FREQUENTLY ASKED QUESTIONS

What is Screening, Brief Intervention, and Referral to Treatment (SBIRT)?

WHAT & WHY?

An evidence-based public health approach to:

  • Identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs
  • Provide early intervention to people at risk of developing substance use disorders
  • Provide treatment services to people with substance use disorders  
  • SBIRT can be implemented by medical assistants, behavioral health technicians, medical providers, or doctors


WHO?

  • Screening should be universally applied to all patients/clients (18 years and older)   
  • SBIRT can be implemented by medical assistants, behavioral health technicians, medical providers, or doctors


WHERE?

  • Screening can occur in any healthcare setting. Many different types of community settings provide opportunities for early intervention with at-risk substance users before more severe consequences occur, such as emergency departments, community healthcare centers, pain management provider offices, and university healthcare facilities.


HOW?

Screening - The healthcare professional assesses all patients (18 years and older) for at-risk substance use behaviors using standardized screening tools.

Brief Intervention - If a positive screen: the healthcare professional engages a patient showing at-risk substance use behaviors in a short conversation, providing feedback and advice, utilizing motivational interviewing techniques.

Referral to Treatment - If additional services are indicated: the healthcare professional provides the patient with a referral to brief therapy or for additional treatment.

How long will it take for me to incorporate SBIRT into my office?

5-10 minutes for screening while waiting to see the provider:

  • Two pre-screen questions
  • Alcohol Use Disorders Identification Test (AUDIT) 
  • Drug Abuse Screening Test (DAST)

5 -10 minutes for Brief Intervention

  • Brief conversation
  • Motivational Interviewing

3-4 weeks for full integration into daily flow

  • There are no set rules on how to implement SBIRT at a particular site. Like all new processes, the first weeks of implementation provide opportunities to identify the processes that work for your site and those that do not. Use this time to fine-tune the procedure so that SBIRT works for your specific site, staff and clients.
  • Implementing SBIRT in its entirety depends on several factors, such as the site’s commitment to integrating the program, provider’s familiarity with SBIRT, the chosen screening tools, and the provider’s familiarity with Motivational Interviewing.

Will I receive reimbursement for speaking with patients?

Although procedural codes exist for Screening and Brief Interventions (SBI), very few insurance companies pay for SBI, at this time.

  • However, steps are being taken to make reimbursement possible.

Is self-reported drug and alcohol and drug use reliable?

Through implementing SBIRT in northern Arizona, staff members have learned that the reliability of self-reporting directly correlates to how the questions are being asked.

  • The personnel implementing Screening and Brief Interventions (SBI) should be comfortable with asking the questions and with Motivational Interviewing.
  • When questions are asked in a non-judgmental manner and tied to the patient’s overall wellbeing/health, patients tend to respond more openly than when they sense disapproval from the provider or staff person asking the questions.
  • Age has been found to be a factor related to willingness to self-report alcohol and drug use, with college students self‐reporting more freely than their older counterparts.
  • Cultural factors may play a role in client willingness to self-report.

How effective is Brief Intervention?

The goal of brief interventions (BI) is to motivate individuals to change their at-risk behaviors.

  • Asking the screening questions, discussing the answers provided, and speaking openly about how the patient’s behavior may affect his/her medical condition(s) and overall sense of wellbeing works to change the patient’s thought processes.
  • By initiating a BI, the provider opens the door for additional dialogue with the patient. If a patient feels “stuck” or uncertain regarding how to proceed with modifying his or her behavior,  he or she knows that the  provider is willing to discuss these issues further.

What is Brief Therapy?

Brief Therapy (BT) is more in-depth than Brief Intervention (BI) and consists of a combination of education, goal setting, and support.

  • The provider ask questions about the patient’s use and personal history.
  • The provider aids the patient in setting goals over the period of a few appointments.

How do I refer a patient to brief therapy or treatment?

Brief Therapy is generally completed at the same location in which the patient receives his/her screening and brief intervention.

  • If the provider believes the patient requires more treatment than he or she is able to provide, the provider should, like with any other referral to a specialist, consult the list of providers contracted with the patient’s insurance company or contact the patient’s insurance company.
  • Should the patient not have a behavioral health benefit, the provider should offer a list of local treatment providers.
  • Providers and others interested in finding treatment services may search for providers at: http://findtreatment.samhsa.gov/
  • To learn how to access behavioral health treatment services in Arizona, please visit: http://www.azdhs.gov/bhs/pdf/AccessingBHsystem.pdf.
  • You may also call 1-800-662-HELP, which offers 24-hour free and confidential information (in English and Spanish) on substance use disorder issues and referral to treatment.

Where can I get more information about SBIRT?

There are a number of sites where you can get more information about SBIRT, including the Arizona SBIRT Facebook page: