LECTURE 8 HYPOTHESIS TESTING AND STATISTICAL SIGNIFICANCE MSc (Addictions) Addictions Department.
Overcoming Addictions & SMART Recovery: Outcomes of a randomized clinical trial & our new web app
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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 [email protected]
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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
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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
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Variable Overall Group SR SR + OA OA (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 (%) White 170 (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
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Percent Days Abstinent
Baseline 3 months 6 months35
45
55
65
75
85
OA onlyOA + SRSR only
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Drinks per Drinking Day
Baseline 3 months 6 months0123456789
10
OA onlyOA + SRSR only
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Alcohol Problems
Baseline 3 months 6 months0
10
20
30
40
OA onlyOA + SRSR only
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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.
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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.
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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.
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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
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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