Table 5.

Suggested improvements from Aboriginal facilitators and group members for the SMART Recovery program

Theme and sub‐themes	Quotes
1. Integrate Aboriginal perspectives into the facilitator training
Knowledge of socio‐economic, cultural and historical determinants underlying Aboriginal people's experiences with substance use and problematic behaviours	‘We're talking about layers, and layers of colonial trauma and pain …. we're talking about a difficult space where Aboriginal people are still not recognised equally … don't have justice … don't have inclusion … are we healing, are we recovering; what does that mean? because recovery to our people it's a multitude of things, and what's underneath … there's so much there underneath’. (female facilitator, 63 years) ‘I think more [training is needed] about the underlying issues. So why they have an addiction in the first place? What are they clouding by using alcohol and drugs? …. Stolen Generation … loss of culture … trauma … all those things’. (female facilitator, 47 years) ‘And then go back to like the guys that do the training, if they're … more aware of how Indigenous people live and how, you know, it can be delivered better to adapt to be more adaptable to our people’. (male facilitator, 42 years
Understanding of Aboriginal views of health and wellbeing	‘Non‐Aboriginal people don't have the same world view. They don't see the world in the same way that we do [for example there's our] intergenerational trauma, there's reasons – I believe there's reasons why I'm like this’. (female member, 44 years)
Need Aboriginal trainers to design and deliver training	‘I think they [need] an Aboriginal … to train us up so we can run it culturally appropriate for our mob [that] would be great!’ (male facilitator, 57 years)
2. Create Aboriginal‐specific program materials
Co‐creation in consultation and collaboration with Aboriginal communities	‘You need to sit down with a group of Elders, and you get their input, you get their understanding of what they want for their community and for their mobs’. (male facilitator, 57 years)
Use Aboriginal artwork and relatable narratives	‘[an Aboriginal workbook is needed] … definitely [with] visual material. So, if things have got pictures … and Aboriginal designs on it, it's going to make them feel more comfortable just to start with. It's inviting’. (female facilitator, 54 years)
Avoid clinical language and be written with sensitivity for a variety of literacy levels	‘I was concerned that some of the language wasn't necessarily able to be understood by older members or older clients that might participate’. (male facilitator, 65 years)
Contain activities that promote healthy cultural identities and foster stronger connections to community and culture	‘We want to do more, we should be able to do more, instead of just talking we should be able to [do cultural] activities … [and] it helps writing something down … try and make it easier’. (male member, 22 years)
3. Community engagement, marketing and networking
Establish a better presence and reputation in the community to increase Aboriginal attendance. This would be achieved by promoting itself via culturally inviting online and social media opportunities, and via face‐to‐face networking.	‘For our Mob, they're just not getting there … they don't know enough about it. It's not advertised in their area’. (female facilitator, 63 years) ‘I think getting out [to the] smaller rural and remote areas is really important and continue going out. Not just go out and do one workshop … and they need to put more on the website … when you go online, have a look at SMART Recovery's Australia, there's nothing really there for Aboriginal people’. (female facilitator, 54 years) ‘[SMART Recovery's could be made better for our community] with more promotion … because it's not very well promoted … and that's why we've only got a few people’. (female member, 40 years)
4. Establish an Aboriginal SMART Recovery program
Flexibility to allow for customisation and localisation by diverse community groups without jeopardising the model's outcomes	‘The yarning … that's a really important aspect of, if people look at redoing SMART Recovery, it really [needs to] have a yarning aspect … and I think in its current format it depends on the facilitator being enabled to adapt it and deliver it at a culturally appropriate manner, while still meeting the outcomes or the guidelines to how it's supposed to be run'. (male facilitator, 65 years)
Retain the ‘concept’ of SMART Recovery's (i.e. problem solving, goal setting, harm minimisation approach)	‘You still have the concept of SMART Recovery you're getting to, you know, like their weekly goals and what they want to achieve, just in a less formal approach’. (male facilitator, 57 years, rural NSW)
Inclusion of Aboriginal health resources and tools	‘There's nothing cultural in [in the current workbooks]’ (female member, 37 years)
Delivered as a yarning circle; ‘Check in’, Recovery yarn, ‘checkout’	‘[an Aboriginal SMART Recovery would be] a yarning circle with a difference, you know what I mean?’. (male facilitator, 53 years)
Avoid clinical language	‘I worry about some of the language … you know, even referring to things like specific, measurable, attainable. You know, I just worry that it would [not be understood by everyone] … I [use the term from the Aboriginal stages of change version] not worried, [instead of the clinical term] abstinence’. (male facilitator, 34 years)
Provision of practical assistance (e.g. food, transport)	‘[food is important because] probably [a lot of them] don't eat for days or weeks at a time. So, if I put a feed on for them, bit of nutrition, bit of education, bit of unloading … drive the bus … [you'll] get more people in’. (male facilitator, 53 years)
Establish an Aboriginal facilitators support network	‘Have like an Aboriginal facilitator support group. That could be something, whether it be online … [to share information and support]. (female facilitator, 54 years)