Referral to Treatment
For patients identified as needing more extensive treatment than what can be offered through an SBIRT program, referral to a specialized treatment provider may be necessary. Referral to treatment is an integral component of the SBIRT process and necessitates strong collaboration between the SBIRT team and substance abuse treatment providers in the community. Some useful links to treatment resources are provided below.
Treatment may include—
- Counseling and other psychosocial rehabilitation services
- Involvement with self-help (AA, NA, Al-Anon)
- Complementary wellness (diet, exercise, meditation)
- Combinations of the above
Substance abuse treatment is provided within levels of care often available in multiple treatment settings. Level of care is determined by severity of illness: Is the patient a dependent or nondependent substance abuser, and are there medical or psychiatric comorbidities? Inpatient treatment is reserved for those with more serious illness (dependence, comorbidity).
When your patient is ready—
- Make a plan with the patient.
- You or your staff should actively participate in the referral process. The warmer the referral handoff, the better the outcome.
- Decide how you will interact/communicate with the provider.
- Confirm your follow up plan with the patient.
- Decide on the ongoing follow up support strategies you will use.
What is a warm-handoff referral?
The "warm-handoff referral” is the action by which the clinician directly introduces the patient to the treatment provider at the time of the patient’s medical visit. The reasons behind the warm-handoff referral are to establish an initial direct contact between the patient and the treatment counselor and to confer the trust and rapport. Evidence strongly indicates that warm handoffs are dramatically more successful than passive referrals.
Common Mistakes to Avoid
- Rushing into "action” and making a treatment referral when the patient isn’t interested or ready
- Referring to a program that is full or does not take the patient’s insurance
- Not knowing your referral base
- Not considering pharmacotherapy in support of treatment and recovery
- Seeing the patient as "resistant” or "self-sabotaging” instead of having a chronic disease
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