Kelly John F, Levy Samuel, Matlack Maya, Hoeppner Bettina B
Psychiatry Department, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Alcohol Clin Exp Res (Hoboken). 2023 Oct;47(10):1926-1942. doi: 10.1111/acer.15164. Epub 2023 Oct 8.
Mutual-help organizations (MHOs) play a crucial role for many individuals with alcohol use disorder (AUD) or other substance use disorders in achieving stable remission. While there is now substantial research characterizing who uses 12-step MHOs, very little is known about who becomes affiliated with newer and rapidly growing MHOs, such as Self-Management and Recovery Training ("SMART" Recovery). More research could inform knowledge regarding who may be best engaged by these differing pathways.
We conducted a cross-sectional analysis of participants (N = 361) with AUD recruited mostly from the community who were starting a new recovery attempt and self-selected into one of four different recovery paths: (1) SMART Recovery ("SMART-only"; n = 75); (2) Alcoholics Anonymous ("AA-only"; n = 73); (3) Both SMART and AA ("Both"; n = 53); and (4) Neither SMART nor AA ("Neither"; n = 160). We compared the groups on demographics, clinical history, treatment and recovery support service use, and indices of functioning and well-being. We computed descriptives and conducted inferential analyses according to the data structure.
Compared to study participants choosing AA-only or Both, SMART-only participants were more likely to be White, married, have higher income and more education, be full-time employed, and evince a pattern of lower clinical severity characterized by less lifetime and recent treatment and recovery support services usage, lower alcohol use intensity and fewer consequences, and less legal involvement. AUD symptom levels, lifetime psychiatric diagnoses, psychiatric distress, and functioning were similar across MHO-engaged groups.
SMART Recovery appears to attract individuals with greater psychosocial stability and economic advantage and less severe histories of alcohol-related impairment and legal involvement. Findings suggest that certain aspects specific to the SMART Recovery group approach, format, and/or contents may appeal to individuals exhibiting this type of profile. As such, SMART appears to provide an additional resource that expands the repertoire of options for individuals with AUD who seek recovery.
互助组织（MHOs）对于许多患有酒精使用障碍（AUD）或其他物质使用障碍的个体实现稳定缓解起着至关重要的作用。虽然目前有大量研究描述了使用12步互助组织的人群特征，但对于那些加入更新且迅速发展的互助组织（如自我管理与康复训练组织，即“SMART”康复组织）的人群却知之甚少。更多的研究可以为了解哪些人可能最适合通过这些不同途径参与互助组织提供信息。
我们对主要从社区招募的361名患有酒精使用障碍且开始新的康复尝试的参与者进行了横断面分析，这些参与者自行选择进入四种不同的康复途径之一：（1）SMART康复组织（“仅SMART”；n = 75）；（2）匿名戒酒互助会（“仅AA”；n = 73）；（3）同时加入SMART和AA（“两者都加入”；n = 53）；（4）既不加入SMART也不加入AA（“两者都不加入”；n = 160）。我们比较了这些组在人口统计学、临床病史、治疗和康复支持服务使用情况以及功能和幸福感指标方面的差异。我们根据数据结构计算描述性统计量并进行推断分析。
与选择仅加入AA或两者都加入的研究参与者相比，仅加入SMART的参与者更有可能是白人、已婚、收入更高、受教育程度更高、全职工作，并且表现出临床严重程度较低的模式，其特点是一生中和近期使用的治疗和康复支持服务较少、酒精使用强度较低、后果较少以及法律介入较少。在参与互助组织的各组中，酒精使用障碍症状水平、一生的精神疾病诊断、精神痛苦和功能状况相似。
SMART康复组织似乎吸引了社会心理稳定性更高、经济条件更优越且酒精相关损害和法律介入历史较轻的个体。研究结果表明，SMART康复组织的方法、形式和/或内容所特有的某些方面可能对具有这种特征的个体有吸引力。因此，SMART似乎为寻求康复的酒精使用障碍个体提供了一种额外的资源，扩展了他们的选择范围。
