More evidence supports SMART Recovery’s Comparable Effectiveness with AA
By Tom Horvath, PhD
The evidence for SMART’s effectiveness keeps growing. There are now five studies that have found that individuals who have chosen SMART do as well as those who have chosen AA. No studies have found that SMART participants do worse.
Studies have illustrated the effectiveness of SMART Recovery compared to AA. The most recently published study compared individuals who chose to attend SMART, AA, both, or neither, as they began a new attempt at addressing an alcohol problem (possibly their first attempt, but typically a later attempt in this study of 361 subjects). The outcomes the study evaluated (at 3 month and 6-month follow-ups) included the percentage days drinking, the percentage of heavy drinking days, the percentage who qualified for a diagnosis of alcohol use disorder, and the level of negative consequences from drinking.
SMART attendees had
“a pattern of less severe clinical pathology and legal system involvement histories, along with higher psychosocial stability and recovery capital. In terms of meeting attendance frequency, the SMART group did not attend as many meetings” [from the abstract]
Both findings, that SMART participants may not have as many problems, and may need fewer meetings, have been reported before. As SMART becomes more widely available, and volunteer subjects more numerous, these findings may change. There are settings I am aware of, that have not been published about, that SMART (apparently effectively) helps individuals with severe addictive problems. However, I will not be surprised if SMART continues to be more efficient.
If someone suggests to you something like “SMART is unproven,” there is now sufficient scientific evidence to indicate otherwise. Unfortunately, if you are talking with someone who does not find scientific evidence persuasive, it may be best to listen to the points they make and acknowledge the degree of truthfulness in each one. You could freely acknowledge that AA is helpful to many people, that AA is very widely available, that AA’s approach will appeal to many people who might not find SMART helpful, and that AA is probably more widely accepted than SMART is (at present). With luck acknowledging these points may open them up to listening to you in turn, when you might be able to help them recognize that no one approach is likely to work for everyone. Multiple approaches are likely to increase the chances that more people will initiate change, which would be good for all of us.
Kelly JF, Boorman E and O’Connor JB (2026) A comparison of recovery benefits associated with participation in SMART Recovery, AA, both SMART and AA, or neither, following a new alcohol use disorder recovery attempt. Front. Psychiatry 17:1886846. doi: 10.3389/fpsyt.2026.1886846
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