the success rate. The first SMART Recovery meeting was held in the United States in 1994, and the organization established its original headquarters in Mentor, Ohio. As interest grew, SMART meetings spread into Canada, the United Kingdom and Australia. Thirty years later, the expansion is ongoing, with SMART meetings now held in 36 countries and 16 languages. In 2017, SMART Recovery International (SRI)

3422-422: Was originally designed to treat depression , its uses have been expanded to include many issues and the treatment of many mental health and other conditions, including anxiety , substance use disorders, marital problems, ADHD , and eating disorders . CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies. CBT

3481-785: Was the successful development of treatments for panic disorder by David M. Clark in the UK and David H. Barlow in the US. Over time, cognitive behavior therapy came to be known not only as a therapy, but as an umbrella term for all cognitive-based psychotherapies. These therapies include, but are not limited to, REBT , cognitive therapy , acceptance and commitment therapy , dialectical behavior therapy , metacognitive therapy , metacognitive training , reality therapy / choice theory , cognitive processing therapy , EMDR , and multimodal therapy . This blending of theoretical and technical foundations from both behavior and cognitive therapies constituted

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