Author(s): Wamsley, Maria; Satterfield, Jason M; Curtis, Alexa; Lundgren, Lena; Satre, Derek D | Abstract: ObjectivesScreening, Brief Intervention, and Referral to Treatment (SBIRT) can effectively identify and address substance misuse and substance use disorders (SUDs), and can be delivered by a range of trained health professionals. Yet, barriers remain to effective training and implementation of SBIRT in health and social service settings, and models of interprofessional collaboration in SBIRT delivery are underdeveloped.MethodsWe reviewed current literature regarding SBIRT effectiveness, training, and implementation by physicians, nurses, psychologists, and social workers. An SBIRT expert and representative from each health profession synthesized literature and training experiences to inform the development of interprofessional training and collaborative implementation strategies.ResultsEach of the health professions involved in SBIRT training and implementation have strengths and weaknesses that influence how SBIRT is taught, learned, and delivered. Some of these are specific to the components of SBIRT, for example, screening versus brief intervention, whereas others depend on profession-driven competencies, for example, motivational interviewing. Professional organizations have encouraged a range of tailored SBIRT training initiatives, but true interprofessional training and the implementation of collaborative, team-based care are largely unrealized.ConclusionsSBIRT can be a valuable approach to screening and treatment for SUDs when delivered by a range of healthcare professionals. A more nuanced understanding of the assumptions and characteristics of each profession, informed by the emerging field of implementation science, may shape more effective training curricula and highlight interprofessional models of SBIRT delivery that maximize the strengths of each profession.

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Alcohol and Drug Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training and Implementation: Perspectives from 4 Health Professions.

Objectives The demand for substance use disorder treatment is increasing, fueled by the opioid epidemic and the Affordable Care Act mandate to treat substance use disorders. The increased demand for treatment, however, is not being met by a corresponding increase in access to or availability of treatment. This report focuses specifically on the treatment referral process, which we have identified as 1 of the key barriers to timely and effective treatment. Difficulties in referral to substance use disorder treatment are examined through the lens of providers who make referrals (ie, referral source) and individuals who work in substance use disorder facilities (ie, referral recipient). Methods Administrative officials, emergency department physicians, addiction physicians, government officials, providers, insurance officials, and mental health advocates (n = 59) were interviewed on the referral process protocol, challenges for providers and others making referrals, and issues with substance use treatment facility intake procedures. Results Several main themes were identified as barriers in the process: difficulties in determining patient eligibility, lack of transparency regarding treatment capacity, referral source knowledge/understanding of options, and issues with communication between referral source and recipient. We then proposed several solutions to address specific barriers. Conclusions Current gaps in the referral process cause delays to care. Improving systems would involve addressing these themes and expanding the use of appropriate treatments for the many patients in need.

Gaps in the Substance Use Disorder Treatment Referral Process: Provider Perceptions.

Social workers have an important role in the field of mental health, and social work programs have a responsibility to prepare students for practice in the field. This scoping review mapped and syn...

https://bmjopen.bmj.com/content/bmjopen/9/6/e024659.full.pdf

Social work education and training in mental health, addictions and suicide: a scoping review protocol

Social workers play a critical role in assessing and treating individuals and families with mental health and addiction concerns. Although social workers are key professionals in the mental health ...

Teaching Note—Enhancing Social Work Education in Mental Health, Addictions, and Suicide Risk Assessment

Background: This study evaluates the degree to which a harm reduction intervention course module impacted Master of Social Work (MSW) students’ knowledge and attitudes towards addressing opioid use disorder issues and clients. Methods: Using a mixed-methods approach, data from 124 MSW students were collected between 2011 and 2015. Students completed a 3-hour course module that focused on harm reduction philosophy and interventions specifically for opioid use disorders. Students completed pre- and posttest of the Harm Reduction Attitude Scale. Students were also engaged in focus groups to gain a better understanding of how and if their knowledge and attitudes changed. Results: Overall, attitudes towards harm reduction approaches for opioid use disorder shifted favorably following the course module. Paired t-test results show a statistically significant difference in the mean scores for pretest attitudes (M = 2.64, SD = 0.16) and posttest attitudes (M = 2.86, SD = 0.12) among social work students. T...

Exploring social work student education: The effect of a harm reduction curriculum on student knowledge and attitudes regarding opioid use disorders.

Background: Counseling and social work programs educate future practitioners who are likely to be engaged in direct practice with individuals impacted by substance use disorders. Recent changes to policy and practice, including the Affordable Health Care Act and DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), contribute to the ongoing need to develop substance abuse competencies among mental health professionals at all educational levels and across multiple disciplines. Methods: The authors reviewed programs of study and course catalogs identified and accessed online for counselor education, Bachelor of Social Work, and Master of Social Work programs to identify offered and required courses focused on substance abuse, as determined by course title and description. Results: Of the 97 master's-level counseling programs reviewed, 67 required at least 1 course in substance abuse and 12 offered at least 1 elective in substance abuse. Of the 89 Bachelor of Social Work program...

An exploration of substance abuse course offerings for students in counseling and social work programs.

Screening, brief intervention, and referral to treatment (SBIRT) is a flexible, evidence-based approach to assessing risk and providing brief interventions for individuals with alcohol use disorders. This article identifies 3 diverse populations that could benefit from universal screening—a foundation of SBIRT—and provides resources and support for implementation across a broad range of settings.

Best Practices Start With Screening: A Closer Look at Screening, Brief Intervention, and Referral to Treatment in Adolescent, Military, and LGBTQ Populations

Jill L. Russett

Papers

An exploration of substance abuse course offerings for students in counseling and social work programs.

Best Practices Start With Screening: A Closer Look at Screening, Brief Intervention, and Referral to Treatment in Adolescent, Military, and LGBTQ Populations