Quick answer: 12-step groups like AA and secular alternatives like SMART Recovery both help people stay sober. The strongest evidence favors AA and 12-step facilitation for long-term continuous abstinence, while research suggests SMART, LifeRing and similar groups work about as well for people who share their goals. The best group is the one he’ll keep attending.
How we put this comparison together
Above All Else Recovery supports and provides transportation to 12-step meetings, and we also respect that men come to recovery with their own beliefs and practices. This comparison is based on the 2020 Cochrane review of AA and 12-step facilitation and the first long-term study comparing 12-step groups with their secular alternatives, published in the Journal of Substance Abuse Treatment in 2018.
12-step vs. SMART Recovery vs. other groups at a glance
| Group | Core approach | Role of a higher power | Evidence | Best for |
| Alcoholics Anonymous / Narcotics Anonymous | Twelve steps, sponsorship, fellowship | Central, defined by the individual | Strongest; superior for continuous abstinence in a Cochrane review | Men who want a large, accessible community and a structured program |
| SMART Recovery | Cognitive-behavioral tools and self-management | None required | Comparable outcomes in a 2018 longitudinal study | Men who prefer practical skills and a secular approach |
| LifeRing Secular Recovery | Peer support focused on the “sober self” | None | Comparable outcomes in the same study | Men who want secular, conversational support |
| Recovery Dharma | Buddhist-inspired meditation and inquiry | Not theistic | Limited outcome research | Men drawn to meditation and mindfulness |
1. What the research says about AA and 12-step programs
The evidence for 12-step approaches is stronger than many people expect. A 2020 Cochrane review led by John F. Kelly of Massachusetts General Hospital analyzed 27 studies with more than 10,000 participants. It found AA and clinically delivered 12-step facilitation produced similar benefits to treatments like cognitive behavioral therapy on most drinking outcomes, and were superior for continuous abstinence and remission.
The review also found AA and 12-step facilitation reduce health care costs. One explanation the authors offer is long-term engagement: meetings are free, widely available, and include sponsors who provide ongoing accountability.
Strengths: the largest network of meetings, sponsorship, and a well-studied track record.
Limitations: the spiritual language and focus on powerlessness don’t resonate with every man.
2. What the research says about SMART Recovery and secular alternatives
Until recently, there was little research on alternatives to the 12 steps. A 2018 study by Sarah Zemore and colleagues at the Alcohol Research Group, the first longitudinal comparison of 12-step groups and their alternatives, followed members of SMART Recovery, LifeRing, Women for Sobriety and 12-step groups.
At first glance, SMART members fared worse. But those differences disappeared once researchers accounted for each person’s recovery goal: fewer SMART and LifeRing members were aiming for lifetime abstinence. The authors tentatively concluded the alternatives are as effective as 12-step groups for people with alcohol use disorder.
The takeaway: across every group, people committed to lifetime abstinence had the best odds of success.
3. How each approach feels in a meeting
The experience in the room differs more than the outcomes do.
- AA and NA meetings center on members sharing their experience, working the steps with a sponsor, and building a sober social network. Many meetings are available every day of the week.
- SMART Recovery meetings are facilitated discussions using cognitive-behavioral tools, such as weighing the costs and benefits of using or planning for urges. There’s no sponsorship and no step work.
- LifeRing meetings are conversational, focused on what’s happened in the past week and how members are strengthening their sober selves.
- Recovery Dharma meetings typically open with meditation, followed by a reading and discussion.
4. Availability matters more than people think
A group he can get to on a hard Tuesday night will do more good than a better-fitting group that meets once a week across town. AA and NA have by far the largest number of meetings, in person and online. SMART Recovery has a growing number of in-person meetings in Orange County and many online options, while LifeRing and Recovery Dharma meetings are less common locally.
Practical step: before choosing, look up the meeting schedules near his home and work for the next two weeks.
5. Who each approach tends to suit
12-step groups are often a good fit if he:
- Wants a large community and daily meeting options.
- Responds well to mentorship and accountability through a sponsor.
- Is open to a spiritual framework, however he defines it.
SMART Recovery or a secular group may fit better if he:
- Is put off by talk of a higher power or of powerlessness.
- Prefers concrete tools and problem-solving.
- Has already tried 12-step meetings and stopped going.
6. He doesn’t have to choose just one
Many people combine approaches, attending AA for community and SMART for skills, or adding meditation from Recovery Dharma. The research suggests engagement is what counts, so an approach he actually uses is better than a theoretically stronger one he doesn’t.
At Above All Else, men attend 12-step meetings with transportation provided, while treatment itself focuses on understanding their condition, building daily habits, service to others and a broader sense of spiritual connection. That leaves room for each man to find the support that fits him after discharge.
FAQ
Is SMART Recovery as effective as AA?
Research suggests it can be for people who share its goals. A 2018 longitudinal study found SMART, LifeRing and Women for Sobriety were about as effective as 12-step groups once differences in members’ recovery goals were accounted for. AA and 12-step facilitation have a larger evidence base, including a 2020 Cochrane review showing superior continuous abstinence.
Do I have to believe in God to go to AA?
No. AA asks members to rely on a higher power of their own understanding, and many members interpret that as the group itself, nature or a set of principles. Still, the spiritual language is a real barrier for some people, which is one reason secular alternatives exist.
Can you go to both AA and SMART Recovery?
Yes. Many people attend both, using AA for community and sponsorship and SMART for cognitive-behavioral tools. Neither group requires exclusive membership. Research suggests consistent engagement matters more than which group someone chooses.
What is 12-step facilitation?
Twelve-step facilitation is a structured, clinician-delivered therapy that prepares and encourages people to engage with AA or NA. The 2020 Cochrane review found manualized 12-step facilitation was more effective than other established treatments, such as cognitive behavioral therapy, for increasing continuous abstinence.
Are there online SMART Recovery and AA meetings?
Yes. Both AA and SMART Recovery offer extensive online meetings, which can fill gaps when in-person options aren’t available. Online meetings work best alongside some in-person connection, since local relationships tend to provide stronger day-to-day support.