A screening and brief intervention program with Alaskan Natives: The Connections SBIRT experience

Introduction: Connections SBIRT provides screening, brief intervention, and referral to treatment services for adults in primary health care settings and generalist community settings in Anchorage, Alaska. The SBIRT program was developed by Cook Inlet Tribal Council (CITC) in partnership with the Southcentral Foundation (SCF) and is funded by SAMHSA's Center for Substance Abuse Treatment (CSAT) for the period 2003 - 2008. The purpose of this paper is to describe the SBIRT model and share experiences and challenges implementing a screening and brief intervention program in Alaska. Program Model: The screenings are conducted by specialists using the AUDIT screening instrument and one drug use question. The brief intervention consists of up to five 15 minute sessions, occurring once monthly, using motivational interviewing and the FRAMES model (Feedback, Responsibility, Advice, Menu of options, Empathy, and Self-Efficacy). Brief treatment consists of 6 to 8 sessions focused on building the client's motivation to quit, analyzing the client's drinking/drugging patterns, and identifying situations that may cause relapse. Results: As of January, 2007, Connections SBIRT screened 17,721 individuals: 13.9% were brief interventions, 2.3% were brief treatment, and 6.2% were referrals to specialty treatment programs. Discussion: Connections SBIRT has achieved a variety of accomplishments. In addition to its role as services provider, the group has also shared its experiences with other Native American organizations (for example, the Cherokee Nation in Oklahoma) as well as presented findings to international audiences. Connections SBIRT has developed a unique program and served an important role in the community.