Effectiveness and Durability of a Mixed-Methods SBIRT/MI Training for First-Year MSW Students

Background: Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based process to facilitate prevention and treatment of alcohol and other substance use, and typically utilizes motivational interviewing (MI) as a supportive skillset.  In order to facilitate implementation and dissemination of SBIRT, the Substance Abuse and Mental Health Services Administration (SAMHSA) funded 17 five-year training programs for physicians in 2008-2009 that produced substantive information on training outcomes for medical residents. Social workers, however, have only been included in the SAMHSA SBIRT training program since 2013, and comparatively little has been documented regarding training methods and outcomes for this group of medical professionals. This study examined the effects of a mixed-methods SBIRT/MI training structure (one hour online, four hours in-person) on MSW students’ knowledge, attitudes, and beliefs toward SBIRT and related behaviors.

Methods:  Data were collected using a longitudinal survey design with three administration points: prior to enrolling in the SBIRT/MI training (paper administration), immediately following the training (paper administration), and 30 days following the training (electronic administration). The researchers recruited first-year MSW students enrolled at a large, urban, public university during the 2014-2015 academic year (n=95). Most participants identified as female (80%), non-Hispanic (99%), and white (83%).  Due to response attrition at 30-day follow-up (82% response rate), the sample used for this study was smaller (n=78) than the targeted population.

The survey instrument contained performance and satisfaction metrics designed to inform training program improvement. Of those items, 19 were taken from a prior survey of knowledge, attitudes, and beliefs about SBIRT that were predictive of likely behavioral performance in the field (Gassman, 2003) and were considered relevant to the study at hand. One-way analysis of variance (ANOVA, α=0.05) was utilized to determine whether students’ mean scores were affected by the training. Post-hoc analyses, either Tukey’s HSD or Games-Howell (contingent on homogeneity of variance), were utilized to further elucidate the differences.

Results: The ANOVA analysis revealed significant post-training improvement in five key areas: knowing what questions to ask patients to obtain information on their alcohol consumption* (F=35.30, p<0.001), comfort asking about a patient’s drinking patterns* (F=3.59, p=0.03), knowing how to effectively help patients reduce their drinking (F=54.97, p<0.001), ease making these sorts of statements* (F=13.40, p<0.001), and endorsement of the belief that care providers can help patients reduce alcohol consumption (F=4.83, p=0.009). Post-hoc tests indicated that observed improvements were sustained for at least 30 days in the indicated (*) areas.

Implications: Findings suggest that the mixed-methods SBIRT/MI training produced short and moderate-term sustained improvements in some key affective areas, but was not effective in other areas – such as normative beliefs about whether and how other social workers manage client alcohol use. Future educational interventions in this area may benefit from adding content regarding the extent to which integration of behavioral health and substance use prevention and treatment is becoming normative in the United States. Educators may also benefit from strategizing as to how to sustain improvements in knowledge, attitudes, and beliefs over longer periods of time.