SBIRT Flashcards
Define SBIRT
- Screening; universal screening
- Brief intervention
- Referral to treatment
What is SBIRT used for?
An evidence based, comprehensive, integrated approach to identify and provide brief and effective early intervention for:
- -Alcohol misuse
- -Substance use
- -Tobacco use
- -Depression/anxiety
Where is SBIRT carried out?
in primary care, specialty care, hospital E/D, and other health care and community settings.
**based on Motivational Interviewing strategies
What are the goals of SBIRT?
- identify and effectively/efficiently intervene with those who are at risk for health problems related to one or more of those conditions
- seeks to identify those in the ‘risky or harmful’ use categories
- not only those with dependency and in need of specialty referral/treatment
What is the rationale for universal first level screening as a foundation for SBIRT?
- results in earlier detection
- reduces risk of future injury or illness
- helps determine provider response
- normalizes the screening and subsequent discussion
- cues the patient on importance
- often initiates reflection by the patient
- increases efficiency
SBIRT screening tools
-patient stress questionnaire
Patient Stress Questionnaire:
- for anxiety: Gad-2
- for depression: PHQ-2
- for suicidality: accepted single question
- for alcohol: Audit-C
- for illicit and prescription drug abuse: single question (prescreen)
- personal violence questions
- PTSD screen
SBIRT screening tools
-AUDIT questionnaire
- low risk, risky, harmful or severe zones r/t alcohol intake
- screen for ETOH use
SBIRT screening tools
-Patient health questionnaire-9 (PHQ-9)
Screen for depression
SBIRT screening tools
-GAD-7
Screen for anxiety
Behavioral tactics for improving symptoms of depression (5)
- Positive Activity Planning: Engaging in activities/hobbies that make the patient happy – you might need to engage the patient by asking about his/her hobbies with the goal of at least 1 positive activity planned per day
- Increasing Physical Activity
- Walking, jogging, walking the dog, stretching
- Again, the patient will need to be engaged about what movement he/she enjoys - Sleep
- Setting a schedule, focusing on sleep hygiene, avoid alcohol before bed - Eating habits
- Plan meals, avoid skipping meals, avoid eating for comfort or convenience – minimize sugar & refined carbs - Friendships
- Reconnect or engage in opportunities to make new friends – avoid isolation, stay connected
What is the goal of brief interventions and how do they reach the goal?
- overall goal of brief interventions is to promote positive behavior change, such as reduced consumption and reduced harm.
- to reach this goal, brief interventions work to raise individuals’ awareness of their substance use and how it impacts their lives.
During the brief intervention, you help the patient to…
- find personal and compelling reasons to change (NOT YOURS!)
- build readiness to change
- make commitment to change
5 steps of a brief intervention
- Initiate reflective discussion
- Provide feedback based on screening/assessment date
- Evoke personal meaning
- Enhance motivation
- Negotiate commitment
What are the questions and techniques used to accomplish the brief intervention?
- initiate reflective discussion
- provide feedback based on screening/assessment date
- evoke personal meaning
- enhance motivation
- negotiate commitment
Explain how to initiate reflective discussion
-start the reflective discussion by asking permission of our patients to have the conversation.
Example: “Would it be all right with you to spend a few minutes discussing the results of the wellness survey you just completed?”
