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    ISSUP Webinar - SBIRT Training Slides - November 2023 - Part 2

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    nay lin
    The document provides information on Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. It discusses the WHO ASSIST screening tool, which screens for risks associated with tobacco, alcohol, and other substance use over three months and lifetime. For those at high risk, it recommends further assessment and specialized treatment. Most individuals can be treated with a brief intervention. It also outlines the goals and components of brief interventions, including providing feedback, discussing responsibility, giving advice, and promoting self-efficacy and change. For the approximately 5% requiring more support, referral to substance use treatment is recommended, with an emphasis on facilitating the referral process and reducing barriers to care.

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    ISSUP Webinar - SBIRT Training Slides - November 2023 - Part 2

    Uploaded by

    nay lin
    9 views22 pages
    The document provides information on Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. It discusses the WHO ASSIST screening tool, which screens for risks associated with tobacco, alcohol, and other substance use over three months and lifetime. For those at high risk, it recommends further assessment and specialized treatment. Most individuals can be treated with a brief intervention. It also outlines the goals and components of brief interventions, including providing feedback, discussing responsibility, giving advice, and promoting self-efficacy and change. For the approximately 5% requiring more support, referral to substance use treatment is recommended, with an emphasis on facilitating the referral process and reducing barriers to care.

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    SBIRT

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    ISSUP webinar_SBIRT training slides_November 2023_Part 2

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    The document provides information on Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. It discusses the WHO ASSIST screening tool, which screens for risks associated with tobacco, alcohol, and other substance use over three months and lifetime. For those at high risk, it recommends further assessment and specialized treatment. Most individuals can be treated with a brief intervention. It also outlines the goals and components of brief interventions, including providing feedback, discussing responsibility, giving advice, and promoting self-efficacy and change. For the approximately 5% requiring more support, referral to substance use treatment is recommended, with an emphasis on facilitating the referral process and reducing barriers to care.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views22 pages

    ISSUP Webinar - SBIRT Training Slides - November 2023 - Part 2

    Uploaded by

    nay lin
    The document provides information on Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use. It discusses the WHO ASSIST screening tool, which screens for risks associated with tobacco, alcohol, and other substance use over three months and lifetime. For those at high risk, it recommends further assessment and specialized treatment. Most individuals can be treated with a brief intervention. It also outlines the goals and components of brief interventions, including providing feedback, discussing responsibility, giving advice, and promoting self-efficacy and change. For the approximately 5% requiring more support, referral to substance use treatment is recommended, with an emphasis on facilitating the referral process and reducing barriers to care.

    Copyright:

    © All Rights Reserved
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    of 22

    South Africa

    International Technology Transfer Centre


    A program of the International Consortium of Universities
    for Drug Demand Reduction

    Screening, Brief Intervention &


    Referral to Treatment (SBIRT) for
    Substance Use
    Shaheema Allie
    Fergus Ashburner
    Nurain Tisaker
    WHO ASSIST (Alcohol, Smoking and Substance
    Involvement Screening Test)
    • Asks about recent substance use over the past 3
    months and assesses for lifetime use risks.
    • Comprehensive list of substances is long and includes
    tobacco and alcohol.
    • Provides a level of risk for each substance.
    • Second part of the tool provides information for Brief
    Intervention (BI) component.
    • Information and feedback about the risks and
    harms associated for each substance.
    • Covers physical, medical, and psychological risks
    of regular substance use.
    • High risk screening scores will lead to further
    assessment and a referral to specialized treatment.
    Usually a small proportion (5%) of the using
    population will be at high risk. The rest of the
    individuals can be treated via a BI.

    3
    WebApp ASSIST https://assistscreening.uct.ac.za

    • Anonymized
    • No personal identifying data included in general structure. This can be
    modified for specific purposes
    • Random code generated with each screening process
    • Any device
    • Data-light
    • Automated
    • Reduces training burden
    • Screening report and intervention recommendation can be screenshot or
    emailed, following which the email entered for receipt is not stored on the
    system

    Development funded
    Developed, hosted
    by US Department of
    and maintained by Supported by WHO
    State INL through
    UCT
    Colombo Plan DAP

    4
    Just to Recap on Screening…

    Use a non-confrontation, non-


    judgmental approach with your patient.

    Describe the purpose of why you are


    using a screening tool.

    Emphasize confidentiality and avoid


    stigmatizing language.
    Recap… (continued)

    Emphasize the timeframe regarding questions.

    • E.g. In the last 12 months, or in the last 3 months…..

    Discuss the score with your patient and explain what


    it means for them.

    Ensure scoring is done and interpreted correctly in


    order to provide the correct steps for further
    assessment or treatment (SBIRT).
    South Africa
    International Technology Transfer Centre
    A program of the International Consortium of Universities
    for Drug Demand Reduction

    Brief Interventions
    &
    Referral to Treatment
    Step 2 of SBIRT:
    Intro to Brief Intervention
    SBIRT Decision Tree

    Addiction Technology Transfer Center


    Network. (2011). SBIRT curriculum. Retrieved
    from http://attcnetwork.org/home/.
    Brief Intervention (BI) Goals
    The general goal of a BI is to:

    Educate the patient on safe levels of substance use.

    Increase the patients’ awareness of the consequences of substance use.

    Motivate the patient towards changing substance use behavior.

    Assist the patient in making choices that reduce their risk of substance use
    problems.
    Why Brief Interventions?

    Time • 5 minutes: brief advice


    • 15-30 minutes: brief counselling

    Cost • Prevent costs related to progression of


    substance use and related consequences

    Effective • Evidence-based for adults and adolescents


    Components of BI that work
    Feedback:
    • Provision of personally relevant feedback
    • Generally follows a thorough assessment of substance use and related problems

    Responsibility:
    • Acknowledge that patients are responsible for their own behaviour and that they can make choices about their substance
    use.

    Advice:
    • Provision of clear advice regarding harms associated with continued use.

    Menu of Options:
    • Alternatives for change

    Empathy:
    • Warm, reflective, and understanding approach by interventionist

    Self-Efficacy:
    • Optimism about substance use behaviour change
    Video: Brief Intervention (Lula)
    Step 3: Referral to Treatment (RT)
    A “Warm Hand Off” = Reduce barriers, build bridges

    3
    Referral within your
    organisation - in-person
    introduction to facilitate
    1 open communication for
    client and provider
    Discuss and
    describe available Spirit of MI
    treatment options
    2 4
    Ask permission to Outside your organisation –
    facilitate referral. explain care coordination,
    Remember identify person being
    confidentiality referred to and organise
    processes. transport if possible

    How to confidently administer SBIRT in daily practice


    Step 3: Referral to Treatment
    Approximately 5% of patients screened will require referral to substance use
    evaluation and treatment.

    A patient may be appropriate for referral when:

    • Assessment of patient’s responses to the screening reveals serious medical, social, legal, or
    interpersonal consequences associated with their substance use.

    These high-risk patients will receive a BI followed by referral.

    Referrals for other health related consequences


    Referral to Treatment
    Always:

    Follow appropriate confidentiality regulations when


    sharing information (and get permission).

    Establish a relationship with your community provider(s)


    and ensure you have a referral agreement.

    Maintain a list of providers, support services, and other


    information that may be helpful to patients.

    Reduce barriers and build bridges.


    Activity
    Community Resources

    Draw a map of your local


    community and
    mark important referral
    networks or resources
    for the treatment of substance
    use disorders.
    What if the person does not want a
    referral?
    Encourage follow-up – at the point of contact

    At follow-up visit:
    ØInquire about use
    ØReview goals and progress
    ØReinforce and motivate
    ØReview tips for progress
    Referral to Treatment
    In summary …

    Provide
    Referral to
    recommended
    Review scores Treatment
    Use ASSIST Brief
    and check level based on
    to screen Intervention
    of risk recommended
    based on level
    intervention
    of risk

    How to confidently administer SBIRT in daily practice


    Wrap-up

    Questions
    Contact us with Questions
    and for follow up support:
    [email protected]

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