SBIRT: A Case Study

There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse. Or allow it run rampant throughout the community. Often times, we hear and read about the level of substance abuse among teen, young adults and mid-aged

Substance abuse is difficult to treat no matter the background someone comes from, but adding sociocultural influences from diverse cultures can add an even more difficult element when it comes to effective prevention and intervention strategies. The United States is a melting pot of diverse cultures, with the Hispanic population accounting for “one-half of the nation’s growth” (Steven & Smith, 2013, p. 328). When it comes to treating Hispanic individuals for substance abuse issues, one needs to be aware of the cultural differences and acculturation issues that are characteristic of this culture. Clinicians who work with the Hispanic population need to understand their cultural values and respect their diversity so that barriers to treatment can be overcome.

Gruber, K.J., & Taylor M.F. (2006). A family perspective for substance abuse: Implications from the literature. Journal of Social

Drinking alcohol is a behavior that diverse ethnicities and cultures have adapted as a form of leisure, celebration, socialization, or cultural practice. Mexican American males have engaged in drinking alcohol for all of these reasons. It is important to analyze the process of acculturation Mexican American experience and how it affects their ability to persuade and control their alcohol consumption. The stress of adjusting to a new place than the one they have been accustomed to and have already been accepted in, can lead males to drink alcohol to help them in coping with their issues. The gravity of extreme alcohol drinking is also

Attempting to treat individuals that have alcohol related issues requires a depth of knowledge and skill, specifically, when providing care to individuals of differentiating ethnic and cultural backgrounds. The National on Alcohol Abuse and Alcoholism (NIAAA) article discusses a multitude of resourceful information that is related to ethnicity, culture, and alcohol. Procuring detailed information that defines and discusses ethnicity, race, culture, cultural identification, ethnoculturally competence, and cultural competence provides a solid foundation for the beginner, intermediate, and expert clinician reading this material. This paper explores and offers an explanation of the author’s efforts to convey a clear, compelling and cogent message, the NIAAAs use of relevant sources to substantiate perspectives assumed, claims made and positions taken, and recommended strategies regarding suggested improvements to this article.

Latinos have a strong culture, as well as a religious culture. Some believe many problems may be fixed with prayer as well as with traditional healers (Alegria et al. 2008a; Berenzon-Gorn 2006; Espin 1987 as cited in Lorenzo-Blanco, & Delva, 2012). They have a lot of faith in religious ceremonies and home remedies before seeking professional help. Latinos seek help with family members before anyone professional (Bermúdez, Kirkpatrick, Hecker, & Torres-Robles, 2010). Latinos most of the time have a big family size, and are always really close. Seeking help with family members, they believe will be more help if the family member has had a similar situation, and they believe their advice can help. Although Latinos don’t always seek professional help, they prefer family therapy (Szapocznik et al. 1989 as cited in Bermúdez, Kirkpatrick, Hecker, & Torres-Robles, 2010). Some prefer to work out their issue together as a family. Overall, when Latinos ask for help, they go to priests, psychiatrists, counselor, and therapists (Bermúdez, Kirkpatrick, Hecker, & Torres-Robles, 2010).

As a social worker using the SBIRT the assess and address Hispanics and substance abuse. SBIRT is an abbreviation for screening, brief intervention and referral to treatment and it used mostly by healthcare professional when dealing with mental and behavioral health problems. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The first step in the SBIRT process requires health care professions and social workers to conduct a screen on their clients. Screen clients will allow for social workers to assess current and past information on substance abuse uses and behaviors. It is very important for social worker and other professions to be culturally aware of the population they are servicing. “Cultural awareness involves social workers being cognisant of their ethnic background, values, perceptions and views that might affect their relations with the client” (Band-winterstein & Freund, 2015, p.969).. Language Barriers, religion, cultures, and values are some factors social workers should be knowledgeable about when working with Hispanics. The final step of the SBIRT involves utilizing a brief intervention and referral sources for clients. The SBIRT is mainly based on strategies utilized during motivational

On June 26, 2015, we visited an Alcoholic Anonymous Hispanic group called “Poco a Poco”. The group was composed of eleven males and two females. Their ages were thirty years old to fifty five years old, which puts them in the middle adulthood stage. The group that was participating in the AA meeting was composed of different levels of education and socioeconomic status. One participant that was from a high income background and the rest were from a low and middle income background. Next to the group’s room, was another group waiting. We did not know its name, but the members' ethnicity was non-Hispanic. We reached the location fifteen minutes early which gave us the opportunity to observe the two different

Many generations may reside in one residence where there is a clear patriarchy (GCU, n.d.). Considering the importance that Latino/Hispanics place on familia and how central a person’s role within the family is to individual identity, it becomes painfully obvious how a family disease such as addiction can be especially devastating to their community. In an adult individual, it becomes a challenge to distinguish whether the addiction causes or results from the family disconnection (Flores, 2014, p. 28). The addicted person tends to be a product of family instability, dysfunctional family environment, and hostile parenting (p. 26), all of which is exacerbated and perpetuated by substance abuse. This cycle of sickness may have begun with the destructive effects of immigration on the original family and trickled into later generations. In 2006, studies indicated that, on a regular basis, 40% of Latino/Hispanic adolescents used alcohol, 24% smoked cigarettes, and 17% used marijuana (SAMHSA National Survey of Drug Use and Health results, cited by Wagner et al., 2010, p. 98). Flores reports that alcoholism rates seem highest within the Hispanic population of Mexican descent (cited by GCU). Unfortunately, heavily acculturated Latinos/Hispanics can be resistant to mental health treatment due to machismo, the fear of

Immigrants who have moved from their origin of birth have changes their set of cultural norms and values. This is seen in Hispanics who have moved to the United States. Most of the women who are sensitive to changes are Cuban American, Puerto Rican, and Mexican American women. They state their drinking behavior has increased because of the dominant society. Washington State conducted a study that showed an accelerated abuse of alcohol and use of illegal drugs within the Hispanic culture. The increase was 7.2%, which was compared with less than 1% of others and 6.4% of whites (Abbott, 2008).

Although all sorts of families can be devastated by addiction, but single parent units (the most common lower class structure) are the most obscured. Behavioral Health of the Palm Beaches supports, “In every family unit, each person plays a role (or multiple roles) to help the family function better and to maintain a level of homeostasis, stability and balance. When substance abuse is added to this dynamic, the family roles naturally shift to adjust to the new behaviors associated with drug or alcohol use, and to continue maintaining order and balance.”4 In single parent units there is an inability of a second parent to fill the void role of the addicted parent. The National Center for Biotechnology Information states, “Frequently, children may act as surrogate spouses for the parent who abuses substances. For example, [young] children may develop elaborate systems of denial to protect themselves against that reality of the parent’s addiction. Because that option does not exist in a single‐parent household with a parent who abuses substances, children are likely to behave in a manner that is not age‐appropriate to compensate for the parental deficiency.”2 So a child growing up in a compromised family unit where addiction is present may develop altered norms and mature into an addict themselves.4

According to (AA.org) the drinking habits and patters of consumptions among Latinos changes due to many circumstances. “One reason that some Hispanics drink more than others here in the USA depends on factors such as accessibility and affordability”. Secondly, because of isolation from their loved ones as they become more susceptible to engage in risky drinking habits than in their countries.

The standardized Screening, Brief Intervention & Referral to Treatment (SBIRT) instrument form is a comprehensive, integrated tool that can enable health professionals in any setting to quickly assess persons with substance use disorders (SUDs) or at risk of developing these disorders, to deliver early intervention to at-risk substance users, and assist those in need of a brief intervention or more intensive treatment receive appropriate treatment services (SAMHSA, 2015). The SBIRT form consists of few sections. It incorporates a 10-item Alcohol Use Disorders Identification Test (AUDIT) questionnaire made of two sections: the alcohol pre-screen which is the first level screen that assesses patients or clients for alcohol use and consists of questions one to three, and the full screen which consists of questions four to 10 and identifies signs of dependence with questions four to six and related problems with questions seven to 10.

The substance abuse of a parent has a lasting and apparent effect on all young children. There are a number of substances that can become a problem in people’s lives, including but not limited to; marijuana, alcohol, stimulants, depressants, narcotics, hallucinogens and inhalants. Drugs critically affect the individual taking them, but also affect the members of the household, especially children. Not only does the person’s addiction emotionally, mentally, and physically affect the individual lives of other members of the family, but it tears apart relationships between the families. Arguments, disagreements, violence, and stress can derive from the abuse of drugs because of the tension it puts on one’s other members of the family.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is commonly used to identify, reduce, and prevent abuse and dependence on alcohol and banned drugs ("Screening, Brief Intervention, and Referral to Treatment (SBIRT) Health Professions Student Training," 2000). This assessment can be broken down simply by: a) conducting a screening where the clinician assesses a patient for risky substance use behaviors using standardized screening tools b) having a brief intervention where the clinician holds a short conversation, then provides feedback and offering advice c) lastly, the clinician can provide a referral to brief therapy or additional treatment for patients in need of the services ("Resource,"2000). Thus, making this a very useful