Overcoming Addictions & SMART Recovery: Outcomes of a randomized clinical trial & our new web app Reid K. Hester, Ph.D. Dir., Res. Div., Behavior Therapy.

Overcoming Addictions & SMART Recovery: Outcomes of a randomized clinical trial & our new web app

Reid K. Hester, Ph.D. Dir., Res. Div., Behavior Therapy Associates, LLC www.behaviortherapy.com [email protected]

Overcoming Addictions An interactive web app based on

the 4-point program of SMART Recovery Additional exercises added:

Increasing change talk (desire, importance, self-confidence exercises)

Values exercise Urge tracking & feedback Mindfulness exercises (Bowen et al.) Happiness Scale & goal setting Sobriety sampling

RCT The First RCT of a self-help group

Other than 2 AA studies w/mandated people (1967 & 1980)

189 participants new to SMART Recovery

Compared OA only, OA + SR, SR only Dropped OA only gp in intent to treat,

examined in actual use analyses

Variable Overall Group

    SR SR + OA OA

    (n = 86) (n = 83) (n = 19)

Female n (%) 114 (60.6%) 52 (61%) 50 (60%) 12 (63%)

Age M (SD) 44.3 (10.9) 43.4 (10.6) 44.6 (11.1) 48.3 (8.4)

Ethnicity n (%)        

White 170 (90.4%) 76 (88.4%) 77 (92.8%) 17 (89.5%)

Hispanic 5 (2.7%) 3 (3.5%) 1 (1.2%) 1 (5.3%)

Other 7 (6.9%) 7 (8.1%) 5 (6.0%) 1 (5.3%)

Education M (SD) 16.1 (2.4) 15.93 (2.5) 16.0 (2.3) 17.3 (2.1)

AUDIT M (SD)a 24.7 (8.1) 24.8 (8.1) 23.95 (8.2) 27.4 (7.2)

BSI M (SD)b 17.4 (12.9) 19.35 (12.5) 15.95 (13.6) 14.8 (11.0)

InDUC M (SD)c 41.4 (17.9) 42.2 (19.0) 40.6 (17.5) 40.8 (15.6)

Pretreatment characteristics of participants by group

Percent Days Abstinent

Baseline 3 months 6 months

OA only 36.46 59.24 54

OA + SR 46.63 82.47 77.2

SR only 41.72 71.5 74.48

40

50

60

70

80

OA onlyOA + SRSR only

Drinks per Drinking Day

Baseline 3 months 6 months

OA only 8.7 4.7 6.2

OA + SR

6.8 3.6 4.2

SR only 8.6 4.7 3.8

0.5

2.5

4.5

6.5

8.5

OA onlyOA + SRSR only

Alcohol Problems

Baseline 3 months 6 months

OA only 40.8 19.5 22.1

OA + SR 35.4 17.8 15.4

SR only 41.2 18.6 17.8

5

15

25

35

45

OA onlyOA + SRSR only

Do attending SR Meetings & other support predict outcomes at 3 mo?

SR only: Yes on all outcome measures at 3 mo.

OA + SR: only #days any support predictive of improvement in PDA & alcohol problems at 3 mo.

Conclusions Both the Overcoming Addictions

Web application and the use of the meetings and other resources of SMART Recovery are effective in helping people recover from heavy problem drinking.

People now have a choice in how they access help in changing.

OA: Cost? There is no free lunch. Much less than treatment or

seeing a counselor. $89 3 mo., $149 12 mo. (w/$30

maintenance fee thereafter in 12 mo.).

Profits from OA are shared with SMART Recovery.

What next? 6 mo. Qualitative data analyses,

part 2 of JMIR paper underway Apply to SAMHSA’s NREPP for

listing 1/1/14 http://www.nrepp.samhsa.gov

Reference Hester, RK, Lenberg, KL, Campbell, W, & Delaney,

HD. (2013). Overcoming Addictions, a web-based application & SMART Recovery, an online and in-person mutual help group for problem drinkers: Part 1, three month outcomes of a randomized clinical trial. Journal of Medical Internet Research. http://www.jmir.org/2013/7/e134