- About MASBIRT TTA
- SBIRT information
Thank you so much for coming to class this past week. I enjoyed your presentation as did the students...this is such important work that you are doing and I really appreciate your efforts to educate nurses who are such important front line providers.Thank you so much!
Betty Morgan, UMass Lowell School of Nursing
Practice Manager Experience:
I wanted to write and thank you again for providing such an in-depth and high quality Motivational Interviewing for our primary care and behavioral health staff. Our staff got a lot out of it, and it will really help us get to the next level.
Louise Weed, Medical Practice Manager & PCMH Project Manger at Codman Square Health Center
Read MASBIRT's feature story, "Questions & Answers: New approach to asking patients about drinking and drug use yields positive results" from the November 10, 2010 issue of the Boston Globe.
Primary Care Provider Experience:
As a primary care pediatrician in the adolescent center at Boston Medical Center, MASBIRT became a very natural part of our clinical practice. Cindy, our MASBIRT Health Promotion Advocate quickly integrated herself into the fabric of our busy clinic without disrupting patient flow.
I always found Cindy added value to my patient visits because she often got different information than I did about the extent of substance use, and triggers for substance use that were of medical significance. For example, during her conversations with patients about substance use, she often discovered mood disorders, violence exposure, and sexual and dating violence. As the medical provider, I was then able to work with Cindy and the teen to address the root causes of substance use. This is really a more satisfying approach for both the patient and the physician.
I was also pleasantly surprised that parents did not mind Cindy screening their children for unhealthy substance use. It quickly became part of the culture of the clinic. While medical providers realize that substance use is an important issue in taking care of teens, they are often hamstrung by competing clinical demands.
Dr. John Knight at Children’s Hospital in Boston identified barriers to screening for substance use in teens: lack of time, lack of training, triaging competing concerns, lack of treatment resources, tenacious parents who won’t leave the room, and unfamiliarity with screening tools. MASBIRT Health Promotion Advocates lower most of these barriers, making it possible to do universal screening for unhealthy substance use in real time.
Susan Gray, MD, BMC provider
Health Promotion Advocate Experience:
As a MASBIRT Health Promotion Advocate I have seen the negative effects of drugs and alcohol on our patients and their families. Many of our patients do not recognize that their level of substance use is unhealthy. They are functioning at work, and at home and miss the subtle signs of the negative effects of their substance use on their health and personal lives.
MASBIRT training has provided me with the tools to accurately identify those patients at risk from their substance use before they develop more severe substance use problems such as addiction. For those patients who have addiction, I am able to link with the help and services that they need.
Providing SBIRT services in general healthcare settings has created a culture where talking about unhealthy substance use is okay. Often a patient only needs a brief intervention to help them change their unhealthy behaviors. Patients are very open to SBIRT services since they are provided in a non-judgmental way with the ultimate goal to keep them healthy.
Here’s an example of a patient I recently saw: A woman in her late 40s came to see her primary care physician for a routine physical. Her son had recently taken a job out of state and she was feeling a little down. She identified herself as an “empty-nester soccer Mom.” She screened positive for unhealthy alcohol use. She was drinking about twice the NIAAA recommended weekly limits, having 3 glasses of wine each night. She had wondered if she drank too much but was not sure what was "too much". She did not identify any negative consequences from her drinking. I provided her with safe drinking guidelines and we developed a plan together on how she might cut back on her drinking. I informed her doctor of the screening results so that she could reinforce the plan. As a result of the conversation, a liver function test was ordered and indicated early liver problems. These test results helped to reinforce the risks discussed and further motivated the patient to decrease her drinking.
Erica Tamlyn, Health Promotion Advocate
Patient Experience: Note that this patient was screened by a Health Promotion Advocate and reported occasional binge drinking.
One of the things I notice is that with doctors you do get asked about alcohol and drug use but the person that I spoke with at MASBIRT was kind of more personal and approachable. When I spoke to the MASBIRT Health Promotion Advocate, Eric, he immediately set me at ease and was non-judgmental.
I know when a lot of doctors ask these questions you feel like they are judging you and that erodes credibility about my lifestyle choices. I felt more open to listening to Eric. No time prior to that had I left the office and thought more about my alcohol use. I immediately felt like I wanted to help Eric out. It was a brave thing to ask me those questions.
I don’t know how everyone reacts, but I appreciated it. I think like a lot of behavioral things the more times that people can be exposed to it in different ways (more shots on goal) the better. Some people would respond to doctors, some people would respond to Health Promotion Advocates. To have someone come in that isn’t a doctor, that seems more like you, might be more helpful. Made me want to open up and he did a great job.
John, 36 year old primary care patient
Administrative Staff Experience:
In our busy urban clinic MASBIRT has been a great benefit to the doctors and patients alike as it has brought a standardized and consistent screening process for unhealthy substance use to our clinic. The Health Promotion Advocates serve as a constant resource for both providers and patients helping to find placement for the patients that are requesting drug and alcohol treatment as well as alerting providers who may have potentially overlooked unhealthy substance use. It also assessing patient’s readiness to address the problem and motivates them to healthy changes.
As we move forward and the nation continues to struggle with economic uncertainty it is more important than ever to reach out and help those patients most at risk. MASBIRT provides an important resource for our community and health center as we continue to work with and for a community that has one of the highest drug related death rates in the region.
Administrative Staff at Community Health Center