Substance Use Prevention in SBHCs

Substance use disorders have significant and long-lasting health and academic consequences for young people.

Children's Aid Society: A student meets with a provider.

A student meets with a provider.

To address this issue, the School-Based Health Alliance recently completed a two-year pilot project (phase I) to train a group of school-based health providers in screening, brief intervention, and referral to treatment (SBIRT) methods and test the feasibility of this approach in a school-based setting. This work was supported by the Conrad N. Hilton Foundation. In 2017, the Alliance began phase II of the project, once again in partnership with the Conrad N. Hilton Foundation

In Phase I, we learned that, with support and encouragement, school-based health centers (SBHC) can and will incorporate SBIRT into their workflow. Providers told us that using SBIRT increased their awareness of substance use and other mental health issues in their schools. We also found that collaborations between several SBHCs and school administrations successfully incorporated SBIRT-in-SBHCs into alternatives to discipline, such as sending students suspected of behavioral issues due to substance use to the SBHC for screening rather than out of school; and using Teen Intervene as an in-school suspension program.

During phase II, we will use the lessons of our SBIRT-in-SBHCs pilot program to expand the adoption and use of SBIRT within the school-based health care field. The new two-year project will use two strategies: (1) a learning collaborative to engage additional SBHCs to use SBIRT-in-SBHCs as a vehicle to identify, prevent, and reduce substance use and depression and to contribute to schools’ efforts to employ alternatives to suspension and expulsion and (2) the development, implementation, and promotion of an online compendium of resources and tools that all SBHCs can use to implement SBIRT in their schools.


SBIRT is an evidence-based approach used to identify, reduce, and prevent substance use, abuse, and dependence developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Grounded in motivational interviewing, the SBIRT model includes the following components that are being adopted by participating sites:

  • Screening: Providers use the CRAFFT tool, a six-question behavioral health screening method for use with children and adolescents, to identifying when a young person is struggling with substance abuse issues.
  • Brief Intervention: When a substance abuse disorder has been identified, providers conduct brief interventions with students through the CRAFFT screening process as mid- to high-risk substance users. Providers use motivational interviewing to help students make their own decision to abstain from substance use.
  • Referral to Treatment: Providers appropriately refer students to treatment for adolescents demonstrating substance abuse disorders requiring care beyond that of a brief intervention.
For more information on SBIRT, visit our Health and Learning section.
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