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SBIRT For Perinatal Substance Use

Published on Dec 06, 2015

Overview of how to screen for perinatal substance use, perform a brief intervention & refer to treatment. Based on SBIRT, this Deck was developed for use in a workshop

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PRESENTATION OUTLINE

1.

SBIRT PRINCIPLES

FOR PREGNANCY AND POSTPARTUM 
Photo by seanrainer
2.

MARGARET S. CHISOLM, MD

JOHNS HOPKINS UNIVERSITY CENTER FOR ADDICTION AND PREGNANCY
Photo by lifewithkarma
3.

@WHOLE_PATIENTS

WWW.TWITTER.COM/WHOLE_PATIENTS
Photo by Leshaines123
4.

SBIRT

SCREENING, BRIEF INTERVENTION, & REFERRAL TO TREATMENT
Photo by AG Toine
5.

EFFECTIVE

AT REDUCING ALCOHOL 8 TOBACCO USE
Photo by Kit4na
6.

IMPROVES

MATERNAL & CHILD HEALTH OUTCOMES
Photo by WiLPrZ
7.

SBIRT STEPS

  • Raise the subject
  • Provide feedback
  • Enhance motivation
  • Negotiate a plan
  • Close on good terms
Photo by Tobias Lindman
8.

LET'S WATCH

SBIRT IN ACTION
Photo by ⌡K
9.

1. RAISE THE SUBJECT

CAN WE TAKE A MINUTE TO DISCUSS ALCOHOL & CIGARETTES?
Photo by Barney Wrightson
10.

ALCOHOL: ASK ABOUT USE

DO YOU SOMETIMES DRINK BEER, WINE, OR OTHER ALCOHOLIC BEVERAGES?
Photo by RLHyde
11.

WHAT IS A STANDARD DRINK?

12 OZ BEER, 8-9 OZ MALT LIQUOR, 5 OZ WINE, 1.5 OZ/1 SHOT LIQUOR
Photo by Billy Wilson Photography
12.

ASK ABOUT HEAVY DRINKING DAYS

HOW MANY TIMES IN THE LAST YEAR HAVE YOU HAD 4 OR MORE DRINKS IN 1 DAY?
Photo by Kuba Bożanowski
13.

AT-RISK DRINKING

= ANY DRINKING AT ALL IF PREGNANT
Photo by Nina Matthews Photography
14.

AT-RISK DRINKING FOR ADULTS

15.

US ADULT DRINKING

72% never exceed daily or weekly; 16% exceed daily; 10% exceed both
Photo by Etwood
16.

CIGARETTES: ASK ABOUT USE

DO YOU SOMETIMES SMOKE TRADITIONAL OR E-CIGARETTES?
Photo by Shreyans Bhansali
17.

DETERMINE THE DAILY AVERAGE

HOW MANY CIGARETTES DO YOU SMOKE IN A TYPICAL DAY?
Photo by arbyreed
18.

AT-RISK SMOKING

= ANY SMOKING AT ALL IF PREGNANT OR POSTPARTUM
Photo by Nina Matthews Photography
19.

2. PROVIDE FEEDBACK

SHARE RISKS WITH PATIENT
Photo by Fabiano Kai
20.

PREGNANCY

THERE IS NO SAFE LEVEL OF DRINKING OR SMOKING
Photo by krzyboy2o
21.

POSTPARTUM

THERE IS NO SAFE LEVEL OF SMOKING 
Photo by krzyboy2o
22.

CONNECT RISK TO REASON FOR VISIT

IT CAN ALSO BE HARMFUL TO YOUR BABY. WHAT DO YOU MAKE OF THAT?
Photo by Kristian Thøgersen
23.

3. ENHANCE MOTIVATION

ELICIT CHANGE TALK
Photo by Fabiano Kai
24.

HAVE YOU EVER CONSIDERED REDUCING OR QUITTING?

IF SO, WHY? IF NOT, WHAT WOULD HAVE TO HAPPEN FOR YOU TO CONSIDER IT?
Photo by chrismar
25.

IMPORTANCE

ON A SCALE OF 1-10, HOW IMPORTANT IS IT THAT YOU REDUCE/QUIT?
Photo by ZarrSadus
26.

IMPORTANCE

WHY THAT NUMBER AND NOT A LOWER ONE?
Photo by add1sun
27.

CONFIDENCE

ON A SCALE OF 1-10, HOW CONFIDENT ARE YOU THAT YOU CAN REDUCE/QUIT?
Photo by nexus6
28.

CONFIDENCE

WHY THAT NUMBER AND NOT A HIGHER ONE?
Photo by add1sun
29.

OARS

OPEN-ENDED QUESTIONS, AFFIRMATIONS, REFLECTIONS, SUMMARIES
Photo by Pörrö
30.

4. NEGOTIATE A PLAN

DEVELOP COLLABORATIVELY WITH PATIENT
Photo by bengrey
31.

DISCUSS NEXT STEPS

FOLLOW PATIENT'S LEAD
Photo by John-Morgan
32.

IF YOU WERE TO MAKE A CHANGE,

WHAT WOULD BE YOUR FIRST STEP?
Photo by Here's Kate
33.

OFFER MENU OF OPTIONS FOR MORE HELP

MEDICATION, BRIEF COUNSELING, SUPPORT GROUPS, FORMAL TREATMENT PROGRAMS
Photo by TerryJohnston
34.

CLOSE ON GOOD TERMS

ASK PERMISSION TO MEET AGAIN TO DISCUSS PROGRESS
Photo by Will Montague
35.

PRACTICE 1

DYADS: CLINICIAN & PREGNANT PATIENT
Photo by foilman
36.

ALISON

PREGNANT, DRINKS 1 MIXED DRINK & ONLY ON NIGHTS OUT (1-2 NIGHTS/WK)
Photo by StephenMcleod - International Man of Mystery
37.

SBIRT STEPS

  • Raise the subject
  • Provide feedback
  • Enhance motivation
  • Negotiate a plan
  • Close on good terms
Photo by Tobias Lindman
38.

1. RAISE THE SUBJECT

CAN WE TAKE A MINUTE TO DISCUSS ALCOHOL?
Photo by Barney Wrightson
39.

PRACTICE 2

DYADS: CLINICIAN & POSTPARTUM PATIENT
Photo by foilman
40.

SBIRT STEPS

  • Raise the subject
  • Provide feedback
  • Enhance motivation
  • Negotiate a plan
  • Close on good terms
Photo by Tobias Lindman
41.

SUSAN

POSTPARTUM, BREASTFEEDING, SMOKING 10 CIGARETTES PER DAY
Photo by lucidialohman

Margaret Chisolm

Haiku Deck Pro User