Kimberly H. McManama O’Brien

Evaluation of Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training for Social Workers

Social work education is well positioned for workforce development initiatives that prepare practitioners to use Screening, Brief Intervention, and Referral to Treatment (SBIRT) with people at risk for alcohol use disorders. This article presents preliminary process and outcome evaluation data from the first year of a three-year grant which suggests that the training is acceptable and results in significant changes in trainees’ knowledge, attitudes, and self-perceived SBIRT skills. Training was embedded within the curricula of an urban school of social work, which includes a Bachelor of Social Work (BSW) program and a single-concentration clinical Master of Social Work (MSW). Trainees included social work students (n = 134) and field instructors (n = 38). More than 90% of students were very satisfied or satisfied with the training, and 100% of field instructors rated the training as excellent or good. Students demonstrated significant changes from pre- to posttraining in substance use knowledge, confidence in SBIRT skills, and attitudes about integrating SBIRT into practice. Field instructors reported increased confidence in screening. Integrating SBIRT training into social work curriculum is a promising method of developing a workforce that can effectively prevent and alleviate alcohol misuse.

Adolescent Alcohol Use: The Effects of Parental Knowledge, Peer Substance Use, and Peer Tolerance of Use

Objective: Parents and peers exert significant influence on a young person’s decision to consume alcohol. This study examines the relationship between parental monitoring and adolescent alcohol consumption and tests whether peer substance use and tolerance of use mediates the relationship between monitoring and drinking. Method: Participants included 116 adolescents (53.5% female; Mage = 15.6). All participants reported drinking alcohol in the past 6 months, and 96 participants had been previously admitted to a hospital emergency department for an alcohol-related event. Mediation analyses were used to test the study hypotheses. Results: The total effect of baseline parental monitoring on 6-month alcohol use was −1.15 (p < .01), with higher monitoring related to less use. Controlling for peer use and tolerance of use, the effect of parental monitoring was reduced to .46, leaving an indirect effect of .69 (p < .01). Peer use and tolerance of use had no effect on participant alcohol use when controlling for parental monitoring. Conclusions: Study findings extend current knowledge about the interactive effects of parental supervision and peer influence on the drinking patterns of adolescents. Results underscore the importance of addressing both parental monitoring and peer influence in interventions that target adolescent alcohol use, recognizing peer factors as a potential mechanism of the effect that parental monitoring has on adolescent drinking.

Interactive Effect of Child Maltreatment and Substance Use on Depressed Mood Among Adolescents Presenting to Community-Based Substance Use Treatment

Abstract Adolescents referred to community behavioral health centers (CBHC) for substance use (SU) problems report high rates of child maltreatment. Although SU and maltreatment are independent risk factors for adolescent depression, few studies have examined their interactive effects. This study examined the interactive effects of SU (alcohol and marijuana) and exposure to different types of trauma on depressed mood among 74 adolescents referred to a CBHC for SU. Hierarchical regressions controlling for sex and common adolescent comorbidities showed that sexual abuse had a stronger relationship with depressed mood than other types of maltreatment. Although SU was not independently related to depressed mood, consistent with the self-medication hypothesis, increased SU was associated with lower levels of depressed mood among adolescents with greater exposure to sexual abuse. Results suggest that teens presenting to CBHCs for SU should be assessed for multiple forms of maltreatment and for depressed mood.

Emotion Dysregulation Mediates the Relationship Between Child Maltreatment and Non-Suicidal Self-Injury

ABSTRACT One risk factor for non-suicidal self-injury (NSSI) in adolescents is exposure to traumatic experiences, particularly child maltreatment. However, the mechanisms through which childhood maltreatment predicts NSSI are largely unknown. Emotion dysregulation (ED) is likely an important mechanism in this relationship. Therefore, this study examined the relationship between childhood maltreatment, ED, and NSSI in a sample of adolescent inpatients (n = 53). Results demonstrated that child physical and emotional maltreatment, but not child sexual abuse, was significantly associated with NSSI frequency. More specifically, ED mediated the relationship between child physical and emotional maltreatment and NSSI frequency. Findings support the importance of ED as a mediating factor in the relationship between childhood maltreatment and NSSI behaviors and highlight the need for teaching emotion regulation skills to youth affected by trauma.

An Innovative Behavioral Health Workforce Initiative: Keeping Pace with an Emerging Model of Care

ABSTRACT Recent policy shifts in health care have created opportunities for social workers to provide services in integrated primary care and behavioral health settings. However, traditionally prepared social workers may not have the skill set necessary to meet practice demands. This article describes a behavioral health workforce initiative that trains master’s of social work students for work in integrated primary care settings with children, adolescents, and transition-age youths. The training model includes field placements in integrated care settings, co-curricular seminars, and advanced clinical electives. This article identifies challenges of creating new field placements and developing new curricula to support students’ acquisition of knowledge and skills required in integrated care settings. Additionally, it presents data on changes in students’ knowledge and confidence.

Development, Implementation, and Evaluation of a Comprehensive Course on Suicide in a Master’s of Social Work Program

ABSTRACT Most master of social work (MSW) programs provide minimal education or training on suicide prevention, intervention, and postvention despite that the majority of social workers encounter suicidal clients during their professional careers. This study describes the development, implementation, and evaluation of a course on suicide in an MSW program. Changes in student suicide-related knowledge, confidence, and preparedness were evaluated using a pre/post design. We found statistically significant increases in knowledge (t [df = 21] = 4.79; p < .001), confidence (t [df = 17] = 8.55; p < .001), and preparedness (t [df = 20] = 7.28; p < .001) from pretest to posttest. Knowledge, confidence, and preparedness were significantly positively correlated, indicating that confidence and preparedness did not increase without a corresponding increase in knowledge. Given the prevalence of suicide and the frequency with which social workers serve populations affected by suicide, it is critical that MSW programs provide effective training on understanding suicide.

The Role of Parents in Safety Planning Interventions with SuicidalAdolescents

Suicide is the second leading cause of death for youth ages 10-24 in the United States. The time following discharge from an acute care setting represents a period of especially high risk for suicide among adolescents, but has not been matched by proportionate prevention and intervention efforts. Safety planning procedures, especially those which include means restriction counseling and family communication training, may be especially useful for suicidal adolescents and their parents during the discharge process. Brief interventions that actively involve parents in safety planning have the potential to reduce suicide-related outcomes among suicidal adolescents, and thus warrant an increased clinical and research focus.

Integrating substance use training into social work education

Background Historically, social work education (SWE) has not included formal and indepth training to address substance use in either coursework or fieldwork. Health-care reform offers promise to integrate medical and behavioral health through employment of social work professionals. It is critical that screening, brief intervention, and referral to treatment (SBIRT) be incorporated as basic skills for all trainees, and other evidence-based practices be offered in SWE [1] to insure an adequate work force. This project describes design, implementation, and learner satisfaction of an adolescent SBIRT curriculum at Simmons School of Social Work (SSW) in partnership with Boston Children’s Hospital (BCH), through a Substance Abuse and Mental Health Services Administration (SAMHSA)-funded SBIRT training grant. We ask the question: “Are brief workshops and intensive practice courses feasible and acceptable methods of training social work students?” Methods