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Brief Interventions

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Brief Interventions

0.5 hr CE

Goal: To provide brief office interventions for patient alcohol use problems.

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Activity Steps

1. Activity Content
2. Post-Assessments
3. Earn Certificate

Funding: Initial development of this activity was supported by funding from the National Institute on Alcohol Abuse and Alcoholism (Grant #1 R43 AA026474-01).

This activity is designed to change: Competence, Performance, Patient Outcome. 0.5 hr

Overview

Needs and Training Gaps

Educational Objectives:

After completing this activity, participants will be able to:

  • Assess willingness to change in patients having alcohol use problems.
  • Perform a brief intervention for patients who misuse alcohol.
  • Manage relapse to alcohol use, encouraging patients who relapse to attempt treatment again.

Training Activity References

Audience and Accreditation

Audience: Health professionals

TypeEst. TimeReleasedExpires
DCBN0.5 hr(s)4/9/214/8/23
FBN CNA0.5 hr(s)4/9/214/8/23

Accreditation Statement: Clinical Tools, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

DCBN Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 0.5 hour(s) of DCBN credit. Clinical Tools, Inc. is an approved provider by the District of Columbia Board of Nursing and is registered with CE Broker, Provider #50-1942.

FBN CNA Credit Statement: Clinical Tools, Inc. designates this enduring material for a maximum of 0.5 hour(s) of FBN CNA credit (Florida Board of Nursing – Certified Nursing Assistants). Providers and other health professionals should claim only the credit commensurate with the extent of their participation in the activity.

Arkansas State Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Arkansas State Board of Nursing as an accredited provider of continuing medical education for nurses.

Georgia Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the Georgia Board of Nursing as an accredited provider of continuing medical education for nurses.

New Mexico State Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the New Mexico State Board of Nursing as an accredited provider of continuing medical education for nurses.

South Carolina Board of Nursing Accreditation Statement: Clinical Tools, Inc. is recognized by the South Carolina Board of Nursing as an accredited provider of continuing medical education for nurses.

A letter of completion for 0.5 hours is available.

A score of 70% on the post-test is required to complete the activity.

Participation Requirements

Authors

Clinical Tools, Inc. requires everyone who is in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest to the provider, which are defined as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Any conflicts of interest are resolved prior to the delivery of the educational activity to the learner. CTI does not permit individuals with financial conflicts of interest to participate in any stage of activity development.

T Bradley Tanner, MD (President, Clinical Tools, Inc.)
Disclosure: Has disclosed no relevant financial relationships. Dr. Tanner is the owner of Clinical Tools.

Read Bio
T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on BupPractice.com. He also has a strong background in technology and oversees the development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role as a Clinical Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.

Karen Rossie, DDS, PhD (Research Scientist, Clinical Tools, Inc. )
Disclosure: Has disclosed no relevant financial relationships.

Read Bio
Karen Rossie, DDS, PhD, directs projects at Clinical Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University, and later, a PhD in Psychology from the Institute of Transpersonal Psychology. She taught and practiced oral pathology and oral medicine for 15 years at the Ohio State University and the University of Pittsburgh, doing research in autoimmune disease, viral effects in bone marrow transplantation, oral cancer, salivary gland disease, candidiasis, and diabetes. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, screening and brief interventions for substance abuse, obesity, and pain and addiction.

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Funding Information Development of this website was funded by grant #2R44AA026474 from the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health. The website contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH. No commercial support is received.
Clinical Tools is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Training Activity References

Agerwala SM, McCance-Katz EF. Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: A brief review. J Psychoactive Drugs. 2012; 44: 307-317. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801194/ Accessed on: 2015-06-10.

Bowen S, Witkiewitz K, Clifasefi SL, Grow J, Chawla N, Hsu SH, Carroll HA, Harrop E, Collins SE, Lustyk MK, Marimer ME. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders. JAMA Psychiatry. 2014; 71: 547-556. Available at: http://archpsyc.jamanetwork.com/article.aspx?articleid=1839290 Accessed on: 2015-06-24.

BSAS. SBIRT: A Step-By-Step Guide. MASBIRT. 2012. Available at: http://www.masbirt.org/sites/www.masbirt.org/files/documents/toolkit.pdf Accessed on: 2015-03-19.

CASAColumbia. An SBIRT Implementation and Process Change Manual for Practitioners. The National Center on Addiction and Substance Abuse at Columbia University. 2012. Available at: http://www.casacolumbia.org/sites/default/files/files/An-SBIRT-implementation-and-process-change-manual-for-practitioners.pdf Accessed on: 2015-03-19.

CDC. Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use A Step-by-Step Guide for Primary Care Practices . National Center on Birth Defects and Developmental Disabilities . 2014. Available at: http://www.cdc.gov/ncbddd/fasd/documents/alcoholsbiimplementationguide.pdf Accessed on: 2015-03-10.

Fiellin DA, Reid MC, O’Connor PG. Screening for alcohol problems in primary care: a systemic review. Archives of Internal Medicine. 2000; 160: 1977-1789.

Gubi PM, Marsden-Hughes H. Exploring the processes involved in long-term recovery from chronic alcohol addiction within an abstinence-based model: Implications for practice. Counselling and Psychotherapy Research. 2013; 13: 201-209. Available at: http://www.tandfonline.com/doi/abs/10.1080/14733145.2012.733716 Accessed on: 2015-06-16.

Hendershot CS, Witkiewitz K, George WH, Marlatt GA. Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention, and Policy. 2011; 6: . Available at: http://www.substanceabusepolicy.com/content/6/1/17 Accessed on: 2015-06-17.

Kaskutas LA, Borkman TJ, Laudet A, Ritter LA, Witbrodt J, Subbaraman MS, Stunz A, Bond J. Elements that define recovery: The experiential perspective. J Stud Alcohol Drugs. 2014; 75: 999-1010. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25343658 Accessed on: 2015-06-16.

Kazemi DM, Wagenfield M, Van Horn RK, Levine MJ, Dmochowski J. Binge drinking among underage college students: Role of impulsivity and the transtheoretical model. Journal of Nursing Addiction. 2011; 22: 193-199. Available at: http://informahealthcare.com/doi/abs/10.3109/10884602.2011.616605 Accessed on: 2015-06-23.

Le Berre AP, Vabret F, Cauvin C, Pinon K, Allain P, Pitel AL, Eustache F, Beaunieux H. Cognitive barriers to readiness to change in alcohol-dependent patients. Alcoholism: Clinical and Experimental Research. 2012; 36: 1542-1549. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22458335 Accessed on: 2015-06-18.

Miller WR, Sanchez VC. Motivating Young Adults for Treatment and Lifestyle Change. Howard G, ed. Issues in Alcohol Use and Misuse by Young Adults. Notre Dame, IN. University of Notre Dame Press. 1994.

NIDA. Principles of drug addiction treatment: A research-based guide. NIDA. 2012. Available at: http://www.drugabuse.gov/sites/default/files/podat_1.pdf Accessed on: 2015-03-30.

Norcross JC, Krebs PM, Prochaska JO. Stages of change. Journal of Clinical Psychology. 2011; 67: 143-154. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21157930 Accessed on: 2015-06-18.

Pisinger C, Aadahl M, Toft U, Jørgensen T. Motives to quit smoking and reasons to relapse differ by socioeconomic status. Preventive Medicine. 2011; 52: 48-52. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21047525 Accessed on: 2015-06-25.

Prochaska JO, DiClemente CC. Transtheoretical therapy: toward a more integrative model of change. Psychotherapy: Theory, Research and Practice. 1982; 19: 276-288. Available at: http://psycnet.apa.org/journals/pst/19/3/276/

Robinson LM, Vail SR. An integrative review of adolescent smoking cessation using the transtheoretical model of change. Journal of Pediatric Health Care. 2012; 26: 336-345. Available at: http://www.jpedhc.org/article/S0891-5245(10)00381-0/abstract?cc=y= Accessed on: 2015-06-11.

SAMHSA. Quick Guide For Clinicians Based on TIP 34 . U.S. Department of Health and Human Services. 2001-2011. Available at: https://store.samhsa.gov/shin/content/SMA06-4136/SMA06-4136.pdfAccessed on: 2015-03-19.

SAMHSA. SAMHSA’s working definition of recovery. SAMHSA. 2012. Available at: http://store.samhsa.gov/shin/content//PEP12-RECDEF/PEP12-RECDEF.pdf Accessed on: 2015-06-11.

SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). SAMHSA. 2014. Available at: http://www.samhsa.gov/sbirtAccessed on: 2015-03-20.

SAMHSA. White Paper on Screening, Brief Intervention and Referral to Treatment (SBIRT) in Behavioral Healthcare. SAMHSA. 2011. Available at: http://www.samhsa.gov/sites/default/files/sbirtwhitepaper_0.pdf Accessed on: 2015-04-28.

White WL. Recovery/remission from substance use disorders: An analysis of reported outcomes in 415 scientific reports, 1868-2011. Philadelphia Department of Behavioral Health and Intellectual disAbility Services. 2012. Available at: http://www.naadac.org/assets/1959/whitewl2012_recoveryremission_from_substance_abuse_disorders.pdf Accessed on: 2015-06-15.

Primary care physicians (PCPs) and other health care providers can have an overall positive effect on the patients they treat. Since about 70% of the population visits a PCP at least every other year, this puts the health care provider in a unique position to help (CASA 2000). Alcohol use continues to be a widespread public and social health problem. The health care provider needs to be able to screen for drinking in patients and assess, provide brief interventions, and/or make appropriate referrals when screening results are positive. Routine screening of all adults and adolescents for the continuum of alcohol use problems is currently recommended (NIAAA 2007) but does not always occur. The reality is that few physicians or other health care providers are routinely providing screening or intervention with their patients (D’Amico et al., 2005). Routine screening of all adults and adolescents for the continuum of alcohol use problems is currently recommended (NIAAA 2007).

At-risk drinkers can be effectively treated solely in primary care by using brief interventions (SAMHSA, 2014). Motivational interviewing skills can be used as a part of brief interventions for alcohol use problems. No two patients with alcohol use disorders will respond to treatment in the same manner. Alcohol abuse can affect anyone, regardless of age, gender, race, or specific lifestyle situations. As a health professional, it will be important for you to tailor your patient interviews about alcohol use to the patient’s age, gender, and race.

Alcohol addiction is a complex disease, and continued research provides insight into the biological basis of this disease. Patient education is key to increasing compliance and thus improving the success of treatment.

Training Gap References

CASA. National Survey of Primary Care Physicians and Patients on Substance Abuse. The National Center on Addiction and Substance Abuse at Columbia University. 2000.

D’Amico EJ, Paddock SM, Burnam A, Kung FY. Identification of and guidance for problem drinking by general medical providers: results from a national survey. Medical Care. 2005; 43(3): 229-236.

National Survey of Primary Care Physicians and Patients on Substance Abuse. The National Center on Addiction and Substance Abuse at Columbia University. 2000.

NIH. Alcohol-Related Traffic Deaths Fact Sheet. NIH. 2010. Available at: http://report.nih.gov/NIHfactsheets/Pdfs/AlcoholRelatedTrafficDeaths(NIAAA).pdf Accessed on: 2015-05-07.

SAMHSA. Screening, Brief Intervention, and Referral to Treatment (SBIRT). SAMHSA. 2014. Available at: http://www.samhsa.gov/sbirt Accessed on: 2015-03-20.

Participation Requirements

Activity Credit: Obtaining credit for participation in this activity requires that you complete the pre-assessments, work through the modules (including all in-module interactive activities), complete the post-assessments with a 70% score on the post-test, and then request credit. At the end of the activity, you will be instructed on how to print out a certificate for your records.

Time Requirement: Keep track of the amount of time it takes you to complete this activity. You will be required to spend a set amount of time in order to claim credit. You should claim credit only for the time actually spent in the activity.

Technical Requirement: To participate in this activity, you will need a computer, an Internet connection, and a Web browser. This activity requires Chrome, Firefox, and IE7 or higher.