IDISCUS InterDisciplinary Collaboration and Implementation of SBIRT Curricula in

University of South Carolina’s Rehabilitation Counseling Program

Michael Walsh, Ph.D, LPC, CRC, CPRP & Suzanne Hardeman, NP

IDISCUS

Screening, Brief Intervention and Referral to Treatment

The idea behind SAMHSA’s Screening, Brief Intervention, and Referral to Treatment (SBIRT) program is deceptively simple: What if you could stop drinking and substance abuse problems before they became serious enough to destroy people’s lives?

SBIRT provides the tools to have a conversation about substance use at a very early point and help people make decisions on substance use based on their own values and life realities.

-SAMHSA

How is SBIRT different?

• Intervenes much earlier than traditional approaches.

• Educates on “healthy limits” or “low risk” use

• Is based in Motivational Interviewing principles

• Is client- value-based

• Easy to learn

The SBIRT Process

Redefining Low Risk Substance Use

A Message from Suzanne Hardeman,MRC, MSN, PMHNP-BC

Dear all, Thanks so very much for coming to this session and I am so very sorry that I couldn’t be with you today. We have just buried my 23 year old nephew. He died as the result of a 10 year struggle with addictions. By the time our family knew, my nephew was already deeply entangled in addictions. I can only wonder if my nephew’s story would have been different had someone asked and assessed his substance use. SBIRT provides the tools we need to talk with people about their substance use  and intervene at appropriate levels. I hope you will join me in renewed passion to make substance abuse assessment a routine part of practice. Warmest regards. 

Where We Started

• Call came late April 2013• Purpose develop and implement training programs

to teach health professionals the SBIRT skills:• <30% medical residents• Curriculum provided

• Division of Biological Research took the lead• Queried interest from graduate health professional

programs

IDISCUS

IDISCUS

SAMHSA

To be opened by

Grant Recipient.

IDISCUS Structure

IDISCUS

The Proposal

IDISCUS

Nursing

Social Work

Rehabilitation Counseling

Graduate Programs

Medical Residencies

Community Sites

Internal Medicine

Family Medicine

Neuropsychiatry

Preventive Medicine

SCDMH NASW-SC Ryan White Providers

SBIRT

Implementation Approach

IDISCUS

SAMHSA

USCColumbia, SC

• Curriculum Customization• Online delivery• Voice-over videos• Handouts• Demonstration videos• Knowledge & Attitudes

Assessment• CSAT Satisfaction Surveys

Implementation Approach

IDISCUS

SAMHSA

USCColumbia, SC

• Curriculum Customization• One curriculum for all

disciplines• Each discipline had the ability

to customize

IDISCUS

Skills Practice

IDISCUS

• Nursing: Simulation lab, in pairs, instructor does patient voice

• Social Work: audio recordings, peer feedback• Rehabilitation Counseling: In-person, triads• Medical residencies: In-person, triads with instructor/faculty

Implementation

IDISCUS

Advanced Health Assessment

Spring Semester: 25-40 studentsSummer Semester: 25-35 students

Implementation

IDISCUS

Dynamics of Substance Abuse

Fall Semester: 70-125 studentsSummer Semester: 25-50 students

Implementation

IDISCUS

Rehabilitation Assessment

Fall Semester: 10-15 studentsSummer Semester: 10-15 students

Rehabilitation Counseling

Implementation

IDISCUS

Why Rehabilitation Assessment?

Screening-based protocol

Standardized instruments used for assessment

DASTAUDIT

Useful as part of a Universal Health Practice, e.g.-Blood Pressure, Temperature, etc.

Rehabilitation Counseling

Implementation

IDISCUS

Second Year of 3 or 4 Year Residency

Neuropsychiatry: 6 Family Medicine: 10Preventive Medicine: 2 Internal Medicine: 11

IDISCUS

Results Total Trainees (All Classes/Programs)

RHAB (N=13)

NURS (N=52)

SOWK (N=25)

Residents (N=9)

Age 34 34 29 31% Female 57% 90% 88% 55%Experience w/patients with alcohol problems [None(1) – Expert(5)] 2.2 2.8 1.6 3.2

Experience w/patients with drug problems [None(1) – Expert(5)] 2.2 2.8 1.8 3.1

Total hours formal addictions training (median) .5 1 3 15

Total hours informal addictions training (median) 3.5 1 0 10

Total hours formal MI training (median)

2.5 0 2 2

Output

• Materials converted to Braille or made accessible to screen reader

• Curriculum revised and updated for Spring• Curriculum update in progress• Plan to develop discipline-specific

demonstration videos

Lessons Learned

• Context and future utility critical • Addition of “contextual session”• In person, real-time practice valued• Class integration critical• Many students still utilizing SBIRT skills in

practicum

Student Feedback

It really has provided a means of having a discourse about such issues without seemingly being overly aggressive, and also the tools to get as much information as possible in a brief amount of time. It provides quantitative information to provide those you are working with, so that they have something that is not in the abstract to 'see'. Creating, hopefully, more openness in the exchange.

I love the materials. I am already using them in my current position and received positive feedback from it. The ease of presentation and the brief period of time it takes are essential in their effectiveness. I will say that I have enjoyed witnessing the changes people will make by themselves when provided with needed educational information.

I feel that the way our instructors used the materials encouraged us to see its application in practice much more than the videos online did. Our professors met with us and broke down the details from the video in how it differs as a style of communication with clients and what to be mindful of when meeting new individuals.

Next Steps

IDISCUS

Community Partners

SCDMH NASW-SC Ryan White Providers

Fall 2014 March 2015 Fall 2015

Thank You

IDISCUS

For more information, Please contact:

Michael Walsh, Ph.D, LPC, CRC, CPRPUniversity of South Carolina School of MedicineDepartment of Neuropsychiatry and Behavioral ScienceRehabilitation Counseling Programmichael.walsh@uscmed.sc.eduPhone: 843-304-1662

Suzanne Hardeman,MRC, MSN, PMHNP-BCUniversity of South Carolina School of MedicineDirector, Division of Biological ResearchDepartment of Neuropsychiatry and Behavioral ScienceUniversity of South Carolina School of Medicinesuzanne.hardeman@uscmed.sc.eduPhone: 803-434-3622