Referral to Treatment

The additional step of referral to treatment has been added to recent brief intervention frameworks (e.g., Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs). This enables brief interventions to be offered to people with severe alcohol problems or dependence, such that, patients who are assessed to require more treatment, or do not respond to a brief intervention are referred for more intensive alcohol treatment.

TABLE 6.3: Key Components of Brief Interventions
Engagement Screening and assessment feedback Information Motivational Interviewing *General principles* Express empathy Highlight discrepancies between current behaviour and the client’s goals and values Resist the “righting reflex” (don’t tell your client what to do) Support self-efficacy Build motivation to address alcohol use Skills Ask open ended questions Listen reflectively Affirm Summarize Rate importance of making a change and confidence in making a change Build commitment to change and develop a change plan Skills Summarize/recapitulate Develop goals Develop a change plan Rate how likely it is the patient will implement their change plan Referral to further alcohol treatment (if required)

TABLE 6.3: Key Components of Brief Interventions

Engagement
Screening and assessment feedback
Information
Motivational Interviewing
- General principles
  - - Express empathy
    - Highlight discrepancies between current behaviour and the client’s goals and values
    - Resist the “righting reflex” (don’t tell your client what to do)
    - Support self-efficacy
- Build motivation to address alcohol use
  - - Skills
    - Ask open ended questions
    - Listen reflectively
    - Affirm
    - Summarize
    - Rate importance of making a change and confidence in making a change
- Build commitment to change and develop a change plan
  - - Skills
    - Summarize/recapitulate
    - Develop goals
    - Develop a change plan
    - Rate how likely it is the patient will implement their change plan
Referral to further alcohol treatment (if required)