Complementing SBIRT for Alcohol Misuse with SBIRT for Trauma: A Feasibility Study

Topitzes, J., Berger, L., Otto-Salaj, L., Mersky, J.P., Weeks, F., Ford, J. (2017). Complementing SBIRT for alcohol misuse with SBIRT for trauma: A feasibility study. Journal of Social Work Practice in the Addictions.

Reducing alcohol misuse is a priority for U.S. health officials considering that misuse of alcohol is a leading preventable cause of morbidity and mortality. Consequently, health centers are routinely integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol misuse within usual care. Although SBIRT is well validated among general patient samples, results have not generalized to drinkers with probable alcohol use disorder, and little is known about the efficacy of SBIRT with low-income, minority patients. Members of these groups are of particular concern because they are at risk for experiencing high rates of trauma exposure concurrent with high rates of alcohol-related problems. Therefore, innovative approaches to delivering SBIRT might be needed in order to enhance the efficacy of SBIRT with these high risk groups and to meet the Grand Challenge of reducing alcohol misuse.

This study combined SBIRT with a model designed to address psychological trauma: T-SBIRT. With a sample of 112 adults, most of whom were African American or Latino/a and of low-income status, authors analyzed multiple indicators of feasibility: a) suitability of treatment, b) acceptability of treatment, c) patient compliance (also known as patient adherence), d) treatment integrity, and e) intended outcomes.

Results indicated that T-SBIRT is suitable for and acceptable to patients accessing community-based health services, and that T-SBIRT can generate high rates of patient compliance. Moreover, behavioral health providers can implement T-SBIRT with high rates of model fidelity, and the model can promote high referral acceptance rates to specialty treatment, particularly among patients with probable alcohol use disorder.

It is feasible to implement T-SBIRT within community-based primary health clinics according to both patient and provider indicators of feasibility. T-SBIRT may prove a promising supplement to SBIRT particularly for service recipients at-risk of alcohol use disorder and/or for low income, ethnic racial minority patients.

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