Screening, Brief Assessment and Referral to Treatment

The Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol helps identify people with problem gambling using evidence-based screening tools and provides recommendations for brief intervention or referral to treatment that is suitable for your client’s specific needs.¹

Gambling, Gaming & Technology Use
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SBIRT

The Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol is a process that community-based clinicians can use to identify clients with gambling problems, help them reduce their gambling, and prevent relapses.¹

This webpage explores the evidence on the benefits of using SBIRT as well as guidelines to identify and help clients with problem gambling. This information for providers of mental health and addiction services working in community healthcare organizations is based on a review of the literature and was reviewed by researchers and clinicians in the field.

About Screening, Brief Intervention and Referral to Treatment

The SBIRT protocol includes three steps:

Screening. The clinician uses a standardized screening tool to determine if the client engages in risky gambling.¹
Brief Intervention. If the screening results show moderate risk, the clinician may use a brief intervention to raise the client’s awareness of the potential consequences of their gambling and explore their motivation to change.¹ Brief interventions can last from 5 to 15 minutes.^2,3,4,5
Referral to Treatment. If the screening results show the client is at high risk, you may provide a referral to specialized treatment according to the client’s specific needs.¹

What does the evidence say?

While there is limited evidence on the benefits of using SBIRT for problem gambling, it has been shown to be effective in reducing substance use in a variety of client populations.^6,7,8

Screening measures for problem gambling are well established, especially among people seeking or receiving treatment for mental health and/or substance use (see Screening and Assessment).⁹

Brief interventions have been shown to reduce gambling frequency and prevent relapses, and the benefits appear to be as good as those achieved with longer interventions.^2,3,4,5

Putting the evidence into practice

To learn how you can apply the SBIRT protocol when working with clients who may be experiencing a gambling problem, see SBIRT for Problem Gambling – a Toolkit for Community and Healthcare Settings.

Simulation Video

The following video demonstrates the second step of a brief intervention. The focus of this step is to provide feedback on the results of a full gambling screen completed by the client.

References

Click to show references

SAMHSA-HRSA Center for Integrated Health Solutions. (n.d.). SBIRT: Screening, Brief Intervention, and Referral to Treatment. Retrieved April 12, 2019, 2019, from https://www.integration.samhsa.gov/clinical-practice/sbirt
Petry, N.M., Rash, C.J. & Alessi, S.M. (2017). A randomized controlled trial of brief interventions for problem gambling in substance use treatment patients. Journal of Consulting and Clinical Psychology, 84 (10), 874–886. https://doi.org/10.1037/ccp0000127.A
Toneatto, T. (2016). Single-session interventions for problem gambling may be as effective as longer treatments: Results of a randomized control trial. Addictive Behaviors, 52, 58–65. https://doi.org/10.1016/j.addbeh.2015.08.006
Abbott, M., Hodgins, D.C., Bellringer, M., Vandal, A.C., Palmer Du Preez, K., Landon, J., … Feigin, V. (2018). Brief telephone interventions for problem gambling: a randomized controlled trial. Addiction, 113 (5), 883–895. https://doi.org/10.1111/add.14149
Petry, N.M., Weinstock, J., Morasco, B.J. & Ledgerwood, D.M. (2009). Brief motivational interventions for college student problem gamblers. Addiction, 104 ( 9), 1569–1578. https://doi.org/10.1111/j.1360-0443.2009.02652.x
O’Donnell, A., Anderson, P., Newbury-Birch, D., Schulte, B., Schmidt, C., Reimer, J. & Kaner, E. (2014). The impact of brief alcohol interventions in primary healthcare: A systematic review of reviews. Alcohol and Alcoholism, 49 (1), 66–78. https://doi.org/10.1093/alcalc/agt170
Tanner-Smith, E.E., Steinka-Fry, K.T., Hennessy, E.A., Lipsey, M.W. & Winters, K.C. (2015). Can brief alcohol interventions for youth also address concurrent illicit drug use? Results from a meta-analysis. Journal of Youth and Adolescence, 44 (5), 1011–1023. https://doi.org/10.1007/s10964-015-0252-x
Platt, L., Melendez-Torres, G.J., O’Donnell, A., Bradley, J., Newbury-Birch, D., Kaner, E. & Ashton, C. (2016). How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis. BMJ Open, 6 (8), e011473. https://doi.org/10.1136/bmjopen-2016-011473
Dowling, N.A., Merkouris, S.S., Manning, V., Volberg, R., Lee, S. J., Rodda, S. N., & Lubman, D.I. (2018). Screening for problem gambling within mental health services: A comparison of the classification accuracy of brief instruments. Addiction, 113 (6), 1088–1104. https://doi.org/10.1111/add.14150

This information is intended to help clinicians in their use of evidence-informed practice (EIP) when screening, assessing, and treating clients with behavioural addiction(s). Evidence-informed practice, sometimes called evidence-based practice, is a client-centred approach to clinical decision making. It’s a way to solve problems by integrating the best available research evidence with the clinician’s experience, the client’s preferences and values, and the organizational and cultural context.^1,2,3,4