title: Protocol for a systematic review of evaluation research for adults who have participated in the 'SMART recovery' mutual support programme.
abstract: Self-Management and Recovery Training (SMART Recovery) offers an alternative to predominant 12-step approaches to mutual aid (eg, alcoholics anonymous). Although the principles (eg, self-efficacy) and therapeutic approaches (eg, motivational interviewing and cognitive behavioural therapy) of SMART Recovery are evidence based, further clarity regarding the direct evidence of its effectiveness as a mutual aid package is needed. Relative to methodologically rigorous reviews supporting the efficacy of 12-step approaches, to date, reviews of SMART Recovery have been descriptive. We aim to address this gap by providing a comprehensive overview of the evidence for SMART Recovery in adults with problematic alcohol, substance and/or behavioural addiction, including a commentary on outcomes assessed, potential mediators, feasibility (including economic outcomes) and a critical evaluation of the methods used.
  
  
  
  Methods are informed by the Cochrane Guidelines for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. 6 electronic peer-reviewed and 4 grey literature databases have been identified. Preliminary searches have been conducted for SMART Recovery literature (liberal inclusion criteria, not restricted to randomised controlled trials (RCTs), qualitative-only designs excluded). Eligible 'evaluation' articles will be assessed against standardised criteria and checked by an independent assessor. The searches will be re-run just before final analyses and further studies retrieved for inclusion. A narrative synthesis of the findings will be reported, structured around intervention type and content, population characteristics, and outcomes. Where possible, 'summary of findings' tables will be generated for each comparison. When data are available, we will calculate a risk ratio and its 95% CI (dichotomous outcomes) and/or effect size according to Cohen's formula (continuous outcomes) for the primary outcome of each trial.
  
  
  
  No ethical issues are foreseen. Findings will be disseminated widely to clinicians and researchers via journal publication and conference presentation(s).
  
  
  
  CRD42015025574.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Beck
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Baker
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kelly
authors.affiliation: School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Deane
authors.affiliation: Department of NDARC, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
authors.affiliation: SMART Recovery Australia (Employee), Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hunt
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Forbes
authors.affiliation: Massachusetts General Hospital, Recovery Research Institute, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods; D006801:Humans; D062405:Motivational Interviewing; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D012648:Self Care / Q000379:methods*; D019966:Substance-Related Disorders / Q000628:therapy*; D000078202:Systematic Reviews as Topic
keywords: Adult psychiatry < PSYCHIATRY; STATISTICS & RESEARCH METHODS; Substance misuse < PSYCHIATRY