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SBIRT Training Grant

SBIRT: Screening, Brief Interview, and Referral to Treatment

Joe Pickard, PhD, LCSW, associate professor of Social Work, recently received an $880,000 grant from the Substance Abuse Mental Health Services Administration (SAMSA). Social Work Professor Sharon Johnson is collaborating on the project, as are faculty at St. Louis University. The grant was established to train social work students and faculty in the relatively new screening tool referred to as Screening, Brief Interview, and Referral to Treatment, or SBIRT for short. SBIRT was developed to provide early identification of and intervention to individuals at risk of dangerous alcohol and drug use; many of these individuals would not be assessed as having a full-blown substance disorder but could benefit from intervention nonetheless.

Although SBIRT was originally developed as a tool for use among primary care physicians, Pickard believes social workers are often in the best circumstance to assess an individual’s risk for developing substance abuse disorders. “Social workers are skilled in the art of the interview, making social work a natural home for SBIRT,” Pickard said. Prior to the SBIRT screening tool, there was not a widely adopted evidence-based intervention technique for potential substance abuse problems. The brief screening aspect of SBIRT also makes it ideal for use amongst social workers who work in the field in variable conditions.

Unlike previous methods for identifying and intervening with potential problems with alcohol and drug use, SBIRT can be used as a universal screening, meaning that everyone being taken into an agency is screened upon first contact. If the initial screening determines the client to be potentially at risk, the brief interview portion of the model is invoked. According to Pickard, the interview is a 4-step procedure using motivational interviewing skills. This process is client-rather than practitioner-centered and relies upon the principle of cooperation whereby the client is engaged as an active partner in identifying problems, finding motivation to change, and developing practical steps to bring about the desired change. In the past, attempts to change clients’ behaviors have focused more on confronting the client with the problem, educating them about the problem, and telling what they need to do to change. According to Pickard, research has confirmed that these top down, practitioner-centered approaches simply do not work. In the past, social workers might avoid the topic of alcohol and drug use altogether because they lacked the tools to deal with the problems or slipped into a practitioner-centered model. Pickard reports that “Part of what I like about SBIRT is that it takes the motivational interviewing technique that social workers are already trained in and puts it around a 4-step, evidence-based model that can be used with diverse populations and settings, ” and that with the advent of SBIRT training, “if in the course of a motivational interview, a social worker recognizes the need for specialty care, the social worker has been trained how and where to make appropriate referrals for treatment and help.”

The reach of Pickard’s SBIRT training goes beyond the School of Social Work and has become a collaborative effort across campus, across the St. Louis region, and across the state of Missouri. This grant is the epitome of the collaborative spirit found in the School of Social Work. Pickard and Johnson’s co-principal investigator, Monica Matthieu is an assistant professor at Saint Louis University whose work centers on the mental health of military veterans. In addition, a four-hour online training course has been developed for SBIRT by the Mid-America Addiction Technology Transfer Center located at the University of Missouri- Kansas City. This online training has been integrated into the introductory generalist practice course for BSW students and is a key factor in the integration of SBIRT training into the undergraduate social work curriculum. Ultimately, the School of Social Work would like all students, both undergraduate and graduate, to undergo SBIRT training and, according to Pickard, this is quickly becoming a reality. This past fall, many of the social work faculty were themselves trained in SBIRT and have begun incorporating the training into their courses. It has been incorporated into the Generalist Social Work Practice course that all incoming MSW students must take. Elian Cabrera-Nguyen, PhD, MSW, has been hired as an assistant teaching professor by the School of Social Work largely to help with the SBIRT training of our students and community. According to Cabrera-Nguyen, “SBIRT training is easy to implement but it’s not as simple as it sounds. An SBIRT interview involves a lot of nuance and complexity that requires training to use effectively.” Cabrera-Nguyen will be teaching both at UMSL’s main campus and also at our Mineral Area College outpost.
Tom Meuser, associate professor of gerontology, took the SBIRT training offered this past fall and guest lectured on SBIRT in the Advanced Seminar in Medical Gerontology early in the spring. He will also be teaching SBIRT in his course Gerontology Assessment this coming fall. Meuser is glad to reach students in classes that have never heard of the SBIRT methodology. Ann Steffen, associate professor in psychology and gerontology, also uses the SBIRT training in her class Psychopathology and Aging and reports that the students have found the training quite helpful. According to Pickard, the SBIRT training is going quite well. “Students seem to like it and they find it useful to have an evidence-based practice at their disposal. Students can begin using this immediately in their practicums, in the field, or in their current jobs,” he said. Pickard has begun SBIRT training for social workers in various agencies across St. Louis that serve as field instructors for our social work practicum students so that these instructors and agencies will be familiar with the methodologies that student bring or may find it useful to adopt the protocol themselves. Matthieu at Saint Louis University reports that one measure of the success of the SBIRT program is “seeing the increased competency of our faculty and students to apply SBIRT in real life settings, and that is what is exciting - getting the innovation out of the classroom and to the clients who will likely benefit.“ Pickard speculates that practitioners may find the SBIRT model useful for screenings that go beyond alcohol and drug use and touch on all sorts of behavioral health issues of their clients. In June, Pickard, Cabrera-Nguyen, and Matthieu will be offering an all-day continuing education opportunity on SBIRT open to licensed social work practitioners as well as licensed marriage and family therapists, licensed professional counselors, and clinical psychologists throughout the region. The course will provide an in-depth introduction of how to conduct an SBIRT interview and the goal is for each participant to be able to use the SBIRT model immediately. The training will be held in the J.C. Penny Summit Lounge on June 24th. For more information about that training, contact Elian Cabrera-Nguyen at cabreranguyene@umsl.edu.