SMART Peer Support and Treatment Study

Overview

Background
Research shows that peer support groups such as AA or NA can amplify and extend treatment effects and enhance long-term recovery from AOD problems. However, these groups have not been integrated into the Victorian AOD treatment system, leaving a missed opportunity for peer-to-peer learning, and increased connection to others in positive pro-recovery social networks.

Aims and Method
The aim of the current study was to explore the uptake, attendance rates and benefits of embedding peer support groups in AOD treatment programs, using both quantitative and qualitative methods. Self-Management and Recovery Training (SMART Recovery©) is an evidenced based alternative to the 12-step model (e.g., AA). SMART Recovery was founded in 1994, and now takes place in more than 23 countries worldwide, with more than 300 meetings run on a weekly basis in Australia. It offers a person-centred, strengths-based approach and adopts a harm-reduction philosophy. In this way it is compatible with the Victorian Government funded AOD treatment system, and so was piloted in three AOD treatment services in Victoria (Turning Point, Odyssey House and Ballarat Community Health). Prior to the pilot, existing SMART recovery facilitators were consulted to determine strategies for successful implementation. These strategies were implemented into the pilot. Eight Clinicians and two peers from the three pilot-sites received facilitator training from SMART Recovery Australia.

Results
During the pilot, SMART recovery groups were delivered initially in-person and then via telehealth due to the COVID19 pandemic, with 486 attendances (138 in person and 348 online). The pilot study demonstrated that it is feasible for AOD services to offer SMART Recovery groups as part of their program. The uptake and participation are testament to the demand for peer support.

Participants survey responses demonstrated the many benefits of integrating SMART recovery into AOD treatment. For example, 66% reported a positive change (reduction) in use of their primary drug of concern, 72% indicated that they could better manage problematic substance use, 73% reported a positive change in their mental health and wellbeing, 86% reported feeling better connected with others, and 90% indicated they felt supported by members of the group during the meetings.

In-depth qualitative interviews with participants revealed that having SMART Recovery groups run by Victorian AOD treatment providers was perceived as attractive and increased confidence that the groups were credible. The groups also allowed participants to maintain the supportive connections they had built during earlier stages of treatment and the participants expressed they felt supported and accepted by other members of the group. Participants also said they found it beneficial to help others from the group. Interviews with facilitators indicated a unanimous belief that the program could be integrated within their service and that doing was highly advantageous.

Conclusion
In summary these findings suggest that the delivery of SMART Recovery in AOD treatment was feasible, well-supported and highly valued by clinician and peer facilitators and service managers and most importantly offers a multitude of benefits to clients in terms of improved social connection, AOD and other outcomes. On the basis of these positive findings AOD services should consider offering SMART Recovery or other peer support groups as part of their treatment program.

For more details see the executive summary report.