J Prev Interv Community. 2026 Jun 8:1-12. doi: 10.1080/10852352.2026.2676383. Online ahead of print.
ABSTRACT
Peer recovery counseling (PRC) programs increasingly incorporate structured goal-setting frameworks, such as SMART, yet the fidelity of goals produced in real-world mental health crisis settings remains under explored. This study evaluated 128 counseling sessions from 20 clients across two PRC programs using the SMART-GEM framework to assess goal quality. Nonparametric analyses indicated that goal fidelity scores significantly improved over time. A series of multilevel models (MLMs) confirmed that 27.4% of variance in fidelity scores was attributable to differences between clients. Session timing emerged as the strongest predictor. Session timing accounted for the majority of between-client variance, suggesting that sustained engagement drives goal quality. Staff identity also emerged as a modest but statistically significant predictor. In contrast, neither program site nor delivery modality predicted SMART goal quality. Implications include the need for targeted staff development and the integration of retention-focused interventions to optimize SMART goal use in recovery services.
PMID:42253029 | DOI:10.1080/10852352.2026.2676383
