Inside SMART Recovery Caribbean

Port of Spain, the capital city of Trinidad and Tobago, now has weekly SMART Recovery meetings

Port of Spain, the capital city of Trinidad and Tobago, now has weekly SMART Recovery meetings

Jeremy Joseph is an experienced SMART Recovery Facilitator who is passionate about SMART and taking the program to the Caribbean.  We recently found a quiet few minutes to ask Jeremy about himself, his journey with SMART and his plans for SMART Recovery Caribbean. 

What drew you to becoming a SMART Facilitator? 

When I made a decision to stop drinking alcohol for two (2) years, SMART was one of the elements of my recovery capital that I found very powerful and effective. Within a few months of me stopping in December 2016, the facilitator at the time could no longer facilitate and the SMART meeting was put on hold.  I believe in SMART and had experienced the benefits and seen the value others got from the meetings, so I committed to do the training and facilitate the meeting in order to help others benefit as I did. I also saw this as a useful way to help maintain my abstinence and to get real learning. Within a few months of relaunching the meeting the number of people attending became consistently over 20 so we decided to run two meetings back to back.

You are originally from the Caribbean, what services are available there for people living with problematic behaviours?

Yes I am.  I am not the best person to answer this but I understand that it varies from island to island and have been told that some islands have precious little, if any, services at all. For those islands that do have services they can range from services provided through the Ministry of Health and non-profit organisations, such as substance (and behaviours) abuse prevention and treatment centres, to counselling and/or medication through private therapists to AA/NA/CA etc.  In terms of mutual support groups, they typically offer a 12 steps approach to problematic/addictive behaviours.

Apparently what can happen is that people may have to leave their home country, where there are no services, to go to another island where there are services and then return home to no support.

 

How did you discover that SMART would be beneficial to people living in the Caribbean?

I first started thinking about this when I went to the UK SMART Recovery conference in 2018 and they showed the map of where SMART is in the world.  What struck me immediately, was where SMART is NOT.  There seemed to be no SMART in the Caribbean and very little across Africa - Regions that I am interested in and where there are huge, and growing, challenges of addictive behaviours.  

In March 2019 I was in Trinidad and Tobago (T&T) and reached out to a range of people to get an understanding of the landscape for people with addictive behaviours and mental health challenges.  I met with the Mental Health Unit at the Ministry of Health, spoke with a therapist and, with the support of someone who is very active in this field in T&T, ran a SMART meeting.  The consistent feedback was that there is nothing like it in the country,   Those that attended the SMART meeting wanted to have SMART available in T&T and the other people I spoke with said it was much needed.  I left energised about bringing SMART to the Caribbean, beginning with Trinidad & Tobago, where I was born.

 

You recently spent three weeks in Trinidad & Tobago, can you tell me what happened during that time and what you achieved? 

Yes I can.  My trip in June was specifically to introduce SMART Recovery to T&T, to build connections that would be instrumental in rolling it out when I am not there and to develop a model for rolling it out across the Caribbean, and eventually Africa. I had great support from someone in Trinidad who is well connected in this field and much of the funding for the trip was through his efforts to get sponsors/donors - I am grateful.

When I left at the end of June there were two weekly meetings - one in Port of Spain (capital of Trinidad) and one at the Scarborough Hospital in Tobago.  This meant that I was flying over to Tobago every Monday to facilitate that meeting - a closed one, at the hospital.  I continue to facilitate it by videocall until the trainee there has completed the online training.

I also facilitated a meeting at The New Life Ministries (NLM) Rehabilitation Centre, which has a two-year rehabilitation program for people addicted to drugs, alcohol, nicotine, and other mind/mood-altering chemicals/ substances.  This meeting was attended by over 20 people and NLM has asked for a SMART meeting once a month.  Some of the attendees would like to become Facilitators and I am really excited about that.  

At the moment there are four (4) people training (2) or trained (2) to become SMART Recovery Facilitators in T&T and more will be starting soon.  The first official SMART Recovery meeting is in Port of Spain and was  registered on 3RD August 2019 by one of the new Facilitators - which I felt was important.

Jeremy’s SMART Recovery information session for teenagers at the Yahweh Foundation in Tobago.

Jeremy’s SMART Recovery information session for teenagers at the Yahweh Foundation in Tobago.

I had the absolute pleasure of meeting with a group of teenagers (about 18 of them) aged 13 to 19 years old at the Yahweh Foundation in Tobago and sharing experiences, insights and tools with each other.  They opened up and shared some very moving experiences and I felt tremendous courage and selflessness from them.  This was extremely special.

We had an excellent meeting with the Assistant Commissioner of Prisons, in which Joe Gerstein participated by video call.  SRI and SMART USA are being tremendously supportive with putting together the proposal to have SMART in the correctional facilities across the twin island Republic.

I have established a good relationship with the Mental Health Unit of the Ministry of Health in Trinidad, as well as the one at the hospital in Tobago.

I am working on getting the Ministry of Education aware and interested in SMART Recovery programmes.

In terms of media and publicity, I did 2 TV and 3 radio interviews and had a press release published in 1 national and 1 local paper.  One of the radio interviews was an hour long and the other 1 hour and 45 minutes! 

I mentioned earlier that there was consistent feedback from those attending the SMART Recovery meeting as well as professionals that SMART is much needed.  It is worth noting that the first SMART meeting I tried to have when I went in June was attended predominantly by people who have been and/or are in recovery using a twelve steps approach.  This ended up being a Q&A session on SMART Recovery with some attendees unable/unwilling to embrace the philosophy of choice and self empowerment because they believe that they are addicts, who in the depths of their addictive behaviour had NO choice and had to surrender.  This acted as a filter and the next meeting was run as a typical SMART meeting.

 

Do you foresee any cultural challenges in delivering SMART Recovery programs in the Caribbean? 

Huge, huge challenges!  These are on different levels and essentially are related to cultural norms around acceptable behaviours on the one hand and stigmatised behaviours on the other.  Shame can have a role in cause and consequences here.

So, at one level, some forms of addictive behaviours may not be seen as real issues because they are so culturally accepted.  Problematic behaviours?  What problem?  We are drinkers!

Let's begin with Trinidad as an example.  The land of rum, carnival, soca and limin' (hanging out/partying), - partying and everything associated with it is a big part of the culture.  Drinking alcohol is tightly weaved into the social fabric of the country and it is common to have partying, alcohol, drinking and disorderly behaviour as the themes and/or titles of music created there. Examples of these include:  Drunk & Disorderly by The Mighty Sparrow (1972); Bottle of Rum by Machel Montano (2012) and Splinters by Shal Marshall (2018). 

In addition, some of the negative aspects of alcohol consumption, such as drinking and driving, have, until recent years, been socially and culturally acceptable and laws not enforced.  There may also be a case for understanding what role alcohol consumption plays in domestic violence, not forgetting violence against children, in the country. 

At another level is the stigmatisation of addictive behaviours and mental health issues in these islands that have small populations and it can feel like everyone knows everyone and is aware of your business.  So generally there is shame, ridicule and disgrace associated with these issues, which can mean they are ignored, swept under the carpet or not considered real issues at all. The attitude towards mental health issues is aptly captured  by the fact that the  mental health hospital in St Ann's, Port of Spain, Trinidad is commonly referred to as The Mad House.  The negative connotations associated with mental health and addictive behaviours therefore has implications for anyone seeking support, of any kind, with these issues.  Furthermore issues of privacy and confidentiality can be of great concern and people will need assurances and comfort around them, especially in a group setting.  Having said that, there are other mutual support groups in existence and people do attend.

This combined with a 'macho' Caribbean heritage can be particularly tough for men - ,You got to man up and get on with life!

What can happen in this cultural context is that the people who are partying or drinking or using drugs or other behaviours more than others, to actually escape challenges in life, are seen as having the best time and as the happiest people alive... until it becomes too problematic to ignore.  The challenge then is how to move the person with the problematic behaviour from precontemplation, to contemplation and further along the stages of change.

With regard to some of the other SMART offerings, such as the Inside/Out program for prisons, it is difficult to say, but potential challenges may be around the beliefs about what the function or purpose of prisons is.  We were fortunate to meet with an Assistant Commissioner of Prisons for T&T who is open minded about new approaches and could see how the program could make a measurable difference.

While the challenges exist and are real, what we have seen from the SMART meetings so far is that people find them refreshing and they get a lot of value out a group meeting where there is a freeflowing conversation amongst attendees as well as facilitated learning about self empowerment.  For FREE!  Private counselling is very expensive!

What are your goals for SMART Caribbean? 

To answer this I have to go back to that map I mentioned at the beginning.  The context for me is that as SMART celebrates 25 years of tremendous growth and success, the Caribbean and Africa are regions that would benefit hugely from SMART Recovery and the countries within them are increasingly ready for the offerings.

We are still working on getting SMART Recovery meetings firmly embedded in T&T and having a model to start rolling out across other countries.  So the immediate, short term goal is to complete those things. 

Putting my business strategy and growth mind to work would mean doing the research and analysis necessary for us to arrive at a priority list for market expansion and using another SMART (Specific, Measurable, Attainable/Agreed, Relevant and Timely) acronym to agree on the goals with SMART Recovery International (SRI).  

Watch this space!

  

Anything else you would like to add, or that you would like people to know? 

Two days before receiving my email (forwarded to him by SRI), Joe Gerstein had reached out to someone in T&T about getting SMART into the country.  In an email to me, Joe shared with me the serendipitous events that led to us having and furthering our discussions about the Caribbean.  Joe, and others, made it possible for me to go Trinidad and Tobago in June and get SMART started and I am grateful.

Drawing on some of the successes of growing SMART in the past I have already started looking into possibilities in other Caribbean islands and have reached out to a very good friend of mine in Kenya to start getting an understanding of the context and what networks there are to tap into there.  

I believe in SMART, am excited about it going into new countries and totally subscribe to our mutual support meetings being free and open to anyone seeking science-based, self-empowered addiction recovery.

Michael Bellamy