Substance Use Prevention in SBHC

About the Substance Use Prevention in SBHC Initiative

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

A student meets with a provider.

The 2016 Surgeon General’s Report on Alcohol, Drugs, and Health, titled “Facing Addiction in America,” is a call to action for the school-based health care (SBHC) field and others. More than 90 percent of individuals who experience a substance use disorder as an adult began their use before the age of 18. Assessing risk and protective factors is a service provided by all SBHCs, presenting the opportunity to develop and enhance substance use prevention and early intervention, delaying the onset of use, and decreasing the likelihood of addiction as an adult. Actively screening and intervening with youth will lead to better outcomes academically and overall health and well-being.

Project Description

In 2015, the School-Based Health Alliance received funding from the Conrad N. Hilton Foundation to conduct a two-year pilot project (SBIRT 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.

In 2017, once again with funding from the Conrad N. Hilton Foundation, the Alliance began the second phase of this initiative. During SBIRT Phase II, lessons learned from the pilot project will be used to expand the adoption and use of SBIRT within the SBHC field with enhanced resources to overcome electronic health record (EHR) challenges.

The new two-year project will incorporate several strategies: a learning collaborative to engage additional SBHC sites in the use of SBIRT; increased use of evidence-base interventions, such as Teen Intervene, to provide treatment in school settings; expert support for EHR integration to support ease of SBHC work flow; youth development to enhance buy-in and efficacy for adolescents; and new educational partners to develop alternatives to discipline policies. Through these strategies, we hope to see an increase in referrals to the SBHC site for further assessment and treatment, to get at the multifaceted issues that could be at the root of the substance use. An online learning compendium of SBIRT-in-SBHCs training resources will be released to the entire field at the end of Phase II.

Download the SBIRT Infographic

Project Updates

SBIRT at the National School-Based Health Care Convention! (July 2018)

Amazing turnout for SBIRT at the National School-Based Health Care Convention in Indianapolis June 24-27!  SBHA’s SBIRT grantees engaged in a Motivational Interviewing Booster Training, some fun networking activities, and convention workshops to support their school-based health professional development.  We also had some award winners in our grantee group: congratulations to 1st place poster winners Blaine Garcia and staff at Waianae Coast Comprehensive Health Center and to 2nd place poster winner Anna Goddard of Child and Family Services of Southeastern Connecticut.  And, HUGE congrats to Amanda Forsmark of Great Lakes Bay Health Centers for winning SBHA’s first annual Rising Star Award!  Following the regular convention, SBHA held a National School-Based SBIRT Convening, bringing together professionals and experts from across the country to evaluate the state of SBIRT in schools and collaborate to move the model forward.  It was a highly engaging and inspiring few days, and we look forward to what comes next!

Read More

SBIRT Grantee MI Booster Training













Blaine & Anna – Poster Winners!


















Amanda – Rising Star Award!


















Amanda & Katy – Rsing Star Award!


















National School-Based SBIRT Convening














National School-Based SBIRT Convening














View our project infographic here.

SBIRT taking off in full force! (March 2018)

SBIRT implementation and data collection have begun across all our grantee sites!  The SBHA research and evaluation team continues to solicit site feedback and refine data measures to best serve SBHCs.  Program Manager Katy Stinchfield provides regular technical assistance, as well as monthly meetings with each site team, and monthly meetings with Site Champions and guest SBIRT experts.  We held another virtual training in March, on the topic of Youth Engagement in Substance Use Prevention, with excellent presentations by Lauren Ranalli, Director of theAdolescent Health Initiative and Amanda Forsmark, Health Educator at Great Lakes Bay Health Centers (one of our grantee sites!).  View the presentation slides here.

All sites trained in SBIRT! (December 2017)

During the fall of 2017, all sites were trained in SBIRT, and are now ready to begin implementation!  Training included several webinars, in addition to travel to each grantee location, site visits at each SBHC, meetings with providers and school administrators, promotion of youth engagement and alternatives to discipline, tailored work flow evaluations, a full day SBIRT training with instructors from the UCLA Integrated Substance Abuse Programs, as well as training in Teen Intervene with SBHA Program Manager Katy Stinchfield.  Sites are now working to finalize Electronic Health Record (EHR) modifications to go live with SBIRT in January!

SBHC Sites Selected for the School-Based Health Alliance’s SBIRT-in-SBHCs Cohort! (August 2017)

The School-Based Health Alliance is excited to announce that four sponsoring agencies and nine SBHC sites have been selected to participate in the SBIRT-in-SBHCs Learning Community.  The Alliance will work with each site to support integration of SBIRT (Screening, Brief Intervention, and Referral to Treatment) into the SBHC setting, with the goal of preventing substance abuse, enhancing youth development capacity, influencing school discipline policies, and addressing the multifaceted issues that could be at the root of the substance use.

See which SBHC sites were selected!


The SBIRT-in-SBHCs Cohort includes:

Child and Family Agency of SE Connecticut (Connecticut)

  • New London High School SBHC
  • Fitch High School SBHC
  • Pawcatuck Middle School SBHC

Great Lakes Bay Health Centers (Michigan)

  • Arthur Hill High School SBHC
  • Saginaw High School SBHC

Thunder Bay Community Health Service (Michigan)

  • Onaway Area Community School SBHC
  • Cheboygan Intermediate School SBHC

Waianae Coast Comprehensive Health Center (Hawaii)

  • Waianae High School SBHC
  • Waianae Intermediate School SBHC

Alliance Releases RFA for SBIRT Phase II (Spring 2017)

Through the generous funding of the Conrad N. Hilton Foundation, the Alliance is launching a learning collaborative called Screening, Brief Intervention, and Referral to Treatment (SBIRT) in School-Based Health Centers Phase II to prevent, identify, and reduce substance use and depression in middle and high school age youth. SBIRT Phase II addresses two of the key topical areas for technical assistance requests from the field:  depression and substance use.

Read more about the RFA.

SBIRT Phase II will fund up to four SBHC sponsor organizations, each identifying up to three SBHC sites, for the national learning collaborative (up to 12 sites total.) The funding will cover on-site training (up to $2,000 per sponsoring agency), stipends for sponsoring agencies ($5,000 per site), evaluation support, electronic health record (EHR) improvements (up to $10,000 per sponsoring agency EHR), travel to School-Based Health Alliance 2018 convention, and ongoing technical assistance and training. The deadline for application is June 30, 2017. For more information, download the full RFA.

Lessons Learned from SBIRT Phase I (Fall 2016)

During Phase I of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) in School-Based Health Centers Phase I pilot project, the Alliance learned that, with support and encouragement, school-based health centers can and will incorporate SBIRT into their workflow. Providers said that using SBIRT increased their awareness of substance use and other mental health issues in their schools.

Read more about Lessons Learned.

The Alliance also found that collaborations between several school-based health centers and school administrations successfully incorporated the SBIRT pilot project into alternatives to discipline, such as sending students suspected of behavioral issues due to substance use to the school-based health center for screening rather than out of school; and using Teen Intervene as an in-school suspension program.

Sites Selected for SBIRT Phase I (Winter 2015)

The Alliance would like to recognize the following school-based health care programs for being selected to participate in Phase I of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) pilot project. Each program will receive training in SBIRT methods and test the feasibility of this approach in their school-based setting.

Cohort I
Beaverton High SBHC, Beaverton, OR
Merlo High School SBHC, Beaverton, OR
Skyline High School/Life Academy, Oakland, CA
United for Success Middle School, Oakland, CA
Madison Middle School Health Center, Oakland, CA

Cohort II
Coolidge High SBHC, Washington, DC
Dunbar High, Washington, DC
St. Francis Academy SBHC, Baltimore, MD
Auburn Gresham, Chicago, IL

What Is SBIRT? (Fall 2015)

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

Read more about the SBIRT Approach.
  • 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.