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Variation in brief treatment for substance use disorder: a qualitative investigation of four federally qualified health centers with SBIRT services

Authors
  • Watson, Dennis P.1
  • Staton, Monte D.2
  • Dennis, Michael L.3
  • Grella, Christine E.1
  • Scott, Christy K.1
  • 1 Chestnut Health Systems, 221 W Walton St, Chicago, IL, 60610, United States , Chicago (United States)
  • 2 University of Illinois at Chicago, 818 S. Wolcott, Chicago, IL, 60612, United States , Chicago (United States)
  • 3 Chestnut Health Systems, 448 Wylie Dr, Normal, IL, 61761, United States , Normal (United States)
Type
Published Article
Journal
Substance Abuse Treatment, Prevention, and Policy
Publisher
Springer Nature
Publication Date
Jul 14, 2021
Volume
16
Issue
1
Identifiers
DOI: 10.1186/s13011-021-00381-y
Source
Springer Nature
Keywords
Disciplines
  • Research
License
Green

Abstract

BackgroundBrief treatment (BT) can be an effective, short-term, and low-cost treatment option for many people who misuse alcohol and drugs. However, inconsistent implementation is suggested to result in BT that often looks and potentially costs similar to regular outpatient care. Prior research is also rife with inconsistent operationalizations regarding the measurement of BT received by patients. As such, there is a need to more explicitly identify and document variations in BT practice.MethodsA qualitative investigation of BT in four Federally Qualified Health Centers (FQHC) was undertaken as a sub study of a larger clinical trial. Researchers interviewed 12 staff (administrators and clinicians) involved in BT oversight, referral, or delivery within the four FQHCs. Data were analyzed following an inductive approach guided by the primary research questions.ResultsFindings demonstrate considerable differences in how BT was conceptualized and implemented within the FQHCs. This included a variety of ways in which BT was presented and described to patients that likely impacts how they perceive the BT they receive, including potentially not understanding they received substance use disorder treatment at all.ConclusionsThe findings raise questions regarding the validity of prior research, demonstrating more objective definitions of BT and fidelity checklists are needed to ensure integrity of results. Future work in this area should seek to understand BT as practiced among a larger sample of providers and the direct experiences and perspectives of patients. There is also a need for more consistent implementation, quality assurance guidelines, and standardized stage of change assessments to aid practitioners.

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