Introduction to Referral to Treatment (RT)
We have presented SBIRT as a best-practice approach to substance use and abuse in the primary care setting; much of the previous content has focused on the SBI components, but there will be situations in which a patient is in need of more substantial treatment than what is offered through the SBI protocol, which in turn leads to the RT (referral to treatment) component of the whole process (SBIRT).
RT really is a BI!
The referral to treatment component of SBIRT uses the same skills and strategies as the Brief Intervention component. Basically, the only thing that changes is the objective: rather than fostering a harm reduction or abstinence change, we are initiating a change in behavior that involves going to another provider or source of support.
Behavioral change is behavioral change, and supporting a patient to accept and follow through on our referral involves the same strategies.
Stage of Change: Is our patient ready for a referral? That is, regardless of what we may thing, does our patient think he or she needs to go? How can we support this acceptance?
FRAMES: How can we build, with our patient’s help, a plan that increase the liklihood of followthrough?
Motivational Interviewing (MI): And, throughout this process, we can incorporate the objectives and strategies, the overall MI approach to patient-provider interaction, to foster this change: that is, to get them to engage in the referral.
RT Patient Follow Through is a Key Indicator of SBIRT
Referral to specialized treatment is provided to those patients who are identified as needing more extensive treatment than offered by the SBIRT program. The effectiveness of the referral to specialty treatment process is a strong measure of SBIRT success and involves a proactive and collaborative effort between SBIRT providers and those providing specialty treatment to ensure access to the appropriate level of care.