CHHS researchers win $526,000 grant to better treat substance use

An interdisciplinary team of researchers at Western Michigan University has received a $526,192 grant to improve substance use screening and boost intervention and referral services.

The grant, from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, was awarded to Dr. Tiffany Lee, assistant professor in the WMU Specialty Program in Alcohol and Drug Abuse, Dr. Stephen E. Craig, associate professor of counselor education and counseling psychology, and Denise Bowen, assistant professor in the physician assistant department. The grant will fund a multi-faceted, three-year study titled Screening, Brief Intervention and Referral to Treatment Training with Students and Community Organizations in the Health Professions in West Michigan.

The project has three major initiatives, says Lee, the grant's principal investigator and project director:

• Train both counseling and physician assistant students. As part of the curriculum in the physician assistant, clinical mental health counseling and counseling psychology graduate programs, more than 100 students will learn substance use screening and referral techniques, take part in a videotaped role play exercise and be followed through their internship or clinical experience and one year after graduation. Students will learn empirically based screening tools and methods of motivational interviewing to more effectively screen and refer patients and clients to services.
• Community outreach. Free workshops on substance use screening, brief intervention and referral to treatment--SBIRT--will be provided to hundreds of health care professionals in the community working at a variety of agencies and organizations. The training has already been implemented at the Kalamazoo Department of Human Services, Kalamazoo Community Mental Health and WMU Counseling Center. In April, the team will train staff at the Family Health Center. The investigators will present SBIRT to at least 140 participants each year and collect data using pre- and post-tests, as well as a 30-day follow-up survey. The number of participants is expected to increase due to the requests for subsequent training by the participants at the agencies identified above.
• Online training.  A four-hour online training program will extend SBIRT education to professionals in other parts of the country. This training will provide participants with continuing education credits upon completion of the training, and the program is free to those who submit the pre- and post-test surveys. Lee hopes to reach some 300 medical and mental health professionals in the first year of the grant cycle.

The screening, brief intervention and referral process were first employed in the medical profession, Lee says.

"Research indicated that people weren't being screened at all, or if they were being screened, it wasn't adequate," she says. "And even if they were screened, they weren't referred or the problem wasn't addressed."

The U.S. Department of Health and Human Services' SAMHSA spent millions of dollars to train medical professionals in screening and brief intervention techniques, Lee says. Now the agency is appropriating additional funding to train professionals in other disciplines. WMU is among the first to obtain funding to train counselors, psychologists, social workers, child protective investigators, foster care workers and other professionals.

The techniques go beyond just identifying a problem, Lee says.

"Once a patient or client indicates that they have risky substance use behaviors, trainees learn how to intervene in a way that doesn't cause resistance," she says. "When someone pushes you to change and you're not ready, oftentimes there's resistance."

The training utilizes motivational interviewing techniques, which make use of the client's motivators for change. If appropriate, they are then referred to the right program, agency or treatment center.

A person could be seeking help for a problem like sleeplessness or depression. Through screening it is discovered they have a risky substance use, and the sleeplessness or depression are a symptom of that. Or a social worker could be investigating a complaint of child abuse or neglect, and it's found the parent is suffering from addiction. Treatment for an alcohol or drug problem might better address everything.

"It's, hopefully, benefiting our society as a whole to do this and provide treatment," Lee says. "They say that, statistically, for every dollar spent on treatment, it saves society as a whole $7. So the importance of doing this is pivotal."

The grant project also has a research component, Lee says. With the help of graduate assistants, the team will assess how well participants are utilizing the techniques.

"We're excited about not only providing the training, but seeing if there's movement towards a higher level of competency and if are they using this in their practice," she says. "So it's not just training."