Overcoming addictions, a Web-based application, and SMART recovery, an online and in-person mutual help group for problem drinkers, part 1: three-month outcomes of a randomized controlled trial
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BACKGROUND: Overcoming Addictions (OA) is an abstinence-oriented, cognitive behavioral, Web application based on the program of SMART Recovery. SMART Recovery is an organization that has adapted empirically supported treatment strategies for use in a mutual help framework with in-person meetings, online meetings, a forum, and other resources. OBJECTIVE: To evaluate the effectiveness of OA and SMART Recovery (SR) with problem drinkers who were new to SMART Recovery. Our experimental hypotheses were: (1) all groups will reduce their drinking and alcohol/drug-related consequences at follow-up compared to their baseline levels, (2) the OA condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR), and (3) the OA+SR condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR only). METHODS: We recruited 189 heavy problem drinkers primarily through SMART Recovery's website and in-person meetings throughout the United States. We randomly assigned participants to (1) OA alone, (2) OA+attend SMART Recovery (SR) meetings (OA+SR), or (3) attend SR only. Baseline and follow-ups were conducted via GoToMeeting sessions with a Research Assistant (RA) and the study participant. We interviewed significant others to corroborate the participant's self-report. Primary outcome measures included percent days abstinent (PDA), mean drinks per drinking day (DDD), and alcohol/drug-related consequences. RESULTS: The intent-to-treat analysis of the 3-month outcomes supported the first hypothesis but not the others. Participants in all groups significantly increased their percent days abstinent from 44% to 72% (P<.001), decreased their mean drinks per drinking day from 8.0 to 4.6 (P<.001), and decreased their alcohol/drug-related problems (P<.001). Actual use relationships were found for the OA groups, between SR online meetings and improvement in PDA (r=.261, P=.033). In addition in the OA groups, the number of total sessions of support (including SR & other meetings, counselor visits) was significantly related to PDA (r=.306, P=012) and amount of improvement in alcohol-related problems (r=.305, P=.012). In the SR only group, the number of face-to-face meetings was significantly related to all three dependent variables, and predicted increased PDA (r=.358, P=.003), fewer mean DDD (r=-.250, P=.039), and fewer alcohol-related problems (r=-.244, P=.045), as well as to the amount of improvement in all three of these variables. Six-month follow-ups have been completed, and the results are currently being analyzed. CONCLUSIONS: These results support our first experimental hypothesis but not the second or third. All groups significantly increased their PDA and decreased both their mean DDD and their alcohol-related problems, which indicates that both interventions being investigated were equally effective in helping people recover from their problem drinking.
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An increase in number of meetings was associated with an increase in number of days abstinence and a decrease in problems.
“↑ in number of meetings = ↑ number of days abstinence and ↓ in problems.”
From Online and Mobile Interventions for Problem Gambling, Alcohol, and Drugs: A Systematic Review (2017) · cites this paper as Hester et al. (2013)
At 3-month follow-up, all groups showed a significant increase in percentage of days abstinent, a significant decrease in number of drinks per day, and a significant decrease on InDUC score.
“3-month follow-up: All groups show significant ↑ in % of days abstinent, significant ↓ in number of drinks/day and significant ↓ on InDUC score.”
From Online and Mobile Interventions for Problem Gambling, Alcohol, and Drugs: A Systematic Review (2017) · cites this paper as Hester et al. (2013)
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- Authors
- Hester, R. K., Lenberg, K. L., Campbell, W., & Delaney, H. D.
- Affiliations
- Behavior Therapy Associates (US)
- University of New Mexico (US)
- Corresponding author
- Hester, Reid K
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2013-07-11
- Volume
- 15
- Issue
- 7
- Pages
- e134
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC3713880
- OpenAlex
- W2101411001
- Cited by
- 77
- References
- 31
- Citations by year
- 2025: 7 · 2024: 7 · 2023: 7 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 9 · 2015: 3 · 2014: 4 · 2013: 1
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R44AA016237)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Keywords
- overcoming addiction, SMART Recovery, problem drinking, self-help groups, abstinence, alcohol-related consequences, heavy drinkers, significant others, alcoholism treatment, relapse prevention
- MeSH terms
- Adult, Alcoholism, Female, Humans, Male, Middle Aged, Self-Help Groups, Outcome Assessment, Health Care, Internet
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