The Monday Memo
April 9, 2019 PITT DPT STUDENTS
What is SBIRT, you may be asking? It’s a process consisting of screening, brief intervention, and referral to treatment. It is an evidence-based tool to assess and intervene with patients with suspected substance abuse or at risk behaviors.
As physical therapists, we should expect to encounter these patients often. Many of our patients may be prescribed pain killers that may modify their symptoms temporarily, but lead to dependence. It is within our scope of practice to screen for these at-risk behaviors and, if the patient consents, to have a brief conversation delving deeper. This may not always be the easiest conversation to have, but an important one nonetheless.
A therapist may be able to pick up on possible at-risk behaviors while taking a patient’s history. If found, there are useful tools for further screening, including the Alcohol Use Disorders Identification Test (AUDIT) and The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST).
Once at-risk behaviors are identified, the therapist should use their clinical judgment to determine how to discuss with the patient steps to change. Motivational interviewing allows the clinician to learn important details while letting the patient drive the conversation. Two acronyms to guide brief intervention are FLO and OARS. FLO stands for feedback, listening, and options. It is important to give the patient feedback, show them that you are engaged and listening, and allow them to explore their options. OARS stands for open-ended questions, affirmations, reflective listening, and summary. Asking open-ended questions allow the patient to share freely in a non-threatening environment. Affirmations are important to encourage positive ideas. Reflective listening and summary are used to demonstrate understanding.
Referral to Treatment
If the patient expresses interest, there are several available resources to share with them:
SAMHSA’s Treatment Routing: 1-800-662-HELP
PA Single County Authorities: www.paedaa.org
Overdose Prevention Resources: overdosefreepa.org
Alcoholics Anonymous: 1-212-870-3400
Narcotics Anonymous: 1-818-773-9999
Tobacco Free Quitline: 1-800-QUIT-NOW
Rather than shy away from these conversations, it is our responsibility as physical therapists to explore options and actively listen to our patients without judgment. Patients are more likely to open up about their behaviors when they feel heard.
-Katie Schuetz, SPT
-Layne Gable, SPT