Researcher Begins Trial on How LGBTQ Individuals Experience SMART Recovery Substance Use Program

Sexual and gender minority individuals experience alcohol and substance use disorders at rates much higher than their peers, yet little is known about how treatment and recovery programs work for them. A University of Kansas researcher is leading a study to better understand how members of the LGBTQ community experience SMART Recovery, an alternative to traditional 12-step programs, and potentially guide improvements to the program.

Briana McGeough, assistant professor of social welfare at KU and an investigator at the Cofrin Logan Center for Addiction Research and Treatment at the Life Span Institute, is leading a two-year, $20,000 grant-funded trial and feasibility program to evaluate how LGBTQ individuals experience SMART recovery and suggest potential improvements to the intervention, with the goal of better serving individuals seeking to stop or reduce their alcohol or substance use and improve quality of life.

SMART Recovery (Self-Management And Recovery Training) is a peer-support group that uses tools and strategies to change unhelpful thinking and behavior patterns to work toward long-term satisfaction and quality of life. Strategies include helping individuals make change plans, addressing how they react to addiction triggers, making a hierarchy of values and reflecting on how substance use affects them. It is a secular program, and unlike traditional 12-step programs, it does not contain religious elements.

“It’s run by peers in the community, and is really about helping folks figure out how to approach changing addictive behaviors and what steps might be helpful to them,” McGeough said of SMART Recovery. “Research has shown that SMART Recovery is often effective. However, there is not much empirical evidence now how LGBTQ individuals experience SMART.”

McGeough and her research team have begun two online trial groups and are recruiting LGBTQ individuals interested in stopping or reducing their alcohol or substance use to form more groups. Participants take part in weekly 90-minute online SMART Recovery meetings for three months, complete a survey about their substance use before and after the program and after each session, then participate in an hour-long interview about their experiences once the program ends. Interviews will be conducted both with participants who complete the trial and those who do not to more fully understand beneficial and detrimental aspects of the program for the population. All of this data will be used to inform the development of a modified SMART intervention that addresses the unmet needs LGBTQ participants express about the program.

KU researchers from the Cofrin Logan Center have also conducted research on making addiction recovery programs such as SMART available online during the pandemic and studying the efficacy of such a virtual approach.

SMART Recovery programs are led globally, often by volunteers, using evidence-based practices to address addictive behaviors. Leaders are trained in the program but not required to be mental health professionals. McGeough said the goal of the trial is not to promote SMART specifically, or imply that it is superior to 12-step programs, but to more fully understand the full range of services available to sexual and gender minority individuals attempting to address alcohol and substance use problems. Researchers also hope to explore the feasibility of LGBTQ-specific offerings of SMART recovery, as only a few such groups currently exist, though such iterations of 12-step programs are common and popular among members.

“Overall, there is a fair amount of flexibility for what makes a SMART intervention,” McGeough said. “I think if we end up finding that, overall, folks like the program, but for example wanted a bit more focus on coping with discrimination, we can likely work with that in a culturally adapted version.”

The trial will help build a knowledge base about how LGBTQ individuals experience mental health and recovery programs. McGeough has previously studied how sexual and gender minority individuals experience 12-step programs and mental health services in general. With a better understanding, mental health professionals and those offering alcohol and substance abuse recovery programs can provide better services to address the disproportionate rates of addiction among LGBTQ individuals, McGeough said.

The trial is open to LGBTQ individuals nationwide age 18 or older who are interested in stopping or reducing their alcohol or substance use nationwide. For more information, contact lgbtqsmart@ku.edu.