From Clinicaltools.com

Course Details

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Brief Intervention and Treatment Referral

Description

Once a physician is able to isolate which of their patients need care for their alcohol use, 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.

Need

No two patients with alcohol use disorders will respond to treatment in the same manner. It is important to be competent in both providing a brief office intervention and knowing when a patient should be referred to a specialist.

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

To provide clinical skills training in brief interventions and the knowledge to make responsible, informed referrals.

Goal

Learners will be competent in performing brief office interventions. Learners will also know when and how to refer patients to other types of treatment for alcohol use disorders.

Learning Objectives

Assess a patient's willingness to change and use this assessment to motivate the patient towards treatment.
Provide a brief intervention to patients who misuse alcohol
Assess and refer those patients who are at a higher risk level to a specialist's care.
Manage patients who have relapsed and encourage those patients to attempt treatment again.

Case Studies

Case Study 1: Melissa

Educational Objectives

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), (2), and (4)

Expected Diagnosis: Alcohol abuse

Take Home Message/Practice Tip: Melissa has a dual role: discuss proper brief interventions and also discuss relapse as a part of recovery. 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.

Case Specifics

Patient: Melissa - 32 YOWF

Case Information: Melissa came in for her annual physical and during the lifestyle questions she reveals that she drinks alcohol.

Chief Complaint: Came in for annual physical, no physical complaints

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. 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.

Case Study 2: Sam

Educational Objectives

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

Course Objectives Met: (1) and (2)

Expected Diagnosis: Alcohol dependence

Take Home Message/Practice Tip: 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. It is important to have a motivational point which the patient can focus on and create a behavioral change.

Case Specifics

Patient: Sam - 43YOBM

Case Information: 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.

Chief Complaint: Admitted to hospital for abdominal pain, acute pancreatitis

Relevant Past Medical, Psychosocial, Family History: Son who is now getting old enough to understand the examples his father is setting forth. Known alcohol problem