SBIRT Frequent Asked Questions
What is SBIRT?
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. Primary care centers, hospital emergency rooms, trauma centers, and other community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur.
What is Motivational Interviewing (MI)?
Motivational Interviewing (MI) is a particular type of conversation about change focused on drawing out motivation of the patient/client to create decisional balance for making changes. MI skills are crucial to executing the SBIRT model.
Learn more at http://motivationalinterviewing.org/.
How valid are the established drinking guidelines?
- Quantifying the Risks Associated with Exceeding Recommended Drinking Limits
Deborah A. Dawson, Bridget F. Grant, & Ting-Kai Li
- 2015-2020 Dietary Guidelines for Americans
How much time should I devote to training students?
The length of the time included is supportive in providing skills practice; this is most beneficial when teaching students something new. We have found that 3 hours, on average, is the sweet spot. Including breaks on the hour is helpful to maintaining attention and focus. Taking 4 hours is a bit too much; however, 2 hours could be acceptable, but 1 hour is just not enough time.
What is a simulation?
Simulation is a chance for the student/learner to take the skills learned during the didactic session and put these skills into action face to face. At OU, the students are given a carefully pre-meditated case, which includes completed screening information, to review for their simulation experience with a Standardized Patient (SP). SPs portray the patient/client in the case. During the simulation students are allotted a limited amount of time (10-15 minutes) to engage with the SP utilizing MI. Students then receive verbal and written feedback from the SP to evaluate their execution.
Why should I participate in/utilize a simulation?
Simulations are a key factor in integration of theory to practice, creating an opportunity for skills practice. Our students have reported finding simulation the most helpful piece of their SBIRT education.
How to practice skills without a simulation center.
Classrooms, clinical areas with small rooms, an empty office, or anything like a client/patient room can be utilized instead of a simulation center. Roleplays with other students can be beneficial for incorporating skills when a simulation center or standardized patients are not available.
What are effective evidence-based screening tools?
Under the training tab of this website is a screening forms section. There you will find links to the AUDIT-C, AUDIT, DAST-10, PHQ-9, PHQ, Annual Questionnaire, and the ASSIST Training Tool.
How long does the screening process take?
Depending on the screening form used (the ASSIST may take longer), most screenings take about 3 minutes and no more than 5 minutes. The screening can easily be incorporated into intake paperwork to shorten the length of time utilized for screening during an actual visit. An efficient use of screening time would be to utilize the Annual Questionnaire, and then, based on what is positive, administer the DAST, AUDIT, or PHQ-9.
How much extra time will this take?
SBIRT is a model that fits well into a visit – the screening can be incorporated into intake forms, administered by the individual taking vitals, the dental hygienist, or even the provider. The brief intervention may take an additional 5-15 minutes, but it is not really additional time when the subject of the brief intervention is a relevant part of the client/patient’s health. Consider how much time could be saved by becoming more aware of potential behavioral changes which could reduce future negative and costly health outcomes.
How will this fit into my practice workflow?
The screening portion can be included in intake paperwork or provided by whoever may spend the most time with the patient/client. The brief intervention can take 5-15 minutes and can be implemented easily during an existing appointment with the client/patient.
Can this model be used with opportunities for behavioral change other than alcohol such as opioids, tobacco, anxiety, or depression?
Absolutely. Most research has been supportive of the use with alcohol and there is significant cost benefit to doing this intervention with alcohol in relation to the short-term and long-term health risks for poor and costly health outcomes.