What if a broader team of healthcare professionals received training to discuss substance abuse with patients non-judgmentally, and then incorporate such issues into treatment? This is the goal of Chatham’s SBIRT training grant, a three-year, $900,000 program to prepare students across several departments for such real-world encounters.
SBIRT stands for Screening, Brief Intervention and Referral to Treatment, a set of evidence-based techniques to identify at-risk patients. Funding comes from Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT). For this grant, Chatham partnered with the University of Pittsburgh School of Pharmacy Program Evaluation Research Unit (PERU) and the Allegheny Health Network, “two organizations who had a wealth of experience [who] could be mutually beneficial,” explains Gabrielle Strong, grant manager for the School of Health Sciences.
The grant is specifically tailored to suit programs and degrees within the School of Health Sciences: counseling psychology (PsyD & MSCP), nursing (BSN), occupational therapy (MOT & OTD), physical therapy (DPT), and physician assistant studies (MPAS), with social work (BSW) from the School of Arts, Science & Business joining this year. “One of the things I think is great about the Chatham SBIRT grant is that we are targeting the whole multidisciplinary team,” says Mary Jo Loughran, associate professor and program director of counseling psychology. With multiple departments participating, and specific interdepartmental exercises implemented, “it promotes some interdisciplinary cross-talk,” she says.
“The SBIRT curriculum is incorporated within existing courses and tweaked to make sure it reflects each particular profession,” says Strong. “This addresses student knowledge, but we also want an increase in competency and confidence, so we have students practice cases in role play exercises specific to their profession.”
Motivational interviewing skills are essential to SBIRT; they aim to remove any sense of judgment about the patient from the care provider–avoiding a traditional scenario of scolding a patient for bad behavior and shutting down an avenue for dialogue. “Rather than honing in on the problematic part of the behavior, let’s get in touch with the person’s motivation for wanting to change and help them develop that,” says Loughran. “You’re inviting the person to look at what they want to change.”
The program thrives on continuous feedback from faculty and students about effectiveness of teaching and implementation. Surveys and assessments provide data on what works best, so exercises and techniques can change as needed. “Some things obviously change and morph as we see what the needs are,” says Strong. “We do implement changes based on student feedback.”
That feedback is consistently positive. After the training, students from the OTD program gave detailed accounts of their interactions.
“I didn’t have to ask a lot of questions. [The patient] opened up and kept talking. I was surprised how willing he was to talk with me and problem solve…to limit his drinking.”
Another commented, “I found the information given and techniques practice to be helpful overall to encourage client- directed conversations and resolutions.”
SBIRT has produced measurable results with patients. In one survey, 31 students described how they had used their new skills within
a period of 30 days. Among 305 patient encounters, 164 said they would change their behavior and cut down, and 44 people were referred to treatment.
This story, written by Charles Rosenblum, originally appeared in the Fall 2017 Recorder.