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SBIRT Training for Social Workers: Meeting the Substance Use Disorder Prevention and Intervention Challenge

By Mary Rawlings, PhD, LCSW, Professor and Chair, Department of Social Work, Azusa Pacific University

National data indicate that 23 million people in the U.S. currently engage in substance use that is considered high or moderate risk for developing a substance use disorder; however, very few (only 2.5 million) of high risk substance users are referred for services or receive intervention (Center for Behavioral Health Statistics & Quality, 2015).

In an effort to prevent high risk users from developing more serious health and social consequences, SAMHSA, the federal Substance Abuse and Mental Health Services Administration, has funded and promoted the training of SBIRT: Screening, Brief Intervention, and Referral Treatment.

SBIRT is an evidenced-based practice, built on universal screening for early identification of risky substance use and triaging risk via brief interventions and/or referral to treatment using motivational enhancement strategies. Historically focused on preparing physicians and nurses in health care settings, SAMHSA more recently has begun to target social workers for SBIRT training, acknowledging that social workers are frontline professionals, well poised to administer SBIRT and provide effective early intervention services. California, in accordance with the Affordable Care Act and associated Medicaid changes that integrate behavioral health services into health care settings, has endorsed SBIRT as an essential practice, supporting Medi-Cal reimbursement of SBIRT for eligible providers, including social workers, as of January 2014.

To meet this substance use disorder national prevention initiative, select social work education programs in California and across the country have received SAMHSA funding to develop and disseminate SBIRT training to social work students and professionals (www.samhsa.gov/sbirt).

BSW and MSW students are being prepared to administer valid and reliable risk screening tools, and to offer brief intervention based on screening results, engaging individuals with substance use risk in a non-judgmental, collaborative conversation regarding their substance use patterns and goals for behavior change.

SAMHSA, recognizing the need for culturally responsive services, recently awarded funding to Azusa Pacific University (APU) to develop, implement and evaluate a multi-disciplinary SBIRT training project that includes integration of cultural components of faith and spirituality for social work, nursing and psychology/counseling professional disciplines. Specifically, the training incorporates research that suggests faith and spirituality can serve as a protective factor facilitating prevention and intervention, as well as a barrier for someone seeking services or assistance. Cultural responsiveness in areas of faith and spirituality are critical components for effective social work practice, and is applicable in both secular and non-secular settings, regardless of one’s personal beliefs. Partnering with other faith-based universities across the state, APU hopes to train more than 9,000 students to be our next generation of social workers, nurses and psychologists in SBIRT practice, responsive to integrating faith and spiritually as important cultural elements of client health behaviors and outcomes.

As social workers, we are well aware that substance use can turn into problematic and dangerous use for anyone, intersecting and impacting all areas of our work, including exacerbating health conditions, domestic violence and mental health issues. SBIRT practice provides an efficient and effective option for social work to assess and intervene with clients to prevent such problematic co-occurring issues.

REFERENCES

SAMHSA www.samhsa.gov/sbirt

California Health Care Services www.dhcs.ca.gov/services/medi-cal/Pages/SBIRT.aspx

Faith and Spirituality Integrated SBIRT Network www.sbirtfaithandspirituality.org/

Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from www.samhsa.gov/data/.