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Contents 1 Brief Intervention and Treatment Referral 1.1 Description 1.2 URL 1.3 Need 1.4 Needs Analysis 1.5 Vision 1.6 Mission 1.7 Goal 1.8 Learning Objectives 2 Case Study 1: Melissa 3 Case Study 2: Sam 4 Module Evaluation and Review 4.1 Student Assessments 4.2 Consultant Review

Brief Intervention and Treatment Referral

Project Framework

Description

(Steve draft) Now that the physician is able to isolate which of their patients need care for their alcohol use which is negatively effecting their health, how do they go about providing an effective intervention which will halt their patient's negative use of alcohol.

This course provides an introduction to brief office interventions and how to refer patients to treatment if needed. Students will learn proper interviewing skills, choose appropriate treatment plans for different patients, treat withdrawal and prevent relapse.

URL

Brief Intervention and Treatment Referral (Draft)

Need

Students need to be able to create and implement a treatment plan and acquire effective interviewing skills that they can apply as part of the treatment plan.

Needs Analysis

In the spring of 2008, we conducted a focus group with 13 medical school faculty and addiction consultants. The results

Brief Summary: The focus group shaped our module outline and content. With a rating scale of 1-5, the importance of Detection, Diagnosis, and Assessment was rated 4.75, as was the belief that the average medical student would benefit from additional instruction in this topic. A rating of 4.42 was given on ease of inclusion for this module into the institution's current curriculum and a rating of 4.54 was given for personal willingness to include this module in current teachings. Faculty were very willing to encourage students to learn more about the topic, with a rating of 4.77, and the topic was deemed to align with recommended physician competencies in the area of substance abuse with a rating of 4.54. The most respondents (6) thought that the topic should have 2 hours of lecture time devoted to it. A number of aspects were requested for emphasis, which we took under consideration when creating the course content.

Vision

Physicians in training can conduct a brief intervention and determine the best course of treatment for patients with alcohol use disorders.

Mission

The CTI Solution.

The solution is learning how to provide a brief intervention and make responsible, informed referrals.

To provide students with clinical skills training in brief interventions, and illustrate different treatment options if a referral is necessary.

Goal

You will be able to conduct a patient brief intervention.

Learning Objectives

1. Assess a patient's willingness to change in order to treat alcohol misuse and use this assessment to motivate the patient towards treatment.
2. Provide a brief intervention to patients and determine whether a patient needs additional assistance with treatment, such as pharmacotherapy or a referral to an addiction specialist or treatment program.
3. Access and refer those patients, who are at a higher risk level, to a specialist's care.
4. Assess, manage, or refer a patient's withdrawal symptoms.
5. Manage patients who have relapsed and encourage those patients to attempt treatment again.

Case Study 1: Melissa

Case Focus: Melissa is presented in 1 page, then picked up again in 5 consecutive pages later in the course. The first time we encounter Melissa is after learning about Brief Interventions. The focus initially of Melissa is to introduce brief interventions; later, Melissa is revealed to have relapsed, and the physician counsels Melissa on giving abstinence another try.

Case Goal: The physician-in-training should learn when to pursue a brief intervention and also be aware that relapse is often a part of recovery.

Course Objectives Met: 1, 5

Patient: Melissa - 32YOWF

• Chief Complaint: Came in for annual physical, no physical complaints
• Narrative: Melissa came in for her annual physical and during the lifestyle questions she reveals that she drinks alcohol.
• Alcohol Use: She usually consumes 3-4 glasses of wine about 5 days/week. The most she has had in the past month is 6 drinks in one sitting.
• AUD Diagnosis: Alcohol abuse
• Relevant Past Medical, Psychosocial, Family History: Husband, who doesn't know she drinks as much as she does, and doesn't know she has relapsed
• Take Home Message: Melissa has a dual role: discuss proper brief interventions and also discuss relapse as a part of recovery.
• Practice Tip: A good social support system can help patients who have relapsed. In Melissa's case, her husband became supportive of the continued attempts at abstinence and even attended Al-anon meetings.
• URL's: Meet Melissa

Case Study 2: Sam

Case Focus: Sam is presented in 1 page following information on interviewing skills.

Case Goal: The physician-in-training should learn how to promote self-efficacy in the patient's motivation to change

Course Objectives Met: 2

Patient: Sam - 43YOBM

• Chief Complaint: Admitted to hospital for abdominal pain, acute pancreatitis
• Narrative: Sam is a 43 year old man who has a history of alcohol use and still drinks despite his condition. Sam's son is now old enough to understand what continued alcohol use is doing to his father.
• Alcohol Use: Known alcohol problem, no other information given
• AUD Diagnosis: Alcohol dependence
• Relevant Past Medical, Psychosocial, Family History: Son who is now getting old enough to understand the examples his father is setting forth
• Take Home Message: Sam has a motivation to change through the example he's setting for his son and the support he's getting from his family now
• Practice Tip: It is important to have a motivational point which the patient can focus on and create a behavioral change.
• URL's: Meet Sam; Case Study

Module Evaluation and Review

Student Assessments

• Knowledge questions

• ASEIB questions

Consultant Review