Adolescent Screening, Brieft Intervention and Referral to Treatment for Alcohol
Alcohol Screening, Brief Intervention and Referral (SBIR) · source . The Site. Alcohol SBIR. The...
Transcript of Alcohol Screening, Brief Intervention and Referral (SBIR) · source . The Site. Alcohol SBIR. The...
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Alcohol Screening, Brief Intervention and Referral
(SBIR)
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Disclosures
• Lundbeck Canada
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SBIR and FASD
• Primary prevention of FASD requires pre-pregnancy screening and intervention.
• This requires a cultural shift to low risk drinking and
• More effective Primary Care intervention for those at elevated risk from their drinking.
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Objectives
• Review the genesis of Canada’s SBIR initiative
• Explore the content and format
• Critique the approach
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Alcohol SBIR
CCSA and CFPCDevelopment and
Background
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Canada’s National Alcohol Strategy
• Led by the Canadian Centre on Substance Abuse
• Developed a comprehensive, collaborative stakeholder endorsed set of 41 recommendations
• Reducing Alcohol Related Harm in Canada: Toward a Culture of Moderation (CCSA 2007)
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Alcohol SBIR: NAS Recommendations
• #7 Develop integrated, culturally sensitive screening, brief intervention and referral (SBIR) tools and strategies.
• #9 Improve access to addiction services in isolated, rural and remote regions of Canada, and for vulnerable populations.
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Development and Implementation
• CCSA contracted Dr. David Brown PhD to develop and pilot test a prototype
• Prototype refined through IT consultants, focus groups and beta testing in conjunction with the College of Family Physicians of Canada (CFPC)
• CFPC now maintains the site, with open access, and have assumed responsibility for further KE activity
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Challenges to Primary Care SBIR Uptake
• Need for national Low Risk Drinking Guidelines• Credible information and endorsement• Time: seamless inclusion in busy practices
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Challenges to Primary Care SBIR Uptake
• Comfort with the process and inclusion of Motivational Interviewing
• Ability to address alcohol abuse and dependency
• Appropriate technology and resources for both the practice and patients
(Lit Review and Practitioner Feedback)
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The Site• College of Family Physicians of Canada, open
source www.sbir-diba.ca
The Site
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Alcohol SBIR
The site, LRDG and
Standard Drinks
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Alcohol SBIR
Menu Orientation
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Alcohol SBIR
Screening and Assessment
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Alcohol SBIR
Brief Interventionand Referral
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Factors Related to Improvement• 30% Therapeutic Relationship• 15% Technique• 15% Expectancy• 40% Extra-therapeutic Factors
(Asay & Lambert 1999)
Factors Related to Improvement
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Factors Related to ImprovementPre-contemplation
Contemplation
DeterminationAction
Maintenance
Relapse
Success
Prochaska & Di Clemente, TranstheoreticalM d l f Ch
Stages of Change
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• Start wherever the person is at: acknowledge their reality.
• Roll with resistance.• Avoid arguments or a power
struggle.• Be persuasive, not
confrontational or abusive.(From Miller)
A Motivational Approach
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Alcohol SBIR
Brief Intervention,Follow up and Support
for Elevated Risk
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Alcohol SBIR
Brief Intervention,Follow up and Support
for Alcohol Abuse
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Alcohol SBIR
Brief Intervention, Referral, Follow up and
Support for Alcohol Dependency
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Objectives Accomplished
• Review the genesis of Canada’s SBIR initiative
• Explore the content and format
• Critique the approach
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References & Recommended Reading• American Society of Addiction Medicine,
www.ASAM.org• Canadian Society of Addiction Medicine,
www.CSAM.org• Canadian Centre on Substance Abuse,
www.CCSA.ca• National Institute of Drug Abuse,
www.NIDA.org
References & Recommended Reading
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References & Recommended Reading• National Native Addiction Partnership
Foundation, www.nnapf.org• Wellbriety Movement,
www.whitebison.org• Mate, Gabor. In The Realm of Hungry
Ghosts. A.A.Knopf Canada. 2008
References & Recommended Reading
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Thank you
Questions?
Contact: P.R. Butt, MD, CCFP(EM), FCFPAssoc. Professor, Family Medicine,University of Saskatchewan