Evaluation of Alcohol Screening,Brief Intervention,and Referral to Treatment (SBIRT) Training for Social Workers

Social work education is well positioned for workforce development initiatives that prepare practitioners to use Screening, Brief Intervention, and Referral to Treatment (SBIRT) with people at risk for alcohol use disorders. This article presents preliminary process and outcome evaluation data from the first year of a three-year grant which suggests that the training is acceptable and results in significant changes in trainees’ knowledge, attitudes, and self-perceived SBIRT skills. Training was embedded within the curricula of an urban school of social work, which includes a Bachelor of Social Work (BSW) program and a single-concentration clinical Master of Social Work (MSW). Trainees included social work students (n = 134) and field instructors (n = 38). More than 90% of students were very satisfied or satisfied with the training, and 100% of field instructors rated the training as excellent or good. Students demonstrated significant changes from pre- to posttraining in substance use knowledge, confidence in SBIRT skills, and attitudes about integrating SBIRT into practice. Field instructors reported increased confidence in screening. Integrating SBIRT training into social work curriculum is a promising method of developing a workforce that can effectively prevent and alleviate alcohol misuse.     

Enhancing Social Work Students’ Knowledge and Attitudes Regarding Substance-Using Clients Through SBIRT Training

ABSTRACT

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based protocol that addresses both moderate-risk and high-risk substance use problems for individuals. In an urban college’s master’s and bachelor’s social work programs with 218 students, SBIRT training was introduced into core course curricula, with many students subsequently using SBIRT in their field placements. Evaluation of the initiative demonstrated increases in the students’ knowledge and favorable attitudes regarding working with substance using clients. Students’ ratings of the usefulness and effectiveness of SBIRT were high. In response to studies indicating the lack of preparedness of graduating social work students to work with substance users, this study demonstrated the effectiveness of SBIRT training to educate students to work with this population.     

SBIRT Training in Social Work Education: Evaluating Change Using Standardized Patient Simulation

A grand challenge for social work is addressing widespread public health problems of alcohol misuse. MSW students (n = 83) received Screening, Brief Intervention, and Referral to Treatment (SBIRT) training through didactic sessions, role plays, and pre–post videotaped standardized patient (SP) interactions. SBIRT knowledge, self-reported practice behaviors, and confidence were assessed at pretest, 30 days, and 6 months posttest. Videos were coded to assess intervention-adherent behaviors. General linear mixed models analyzed changes. Participants demonstrated increased adherence to SBIRT behaviors, and knowledge, skills, and confidence increased posttraining. Findings suggest SBIRT training increases students’ capacity to implement evidence-based interventions designed to reduce alcohol misuse.     

Simulating Real Life: Enhancing Social Work Education on Alcohol Screening and Brief Intervention

Social work students typically use role play with student colleagues to practice clinical intervention skills. Practice with simulated clients (SCs) rather than classmates changes the dynamics of the role play and may improve learning. This is the first known study to employ the SC model in substance use assessment in social work education. Social work students completed a questionnaire assessing attitudes, knowledge, and perceived skills (AKS) regarding substance misuse prior to completing an online screening, brief intervention, and referral to treatment training, and then following role plays with SCs. Paired t-tests indicate increased confidence in substance use assessment and intervention ability, and stronger feelings that routine screening is critical to practice. Incorporating SCs with didactic learning increases students’ self-perceived ability to assess and change client behaviors and reduce substance misuse.     

Pediatricians could help SUD workforce by using SBIRT

Most studies on the use of screening, brief intervention and referral to treatment (SBIRT), a primary care model for screening and prevention of substance use, in adolescents have looked only at outcomes related to substance use. But SBIRT can also affect use of medical services, as well as comorbidities. Researchers found that SBIRT does reduce psychiatry visits, mental health diagnoses and chronic conditions at one and three years following the intervention. Ultimately, providing SBIRT in primary care may reduce utilization in other areas of health care later on, researchers write in the May issue of Pediatrics.     

Using the NIAAA brief alcohol screener in social work practice for selected prevention targeting youth

ABSTRACT

This article discusses the use of brief screeners in social work practice to identity adolescents in need of selected interventions for alcohol and other drug use problems. Brief screeners can increase access to alcohol or other drug intervention services and promote the diffusion of evidence-based interventions to underserved communities when integrated in Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiatives. The two-item NIAAA Brief Alcohol Use Screener is discussed as a developmentally tailored assessment tool that can be integrated into SBIRT in social work practice to improve detection of early-stage alcohol problems among adolescents who lack routine access to preventative health care. The use of brief, empirically supported alcohol screeners in trainings for social work students and new professionals can enhance their preparation and competence to offer child and adolescent clients appropriate selected intervention options to reduce harms associated with underage alcohol use.     

Understanding perceptions of substance use education in social work: an analysis of survey responses from MSW program leaders

ABSTRACT

This article details the findings of a series of analyses regarding how the institutional leaders of Master of Social Work Programs (MSW) in the United States form their perceptions on the role and implementation of substance use concepts in social work education. Five statistical tests were performed on data collected from a 2017 substance use education (SUE) survey of MSW program leaders, and the analyses were used to explore how program leaders form their perceptions on: the importance of SUE to social work, the need for regulatory measures for SUE in social work, the SUE needs of individual MSW programs, the implementation of substance use course content, and graduating students’ substance use intervention capacities. Significant findings from the analyses showed that: the amount of foundational course emphasis on clinical SUE within individual programs is a significant predictor of program leader perceptions on students’ clinical substance use intervention capacities; different categories of substance use intervention preparedness have interconnected effects among domains of preparedness; and perceptions on the importance of SUE to social work have a significant impact on program leaders’ opinions regarding regulatory measures for SUE in social work.     

Effects and Durability of an SBIRT Training Curriculum for First-Year MSW Students

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based process for identification, prevention, and treatment of alcohol misuse. The purpose of this study was to examine the effects of an alcohol-focused training on first-year MSW students’ (n = 71) knowledge, attitudes, and beliefs about SBIRT. Changes in item means were assessed using repeated-measures analysis of variance (critical α = .002). Data indicated a significant and strong main effect for training; perceived competence improved immediately and remained significantly higher 30 days posttraining. Other improvements included knowing what questions to ask patients, ease making alcohol-related statements, and believing that it is rewarding to work with at-risk patients.     

Implementing Rigorous Survey Methodology within Contexts of Social Work Education,Training and Practice: A Case Study in Substance Use

With the integration of evidence-based practice central to all areas of social work education and training across the globe, it is crucial that we continue to engage with the methodological challenges inherent in gathering this evidence, particularly when it is related to the nature of social work education itself. As a result, this paper addresses some of the methodological challenges involved in examining the education available to social workers on engaging with substance use, both within the social work academy and local authorities in England. Drawing on experiences of implementing large scale online surveys from three substantial research projects completed by the authors, this paper highlights four methodological themes: (1) Constructing a representative sampling frame; (2) Identifying participants within organisations with many departments; (3) Response rates; and (4) Questionnaire design. While these are familiar methodological considerations, this article draws attention to the specific complexities of gathering ‘representative’ knowledge to inform educational strategies on substance use within social work education and employment contexts. Finally this paper offers lessons learned and guidance for social work academics, students and practitioners who are minded to build, or draw from, an evidence-base using representative samples from and within these environments.     

Social work students’ professional and personal exposure to social work: an Australian experience

General career research suggests that many factors may influence how people select a career, including information about or exposure to the career. The focus of this paper is upon how exposure to a social worker personally (e.g. friend or family) or in a therapeutic capacity (e.g. received social work therapy) may influence the decision to become a social worker, when compared to other disciplines. The results showed that 63% of 64 social work students had personal and/or professional exposure to social work prior to making a career decision. When compared to other students (n?=?447) the social work students were significantly more likely to have accessed social work services (themselves or a family member). The influence of a friend who was a social worker and working with a social worker was noteworthy for mature-aged students. These results highlight that every interaction social workers have with the community provides valuable information about the profession and gives insight into social work as a career. Additionally, the results suggest that the increase in numbers of social workers and the influence of that exposure to a social worker have resulted in an increase in the use of social work services by students, and may continue to rise in the future.     

Repositioning Risk in Social Work Education: Reflections Arising from the Threat of SARS to Social Work Students in Hong Kong during their Field Practicum

The social work profession has always been involved in dealing with uncertainty and risk in the life politics of clients. However, it is not easy for young social work students to translate this philosophical disposition into their real life practice with clients. In spring 2003, when the SARS epidemic broke out in Hong Kong, a group of social work students from the Chinese University of Hong Kong were doing their fieldwork practicum. Suddenly confronted by a collective sense of risk in their role as social workers, the students went through a period of unrest, as performing their helping duties brought with it a simultaneous exposure to personal risk. This paper is based on four focus group interviews with these social work students, to understand how they processed their experience of risk during their exposure to the SARS crisis, and how they connected the experience to their social work practice with clients. It is found that the predicament arising from the exposure to personal risk brought about by the SARS crisis during the students' field placement engendered the reflective process that enabled a renewed and personalized meaning of professionalism. The results provide a basis for reflection among social work educators on the role of risk in the training of prospective social workers, and on how social work education can better prepare students for practice in a high‐risk environment.     

Teaching Note—Meeting the Demand for Behavioral Health Clinicians: Innovative Training Through the GLOBE Project

ABSTRACT

The national move toward integrated mental health and substance abuse service delivery has a significant impact on social work education and necessitates changes in how we train students. To address this need, the Global Leaders of Behavioral Health Education (GLOBE) training project was developed. GLOBE is a student training and stipend program that prepares students for clinical behavioral health practice in integrated care. This teaching note describes GLOBE, reports challenges encountered in its implementation, and provides strategies for overcoming them. The challenges include assigning students to grant-compliant field placements, engaging other health care professionals in the educational efforts, and implementing curriculum changes. Suggestions for social work program administrators interested in integrated care training are provided.     

Promoting Readiness to Practice: Which Learning Activities Promote Competence and Professional Identity for Student Social Workers During Practice Learning?

Practice learning is integral to the curriculum for qualifying social work students. Accreditation standards require regular student supervision and exposure to specific learning activities. Most agencies offer high-quality placements, but organizational cutbacks may affect supervision and restrict the development of competence and professional identity. Undergraduate social work students in Northern Ireland universities (n=396) were surveyed about the usefulness of the learning activities they received on placement for developing practice competence and professional social work identity. Results suggest that students most valued regular supervision, constructive feedback, observing social workers, and thinking critically about the social work role. Differences were reported across placements with students feeling disadvantaged in agencies where there was no clear social work role.     

Brief mindfulness training in the social work practice classroom

Social Work educators are increasingly concerned with discerning how to help students develop the affective, relational, and meta-cognitive skills needed for effective, resilient, and sustainable social work practice. A small but growing literature supports mindfulness training as a path to those ends. However, most mindfulness intervention studies, even those mentioning ‘brief intervention,’ have typically used fairly lengthy training programs, often 2–3 h per week for 6–8 weeks. It is unlikely that already over-committed social work practice classes would devote this amount of class time to these strategies. This concurrent mixed methods study examined whether very brief mindfulness training in undergraduate social work practice classes (100 min over the course of a 3.0 semester credit hour course) would influence outcomes on measures of mindfulness, emotional regulation, and empathy, as well as student perceptions of helpfulness in managing stress and meeting course goals. No significant differences were found on quantitative measures at post-test. However, results of the qualitative analysis suggest that even brief mindfulness exercises in social work practice classes are perceived by students as helpful for managing anxiety, staying present-focused with clients, reducing premature judgment, and feeling safe and connected in the classroom. Implications for social work education are discussed.     

Dementia: challenges for social work education in Europe

ABSTRACT

Dementia has been identified as a global challenge across the spectrum of health and social care (World Health Organisation. (2012) Dementia: A public health priority. Geneva: WHO). This paper will explore the implications of this for social work education and the challenges it poses. There is a lack of this focus on social work with older people and people with dementia (pwd) in social work education. Based on calls for an infusion of content on ageing and dementia in social work curricula, paper proposes that we should adopt a person-centred philosophy alongside gerontological social work competencies to achieve this. The specific aim of this paper, therefore, is to explore how we can use these ideas as teaching tools to engage social work students in the discourse on dementia and to develop appropriate skills to work with pwd, their families and carers.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

Substance Use Training Experiences and Needs: Findings From a National Survey of Social Care Professionals in England

For more than 30 years there have been calls in the UK to improve training for social workers in relation to substance use. Yet very little research has explored what training practitioners have received or what their training needs are. This study sought to establish practitioners' experiences of previous training in substance use and identify their current training needs. An online survey was disseminated to 3,164 practitioners in adults' (AS) and children's (CS) social care and 12 vignette-based focus groups were also held. Of the final sample of 597, more than a third of social workers had not received any training and a further fifth only received between one and four hours. Other social care staff fared worse. Overwhelmingly, respondents said that substance use knowledge and skills were very important to their practice but their professional education had not prepared them well. They identified a number of training needs including ‘how to talk to people about substance use’ and ‘the types of intervention and treatment available’. Most social care professionals report not being adequately prepared for working with substance use, particularly basic knowledge and skills which would help them to conduct assessments and signpost people to specialist substance services.     

Homophobia within schools of social work: the critical need for affirming classroom settings and effective preparation for service with the LGBTQ community

Social work programs must effectively meet the needs of their diverse lesbian, gay, bisexual, transgender, and queer (LGBTQ) student populations as well as effectively train all students to work with minority groups including the LGBTQ community. While many undergraduate and graduate social work programs provide open, supportive, and affirming experiences for LGBTQ students, there remain ongoing challenges related to hostility, stigma, heterosexism, and homophobia within classroom settings across programs in the US and Canada. This study examines classroom experiences of homophobia among 1,018 social work students. Qualitative data associated with three optional open-ended questions were analyzed utilizing grounded theory. Main qualitative findings identified several major themes associated with social work student experiences of homophobia in the classroom including: (1) Coming out; (2) Faculty inaction; (3) Implicit and explicit content; (4) Direct language and actions; and (5) Religious rationalizations and non-affirming positions. Conclusions and recommendations for social work education are discussed that center around creating safe and affirming classroom settings; the vital role of out faculty, students, and allies; impactful integration of diversity content within curricula, policies, and accreditation standards; ongoing training and mentorship; understanding the role of power and oppression; and a call to action among social work educators and the profession.     

Provider Preparedness for Treatment of Co-occurring Disorders: Comparison of Social Workers and Alcohol and Drug Counselors

Substance use and mental health disorders remain significant behavioral health concerns in the United States and other Western nations. Nearly half of the 20.3 million adults with substance use disorders in the US have a co-occurring mental illness . Despite growing research support, integrated treatment by providers with expertise in both mental health and substance use is critically lacking. As part of a co-occurring disorders (COD) training initiative in the USA, this study investigated providers' (n = 438) past training, current COD service provision, and future training needs. Specifically, we examined the extent to which social workers were prepared to treat individuals with COD compared to alcohol and drug counselors. Unsurprisingly, social workers reported receiving significantly more mental health related training, while alcohol and drug counselors reported more substance use related training. Alcohol and drug counselors reported significantly more COD-specific training including general COD, psychopharmacology, COD treatment, and relapse prevention. Social workers were significantly more likely than alcohol and drug counselors to report wanting more training in substance use disorders and culturally-specific intervention techniques. These findings suggest that tailored training and licensure changes are needed to enhance social workers' capacity for competent COD treatment.