Alcohol use disorders (AUD) are a critical public health issue in the United States linked to elevated morbidity and mortality. Mutual help groups (MHGs), which provide peer advice and support, are among the most widespread forms of treatment for individuals with AUD. Twelve-step MHGs like Alcoholics Anonymous (AA), are the most utilized and evidence-based interventions for AUD. In recent years, several secular 12-step/AA alternative MHGs have emerged, including Self-Management and Recovery Training (SMART) Recovery, LifeRing, and Women For Sobriety (WFS). The outcomes and mechanisms of these 12-step alternative MHGs are poorly understood. In the present study, we conducted a systematic review with the goal of updating the scientific literature on outcomes, moderators, and mechanisms of change of SMART Recovery, LifeRing, and WFS for alcohol use problems in adults with AUD. Our review was pre-registered with PROSPERO and followed PRISMA guidelines. Alcohol-related outcomes, such as alcohol abstinence/reduction in alcohol use, heavy drinking, and other negative consequences were examined. Additionally, we included analysis of engagement-related outcomes, like membership characteristics, moderators of engagement/involvement, and mechanisms of change for MHOs. Preliminary Results from our qualitative review suggest differential alcohol-related and engagement-related outcomes by MHG. These findings highlight the importance of defining similarities and differences between MHGs, as individual differences in patient history and/or ideology disprove notions of universal MHG suitability. Study findings provide valuable insights into the different mechanisms and moderators of 12-step alternative MHGs that may inform future precision medicine strategies.
