Systematic Review of SMART Recovery: Outcomes, Process Variables, and Implications for Research

Clinical guidelines recommend Self-Management and Recovery Training (SMART Recovery) and 12-step models of mutual aid as important sources of long-term support for addiction recovery. Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predomina...

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Veröffentlicht in:Psychology of addictive behaviors 2017-02, Vol.31 (1), p.1-20
Hauptverfasser: Beck, Alison K, Forbes, Erin, Baker, Amanda L, Kelly, Peter J, Deane, Frank P, Shakeshaft, Anthony, Hunt, David, Kelly, John F
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container_end_page 20
container_issue 1
container_start_page 1
container_title Psychology of addictive behaviors
container_volume 31
creator Beck, Alison K
Forbes, Erin
Baker, Amanda L
Kelly, Peter J
Deane, Frank P
Shakeshaft, Anthony
Hunt, David
Kelly, John F
description Clinical guidelines recommend Self-Management and Recovery Training (SMART Recovery) and 12-step models of mutual aid as important sources of long-term support for addiction recovery. Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predominant 12-step approach. A similarly rigorous exploration of SMART Recovery has yet to be undertaken. We aim to address this gap by providing a systematic overview of the evidence for SMART Recovery in adults with problematic alcohol, substance, and/or behavioral addiction, including (i) a commentary on outcomes assessed, process variables, feasibility, current understanding of mental health outcomes, and (ii) a critical evaluation of the methodology. We searched six electronic peer-reviewed and four gray literature databases for English-language SMART Recovery literature. Articles were classified, assessed against standardized criteria, and checked by an independent assessor. Twelve studies (including three evaluations of effectiveness) were identified. Alcohol-related outcomes were the primary focus. Standardized assessment of nonalcohol substance use was infrequent. Information about behavioral addiction was restricted to limited prevalence data. Functional outcomes were rarely reported. Feasibility was largely indexed by attendance. Economic analysis has not been undertaken. Little is known about the variables that may influence treatment outcome, but attendance represents a potential candidate. Assessment and reporting of mental health status was poor. Although positive effects were found, the modest sample and diversity of methods prevent us from making conclusive remarks about efficacy. Further research is needed to understand the clinical and public health utility of SMART as a viable recovery support option.
doi_str_mv 10.1037/adb0000237
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Methodologically rigorous reviews of the efficacy and potential mechanisms of change are available for the predominant 12-step approach. A similarly rigorous exploration of SMART Recovery has yet to be undertaken. We aim to address this gap by providing a systematic overview of the evidence for SMART Recovery in adults with problematic alcohol, substance, and/or behavioral addiction, including (i) a commentary on outcomes assessed, process variables, feasibility, current understanding of mental health outcomes, and (ii) a critical evaluation of the methodology. We searched six electronic peer-reviewed and four gray literature databases for English-language SMART Recovery literature. Articles were classified, assessed against standardized criteria, and checked by an independent assessor. Twelve studies (including three evaluations of effectiveness) were identified. Alcohol-related outcomes were the primary focus. Standardized assessment of nonalcohol substance use was infrequent. Information about behavioral addiction was restricted to limited prevalence data. Functional outcomes were rarely reported. Feasibility was largely indexed by attendance. Economic analysis has not been undertaken. Little is known about the variables that may influence treatment outcome, but attendance represents a potential candidate. Assessment and reporting of mental health status was poor. Although positive effects were found, the modest sample and diversity of methods prevent us from making conclusive remarks about efficacy. 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subjects Addiction
Addictions
Assessors
Attendance
Candidates
Clinical practice guidelines
Clinical research
Efficacy
Feasibility
Functional impairment
Health status
Humans
Mental health
Outcome and Process Assessment (Health Care)
Public health
Recovery
Recovery (Disorders)
Self Care - methods
Self-Help Techniques
Selfmanagement
Substance abuse
Substance-Related Disorders - rehabilitation
Substance-Related Disorders - therapy
Support Groups
Systematic review
Twelve step model
Twelve Step Programs
Variables
title Systematic Review of SMART Recovery: Outcomes, Process Variables, and Implications for Research
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