1. 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 reidhester@behaviortherapy.com www.overcomingaddictions.net

2. 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

4. 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

5. VariableOverall Group SRSR + OAOA (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 (%) White170 (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

6. Percent Days Abstinent

7. Drinks per Drinking Day

8. Alcohol Problems

9. 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.

10. 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.

11. 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.

12. 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

13. 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 http://www.jmir.org/2013/7/e134