St. Elizabeth's Medical Center

736 Cambridge Street, Brighton, MA 02135
617-789-3000

St. Elizabeth's / Services and Clinical Centers / Substance Abuse

SBIRT FAQs

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Mission Clarification

Your main pages uses a fair amount of specialized terminology. Can you clarify?

First and foremost, the SBIRT Collaborative aims to support the health needs of at-risk substance use patients in Greater Boston utilizing externally validated brief intervention techniques in an effort to reduce the number of patients who fall victim to substance abuse and dependency. Through our outreach/training process we identify undergraduate screener candidates able and eager to master these skills and capable of bridging traditional hospital demarcations between emergency medicine, in-patient detox, psychiatry, and other specialties. Educationally, we offer structured, supervised patient encounters to these highly experienced and competent undergraduates, many of whom come to St. E's with earnest requests for a "worthwhile patient contact opportunity." Our evidence-based model provides SBIRT coverage in a medical setting for a miniscule fraction of the costs of existing intervention programs while simultaneously minimizing staff time commitments. SBIRT provides a singular opportunity for future health care professionals to begin an ongoing dialogue regarding health care communication techniques, a vital skill set not easily conveyed in a classroom setting and not yet a required component in either undergraduate or post-graduate medical training. In addition, our program provides local colleges with an invaluable resource: fully trained substance use screeners capable of supporting ongoing local substance use education efforts, functioning in a peer mentor role, and advising hospital/university leadership regarding new potential strategies to reduce the risks of alcohol poisoning and other adverse health outcomes based on their direct observations from both social and medical perspectives. As a forward-thinking health care initiative, the SBIRT Collaborative also embraces a number of proven communication avenues including text messaging, Skype videoconferencing, and other media resources that have yet to find a formal role in medicine but which we have found absolutely essential given the technological competencies of our volunteers. We see our program as strategically situated to trial the aforementioned medical, educational, and technological innovations with potentially profound implications for the future of US medical care, especially in the wake of recently passed federal health care reform legislation which intends to replace the current fee-for-service (quantitative) model with a pay-for-performance (qualitative) sliding scale.

Why are you targeting substance use instead of some other public health issue?

According to the National Institute on Alcohol Abuse & Alcoholism, the social and legal consequences of misuse of alcohol (excluding other substance use) include more than 100,000 preventable deaths across the United States each year. The statistical likelihood for the onset of alcohol dependency is highest in the 16 to 25 age range which indicates that our program can potentially impact decades of future behavior with an appropriately targeted emphasis on at-risk patients in high school and college environments as well as surrounding communities. Funding cuts have seriously impacted the availability of specialized treatment; meanwhile, the national cost of alcohol abuse and dependency care is growing at an unsustainably high rate (estimated by the National Institute of Health at approximately 3.75% annually). Substance use is a front-line health care issue with major implications for national and state health policy, and our approach offers a path toward sustainable preventative health care measures using externally validated tools and volunteer screeners who are personally invested in their efforts. We see Greater Boston as an ideal setting to trial our substance use education efforts given the considerable number of local institutions, both medical and academic, that stand to benefit directly from our work. The approximately 250,000-strong transient student population of Greater Boston represents a respectable fraction of persons in the United States seeking higher education. One of our stated goals is that persons who come to the Hub for higher education should be able to complete that experience with minimal risk of experiencing the academic, legal, and bio-psycho-social-spiritual issues that can accompany at-risk and dependent substance use with excessive alcohol consumption and regular use of illicit drugs. We feel that such outcomes will benefit such individuals as well as the area's permanent residents and local health and academic institutions that support both demographics.

Outreach & Recruitment

How does the SBIRT Collaborative conduct outreach & recruitment?

The SBIRT Collaborative welcomes the chance for dialogue with potential applicants, medical professionals and members of the community regarding our work. To facilitate discussions of at-risk substance use issues and how our program can substantially enhance the functionality of existing substance use services, the SEMC-BC SBIRT Collaborative conducts information sessions that are open to the public.

We currently have a Spring 2011 Information Session scheduled for:

Sunday January 30th, 6 PM to 8 PM (Boston College, Fulton Hall, Room 511)

We currently have Fall 2011 Information Sessions scheduled for:

Friday September 9th, 8 AM to 6 PM (Boston College Dustbowl - Student Activities Day)
Sunday September 18th, 5 PM to 7 PM (Boston College, Fulton Hall, Room 511)

To request an SBIRT Collaborative Information Session at your institution or event, please contact Manager Aaron Lemmon at 617-789-2413 or sbirt@steward.org with at least one month's advance notice.

Are there other programs where I as a college student screener can participate in SBIRT?

At the present time, the St. Elizabeth's Medical Center-Boston College SBIRT Collaborative is the only SBIRT program in the United States specifically structured to recruit and train undergraduate college students to conduct one-on-one brief intervention encounters regarding substance use. Other institutions such as the Massachusetts Department of Public Health, Bureau of Substance Abuse Services, Children's Hospital Boston, and Northeastern University fund staff-based screening through the federal Department of Health and Human Services, which underwrites some SBIRT research nationwide through the Substance Abuse and Mental Health Services Administration (SAMHSA). Staff-based SBIRT has shown extraordinary promise as a preventative health care approach, although there are several significant barriers to implementing it nationally. First, future deferred health care costs from preventative medicine (including SBIRT) are diffuse and uncapitalized which forces health care institutions to largely rely on third-party funding such as federal grants to implement approaches with six-figure cost structures such as clinician-based brief intervention. One recent report by the Boston University-based substance use education advocacy organization Join Together also cautions that in terms of education, time availability, and willingness to engage patients as equals that some clinicians can be less than ideal candidates to perform SBIRT interventions. Three common responses screeners can see (particularly during high school and college patient encounters) are: "You don't understand me," "You want to tell me what to do," and "You're being paid to tell this to me," which we believe that our volunteer-based model can mitigate through a peer-based intervention for the highest-risk patient demographics. To date, St. Elizabeth's and Boston College have not sought outside funding for our program because we have been able to support our infrastructural needs out of existing funding allocations across multiple departments at both St. Elizabeth's Medical Center and Boston College. Our unique approach to SBIRT resulted in our program being selected for a highly competitive breakout session slot at the 2010 Catholic Health Assembly in Denver (and again at the 2011 NASPA Alcohol & Other Drug Abuse Conference) because of its singular potential in terms of undergraduate health care education and cost of care savings.

I'm not a Boston College undergraduate, but this sounds so cool! Can I apply?

St. Elizabeth's Medical Center and Boston College partnered for this program for a variety of reasons. First and foremost, a large percentage of the substance use-related patient volume at St. E's comes from BC. Also, Boston College possess three crucial avenues of recruitment and support for our program: the student-run Eagle EMS, School of Nursing, and Graduate School of Social Work. Boston College administrators and staff have been invaluable partners in the SBIRT Collaborative from the beginning, coordinating university services and BC screener shift transportation for the Collaborative as well as providing on-campus meeting spaces to aid our screeners in their work. The Allston-Brighton Substance Abuse Task Force was also asked to join our program at the leadership level so that the hospital, university and community would all have a voice in the ongoing development of our program to ensure we are adequately balancing the needs of our patients with the capabilities of our screeners. We have had an active screener from Brandeis University participate and are more than willing to consider additional applicants from Brandeis, Boston University, and other local schools. Recent graduates and other local residents with the prerequisite skill sets and availability are also welcome to apply. On-site parking is available for non-BC applicants but such persons will be responsible for arranging their own vehicle or other substitute transportation in coordination with the SBIRT Collaborative Director since some shifts are scheduled during times when MBTA services are not available. Program meetings are typically held on-campus at Boston College for the convenience of the majority of our screeners.

Your program is growing so you definitely need more people. How many slots are available?

Our recruitment approach is entirely qualitative. We always recruit based on the minimum number of qualified candidates interested and we categorically do not have a quota system or similar arrangement in place. We would rather scale back screener coverage and miss interviewing a percentage of patients than accept candidates who in our best judgment are insufficiently prepared to participate in our program at any specific time. Prior applicants are welcome to re-apply in the future once they believe previously problematic factors have been sufficiently addressed. In the event that we receive more qualified applicants than we can reasonably support, the remaining finalist candidates will be waitlisted upon request to be re-evaluated during our next application cycle. We are committed to offering a worthwhile volunteer experience to applicants as per our shift/meeting schedule page and thus require three four-hour screening shifts per month plus consistent attendance at our two-hour biweekly roundtable meetings for a minimum of sixteen service hours monthly, in keeping with the standard volunteer commitment stipulated by St. Elizabeth's Medical Center Volunteer Services. Our current shift coverage schedule permits a maximum of fourteen active screeners at any one time and our current on-boarding process is capped at a maximum of six incoming screeners per semester. We are proud to have twelve screeners as of Fall 2010 including three undergraduates from the class of 2011, four undergraduates from the class of 2012, and five undergraduates from the class of 2013. We are open to expanding our program's coverage area to serve additional screening sites and roles across Greater Boston as quickly as prudence, limited time and scarce resources permit.

SBIRT Screener Application

What are the recommended criteria for a competitive SBIRT Collaborative application?

Due to the high level of interest in our program, we predict candidates with prior experience across the spectrum of health care (i.e. EMT training/certification, internships/practicums, & volunteering) and the willingness to commit to more than our required minimum one year of service will be best positioned to compete for future vacancies. As a certified national standard for health care support, persons with Emergency Medical Technician training will always be our first preference for SBIRT candidates and student screeners are prioritized for placement because of their unique peer intervention capability with high school and college-aged patients who demographically are at significantly increased risk for substance abuse and dependency. If you're interested in becoming an Emergency Medical Technician, we recommend contacting Boston College Eagle EMS and similar local organizations such as Boston University's Emergency Medical Services to inquire about their EMT training curricula. As a rule, we do not accept actively training EMTs because our application process has shown that such candidates do not have the time available to complete an additional demanding experiential learning curriculum and related ongoing commitments simultaneously with their EMT coursework. Such a situation inevitably results in severe stress on the candidate due to the competing priorities involved. EMT training provides a highly useful conceptual and procedural foundation for later screener training and the successful completion of an EMT course is a significant indicator of a screener candidate's functional competence in a professional-level health care support role. Having said that, please keep in mind that EMT-Basic training is preferred, not mandated, and all applications are evaluated on a case-by-case basis. Prior exposure to a clinical/research setting, multi-lingual fluency and non-clinical academic interests/skill sets are additional crucial factors that our program takes into consideration when applicants have otherwise similar credentials. Boston College undergraduates are asked to keep in mind that BC offers PULSE, a very competitive and worthwhile public service course set which provides academic credits toward multiple core requirements with opportunities for placement in health care contexts. For immediate exposure to a health care setting, St. Elizabeth's Medical Center offers a number of non-SBIRT volunteer positions posted online at our Volunteer Services web page. Information about SEMC internships is available from our Human Resources Department at 617-789-2647.

How does the SBIRT's screener application process work?*

1. All SBIRT candidates must first submit the required online application as well as SEMC's standard Volunteer Services application form. Candidates who submit applications in advance of the informational sessions listed above are strongly encouraged to attend as the experience will broaden their understanding of the conceptual elements of SBIRT and help them prepare for screener training. Applicants are welcome to submit an application at any time with the understanding that competitive submissions will not be evaluated to move forward with the candidacy process outside of active recruitment windows (the first four weeks of each fall semester effective the 2011-2012 academic year).

Spring 2011 application cycle deadline: Wednesday February 9th, 2011
Fall 2011 application cycle deadline: Wednesday, September 29th, 2011

2. The SEMC-BC SBIRT Collaborative Manager conducts a preliminary in-person interview with each qualified prospective candidate (as per the candidate's individual preference and scheduling availability) to discuss his/her application and answer any questions the candidate has about the program. The Manager also discusses screener service requirements in detail to ensure the candidate is fully informed regarding the necessary commitments. After the initial interview is complete the Manager will contact the applicants' reference and verify transcript eligibility before submitting an initial report to the other members of Collaborative Executive Committee.

3. The SEMC-BC SBIRT Collaborative Manager re-contacts selected screener candidates in order to schedule follow-up in-person interviews including with Director Barbara Herbert, MD. Dr. Herbert serves as the Chair of Addiction Medicine for SECAP (St. Elizabeth's Comprehensive Addiction Program) and formerly worked part-time as an Emergency Medicine attending physician. Due to the constraints of Dr. Herbert's crowded calendar and an extraordinary level of student interest as reflected by the number of submissions we receive, not all qualified applicants may be invited to second-round interviews. In-person finalist interviews will be scheduled through the second Friday following each application cycle deadline. Final determinations will be made regarding a candidate's status after the conclusion of the in-person interview.

*Please note that our online application time frame expires less than two weeks before the subsequent interview process concludes. Because of the relatively small number of openings we have available the SBIRT Collaborative reserves the right to accept applicants on a first-come, first-served basis and to close the candidacy process in advance of posted deadlines if a sufficient number of qualified applications have been received.

Do older students have an edge in the application process?

The SBIRT Collaborative actively seeks mature, responsible student candidates regardless of their class year. We have trained screeners from the classes of 2010, 2011, 2012, & 2013; we are not adverse to recruiting any student aged 18 or older, including freshmen, provided they can demonstrate that they can meet our requirements and minimum service commitments. Our willingness to recruit across all class years is one reason that our recruitment needs remain balanced over time: our screeners are welcome to participate in the SBIRT Collaborative on an ongoing basis provided their academics are not adversely affected. Openings may become available based on a variety of situations, typically either an expansion in shift coverage, or the graduation or other voluntary retirement of an existing screener.

I'm filling out an application right now! What can you tell me about your evaluation process?

The SBIRT Collaborative evaluates all candidates based on the information included in their applications and conversations that occur during the interview process with the candidate and with his/her designated reference(s). Our primary focus is on how each candidate fits with our program. Adequate prior hands-on health care experience and shift scheduling flexibility are two of numerous factors taken into consideration when trying to assess if a prospective screener is a suitable candidate for participation in the SBIRT Collaborative. All active screeners and screener candidates actively pursuing at least a half-time course of study are required to maintain a minimum 3.0 grade point average to be eligible to apply or continue working for the SBIRT Collaborative. We require a minimum GPA in order to ensure that applicants would not jeopardize their academic standing by adding this highly qualitative time-intensive initiative to their schedules; despite this initial threshold for consideration, grade point average is otherwise not considered when assessing respective candidates. We welcome extended responses to our application questions as such a comprehensive level of discourse enables us to develop an enhanced perception of each individual candidate. The large number of applications we receive may result in otherwise qualified applicants being turned down because of a lack of available openings; such applicants may request to be placed on our waitlist for re-consideration in the next round of candidacies. Applicants unable to pursue participation in the SBIRT Collaborative at the present time are more than welcome to pursue alternative SEMC Volunteer Services opportunities in the interim to strengthen their resumes for future program application cycles. The SBIRT Collaborative does not discriminate against applicants on the basis of race, color, national origin, sex, handicap, age, religion, sexual orientation, genetic information, or any other legally protected status.

I plan to apply for SBIRT in the near future. In the meantime, do you offer an "observer" role?

As clinician-equivalent patient support roles, SBIRT volunteer screeners are bound by HIPAA confidentiality guidelines regarding protected patient information as well as an enhanced set of mandates known as 42 CFR Part 2 specific to substance use patient encounters and records. Thus, the actual narratives of specific patient encounters (which includes the content of our biweekly Roundtable Meetings and our physical documentation of each intervention and outcome) are bound by medical privilege which cannot and will not be violated. Non-screeners, including our administrative partners not directly involved in the patient care experience, are restricted from accessing patient-specific information; this policy is not open to revision. We know that many students, health care professionals, and members of the community find our work extremely interesting (at least judging by our Google search rankings) and we try our best to keep updating this web site with new content. We encourage all interested persons to check back regularly to stay current on our project's status as well as the dates/times of our upcoming Information Sessions as those outreach meetings are the only times that our screeners and leadership are available to discuss the opportunities and complexities involved in our work to the general public. We are also happy to hold additional Information Sessions if five or more interested persons would like a briefing on our work and its implications for health care best practices, experiential education, and reconceptualizing volunteer support to medical professionals. To request an SBIRT Collaborative Information Session at your institution or event, please contact Manager Aaron Lemmon at 617-789-2413or sbirt@steward.org with at least one month's advance notice.

SBIRT Training Program

What time frame is involved with the SBIRT's training program?

The SBIRT training methodology developed jointly by St. Elizabeth's Medical Center and Boston College is an accelerated enrichment curriculum that prepares undergraduate screeners for one-on-one hospital patient encounters. Accordingly, each screener receives a solid grounding in SBIRT theory and best practices via the following comprehensive training approach offered every fall semester, effective the 2011-2012 academic year (previously offered biannually):

1. Mandatory Initial Training Sessions - All prospective screeners are required to attend two initial training sessions at the times specified below to ensure that they complete the preliminary requirements for all SBIRT volunteers by the conclusion of this training timeline. Prospective screeners must also set aside time to view this introductory video lecture beforehand and come to the first mandatory initial training session having previously submitted email notes to the SBIRT Collaborative Director detailing at least 3 talking points from it they find relevant to SBIRT encounters.

Spring 2011:

Saturday February 19th, 4 PM to 8 PM (Boston College, 21 Campanella Way, Room 211)
Sunday February 20th, 4 PM to 8 PM (Boston College, 21 Campanella Way, Room 211)

Fall 2011:

Saturday October 8th, 4 PM to 8 PM (Boston College, 21 Campanella Way, Room 211)
Sunday October 9th, 4 PM to 9 PM (Boston College, 21 Campanella Way, Room 211)

2. Advanced Training Sessions - After prospective screeners have had the opportunity to discuss the conceptual foundations of SBIRT and begin the hospital's volunteer clearance process, they then attend intensive Advanced Training Sessions which emphasize the knowledge base and methodology essential to the SBIRT Collaborative patient encounter. Screeners are required to attend two of these Advanced Training Sessions, with the option to attend a third session and/or other private preparation as recommended by the SBIRT Collaborative Manager. Each session incorporates role-play elements and peer critiques to encourage cooperative experiential learning.

Advanced Training Sessions have been scheduled for the following times.

Spring 2011:

Tuesday February 22nd 7 PM to 10 PM (Boston College, 21 Campanella Way, Room 211)
Saturday February 26th, 4 PM to 7 PM (Boston College, 21 Campanella Way, Room 211)
Sunday February 27th, 4 PM to 7 PM (Boston College, 21 Campanella Way, Room 211)

Fall 2011:

Tuesday October 11th, 7 PM to 10 PM (Boston College, 21 Campanella Way, Room 211)
Saturday October 15th, 4 PM to 7 PM (Boston College, 21 Campanella Way, Room 211)
Sunday October 16th, 4 PM to 7 PM (Boston College, 21 Campanella Way, Room 211)

3. Video Role Play - Each screener candidate finalist is required to contact the SEMC-BC SBIRT Collaborative Manager following the conclusion of the advanced training sessions in order to schedule a live demonstration of his/her SBIRT proficiency (time slots are available during the weekend following the conclusion of each advanced training sequence). The SEMC-BC SBIRT Collaborative Manager will provide a previously unseen role play scenario and a tripod-mounted video camera; the resulting practice screening encounter will be documented via videorecording with the prospective screener demonstrating her/his capabilities directly to the SEMC-BC SBIRT Collaborative Manager, who plays the "patient" role. Following the Video Role Play, the screener is asked to self-critique his/her performance for demonstrated strengths and areas for improvement. Prospective screeners are strongly encouraged to schedule additional private preparation with active screeners or fellow screener candidates in advance of the Video Role Play.

4. Video Role Play Feedback - The SEMC-BC SBIRT Collaborative Director will view the recorded Video Role Play and send comments to the prospective screener based on his/her performance and subsequent self-critique. This feedback may include the opportunity for a repeat performance. Until a screener has demonstrated adequate proficiency, he/she cannot receive an official SBIRT volunteer identification badge or be cleared for work in-hospital.

5. Hospital Orientation/Health Clearance - SBIRT applicants indicate their ongoing availability for interviews and other one-time events as part of their SBIRT application. St. Elizabeth's Volunteer Services department is committed to offering two-hour orientation sessions convenient for screeners during the training interval between the conclusion of the application/interview process and the effective start date of the SBIRT patient contact experience each semester. In addition, all incoming screeners are required to submit Measles/Mumps/Rubella (MMR) vaccination records, chickenpox (varicella) vaccination records or titers, and a minimum of one PPD tuberculosis skin test from the past twelve months to St. Elizabeth's Employee Health Services department by way of SEMC Volunteer Services no later than one week in advance of the effective start date of their SBIRT patient contact experience in order to be eligible to begin service in-hospital. Completion of all of St. Elizabeth's Medical Center's standard requirements for incoming volunteers, including a Criminal Offender Record Information background check, is required before an SBIRT volunteer can receive the specialized identification badge required for their duties. Such badges remain in the custody of the SEMC-BC SBIRT Collaborative Manager until the hospital's on-boarding process has been completed and the SBIRT's entire training process in advance of the patient contact start date has been completed.

6. In-Hospital Introductory Training Period - New screeners are expected to begin their service at our St. Elizabeth's Emergency Department brief intervention site during Halloween weekend in the fall and St. Patrick's Day weekend in the spring. High patient volume is expected for both holiday weekends, especially given the usual inclusion of a Boston College home football game in the fall. The SEMC-BC SBIRT Collaborative Manager or designated substitute supervision will be present in-hospital for the entirety of each shift during the first four weekends following training, beginning with the Halloween/St. Patrick's weekends, to ensure new screeners are adjusting to their role as patient interviewers and advocates. New screeners will then be paired with previously certified screeners to facilitate their mastery of the conceptional and contextual knowledge required for effective SBIRT encounters. After the conclusion of the introductory service period screener candidates will be re-classified "ready for active service" and extended additional responsibilities and privileges regarding the screening role. All incoming screeners begin their service period at our SEMC Emergency Department site for their first three months. Please click on the following link for an in-depth discussion of SBIRT shift/meeting schedules.

The logistics involved with your training seem pretty intense. Any advice?

The St. Elizabeth's Medical Center-Boston College SBIRT Collaborative has a lengthy checklist of prerequisites for accepted candidates because of our unique identity as a clinician-equivalent health care volunteer program. We need to ensure that standard Joint Commission/Department of Public Health requirements for incoming volunteers are fulfilled; additionally, our recruits must demonstrate a sufficient grasp of both the methodological framework and conceptual understanding necessary to perform adequately in a real-life patient encounter setting. Many of our requirements (most notably our online application, transcript, video lecture and health clearance stipulations) can be completed weeks or even months in advance of posted deadlines by candidates who want to move forward with entire the process as expeditiously as possible in the event they are accepted into our program (particularly if they are serving as volunteers in other roles at St. Elizabeth's in advance of their SBIRT candidacy). We similarly post our scheduled information session, training session and meeting commitments more than one full year in advance so applicants have every opportunity to anticipate the specific time commitments involved in order to plan their schedules accordingly. We would also like to add that email, phone, text and other communications from the SBIRT Collaborative are never sent casually - we try our best to respond promptly to inquiries and endeavor as much as possible to contact in-process candidates proactively regarding pending deadlines. We ask candidates to take our outreach as seriously as we value our qualitative level of communication back to candidates. In the event that a candidate receives an email or other communication that would cause him/her any uncertainty, we are more than happy to address any questions, comments or concerns immediately in the best interest of both parties.

Screener Expectations, Support, & Compensation

I'm concerned about the time commitment. Will screener duties balance with my academic/personal life?

Active SBIRT screeners are held responsible for a minimum of one four-hour shift three weekends per month as well as consistent attendance at our biweekly Sunday night clinical review meetings, which last two hours. While this may seem a hefty commitment, our past and current screeners have found that it does not significantly interfere with their other commitments which include PULSE placements and leadership roles in other student organizations. (In fact, our program's structure very closely follows St. Elizabeth's Medical Center's standard 4-hour weekly commitment stipulated for all volunteers, with the caveat that SBIRT service times are very specifically marked out in advance to provide necessary shift coverage and clinical supervision.) Our active SBIRT Collaborative screeners compromise on which shifts work best for them on a week-by-week basis. The Sunday night meetings are designed to provide a continuing education component as well as a channel to voice any concerns or comments in order to ensure consensus among members regarding best practices and ongoing development. With a comprehensive support system for active volunteers already in place, our screeners find that the SBIRT program offers as much to them as they put in. We know undergraduates balance a multitude of academic, social, familial, and other commitments during their college years. Indeed, we've come to expect that persons with a plethora of activities are often some of the strongest candidates for our program due in large part to the other experiences they have already sought for themselves outside the standard graduation track. We encourage all candidates to seriously weigh both the opportunities and the obligations involved before applying to our program. Our application is designed to help us assess a screener candidate's suitability for our program by beginning a conversation about the necessary mindset and prior experiential background to perform this work at an acceptable level of proficiency despite a relatively brief training and on-boarding time frame. Our detailed training requirements are intended to ensure that incoming screeners receive the necessary foundation and ongoing support for the successful performance of their duties. Our academic transcript requirement exists to ensure that each screener candidate is demonstrating adequate proficiency in the academic aspects of health care and not jeopardizing their degree through excessive extracurricular commitments. The SBIRT Collaborative Manager and a number of current and former screeners are available to speak with candidates at their convenience regarding the strengths of our program structure and the considerable long-term benefits for screeners who participate in the SBIRT Collaborative. The St. Elizabeth's Medical Center-Boston College SBIRT Collaborative is a strong team environment where our staff and screeners support each other for the collective benefit of patients as well as our own self-improvement.

This seems more like social work as opposed to clinical medicine. Why should I be interested?

Brief intervention methodologies do have some structural elements in common with social work encounters but there is clear value in SBIRT for any pre-clinician, especially for persons interested in behavioral health, neurology, and trauma. Our highest-risk patients (i.e. high school and college students) frequently exhibit altered mental status during hospitalizations for substance use and such Emergency Medicine/inpatient admissions constitute a significant percentage of medical care provided to persons in the 16 to 25 age demographic including testing and care required to treat falls, concussions and other related trauma associated with excessive alcohol use or regular use of illicit substances. The SBIRT Collaborative has partnered with Eagle EMS to develop a comprehensive hospitalization protocol for substance use patients which will directly impact procedures undertaken by campus and hospital professionals including Boston College Police, University Health Services, and Eagle EMS as well as St. Elizabeth's Emergency Medicine. Screeners are not social workers but knowledge of behavioral health skills is highly useful in assessing if a patient referral to supportive services like chaplains, counselors, or social workers is advisable and makes providing access to those resources much more straightforward should the need arise. Such support services are crucial in helping some patients break cycles of self-destructive behavior, which will take on much greater financial importance once health care reform implements pay-for-perfomance standards to replace the current fee-for-service compensation structure for health care providers. The SBIRT Collaborative believes that the communication skills required for brief intervention are equally important to health care as compared to clinical knowledge because even after a diagnosis has been made the patient needs to receive the necessary information in a constructive fashion in order to make an informed decision in his/her own long-term interest in order to increase the odds of an outcome that will minimize or even remove the need for additional care. Clinicians with a proven track record of preventative health care experience extending back through their undergraduate years will be best-positioned to demonstrate proven value when competing for future residency, fellowship, and related medical staff opportunities.

Can SBIRT really help me professionally with future medical career aspirations?

Several of our current and former screeners have related to us that their participation in SBIRT has been extremely advantageous for them when applying to a broad range of post-graduate programs, research opportunities, and job openings. A few have even reported being contacted by application review committees and prospective supervisors with the specific question, "What is SBIRT, and what did you do for it?" which gave them the opportunity to share their patient contact experiences at-length. Several of those managers later contacted us to confirm the service our screeners had performed with us, largely because other programs with similarly high standards and intensive training regimens rarely accept undergraduates, let alone provide patient services relying solely on such recruitment. We feel that any screener who demonstrates the passion and commitment to master our substance use intervention methodology will be an extremely competitive candidate going forward regardless of the specific career track or opportunities he/she chooses to pursue. SBIRT competence is built on a solid foundation of communication skills - essential in a variety of professions but particularly crucial in medicine, where empathy and patience are vital to the process of earning patient trust and achieving an improved health care outcome. Screeners (particularly persons making multi-year commitments) are welcome to add-on to their required roles within our program as their skills sets and availability permit. Our screeners have already achieved a number of notable milestones, including the identity of first-ever undergraduate SBIRT screeners, a presentation of their preliminary research at two national conferences, the composition and production of their own screening how-to demos and direct assistance to Collaborative staff with incoming screener recruitment and training. We are confident that all current and incoming screeners will exhibit the same spirit of dedication to public service and continue identifying new ways to support substance use intervention and prevention efforts in Allston-Brighton and beyond.

I'm curious. From a logistical perspective, what resources support the Collaborative?

As a cross-disciplinary program, the SBIRT Collaborative has successfully mobilized a broad alliance of partnerships and support structures to ensure our success. We are a self-contained volunteer-driven research effort with oversight from SECAP (St. Elizabeth's Comprehensive Addiction Program) and pro bono operational assistance courtesy of Boston Medical Center. The SBIRT Collaborative Manager is available 24/7/365 via mobile phone and email to assist screeners in any emergency situation and resides less than fifteen minutes from both St. Elizabeth's Medical Center and Boston College. On-boarding new screeners is handled by SEMC's Volunteer Services, Employee Health Services, Security, and Nutrition departments who ensure volunteers are properly oriented to the hospital and fully equipped for their service experience. Screeners interface directly with Emergency Medicine and operationally integrate their activities into the ED patient experience at the direction of charge nurses and attending physicians, which includes access to confidential patient charting and test results from Patient Access, Medical Records, Radiology, and Phlebotomy. Screeners frequently refer patients to a number of in-hospital departments including SECAP, Psychiatry, Spiritual Care Services, Interpreter Services, and Social Work for specialized support and assist discharged patients in transitioning to off-site programs and services, including on-campus offerings at BC and elsewhere. Boston College's Office of the Dean for Student Development and Alcohol & Drug Education Program coordinate the SBIRT Collaborative's on-campus presence, meeting spaces, and activities while Eagle EMS, the Connell School of Nursing, and Graduate School of Social Work provide recruiting avenues and relevant expertise. Spiritual advisors from Boston College's Campus Ministry are available to discuss SBIRT encounters confidentially with screeners, receive patient referrals from screeners, and assist with our modifying SBIRT methodology to incorporate a more comprehensive spiritual assessment component. BC's Media Technology Services has made their studio, camera and editing facilities available for our media production efforts. Boston College screeners are directly supported in their work by the Boston College Police and Eagle Escort, who provide transportation for them and advise the Collaborative regarding upcoming on-campus events expected to result in increased patient flow. Screeners meet regularly with the SBIRT Collaborative Manager in group and one-on-one settings to discuss their experiences as members of our program.

I'm very interested in finding a work study job or paid internship. Do you offer anything like that?

The SBIRT Collaborative is obligated to seek out the strongest candidates from each pool of applications for the benefit of our patients. Becoming an off-campus work study site would interfere with our efforts to provide effective ongoing coverage by reducing the number of qualified applicants without regard to their prior experience, level of maturity, and other critical factors. Our program's qualifications are sufficiently rigorous that the additional requirement of a work study award would significantly hamper our recruiting efforts. Screener candidates have various remunerative work opportunities available including the possibility of per diem work at local health care institutions (click the following link to be connected to our job openings page). Boston College's Alcohol & Drug Education Program has generously agreed to consider SBIRT screener candidates for financially remunerative positions as on-campus CHOICES facilitators provided they have completed a minimum of one year of prior service in the SBIRT Collaborative and remain active with our organization while taking on such a role since the CHOICES program is a common requirement for Boston College student patients referred to ADE through the judicial review process. The SBIRT Collaborative does not actively assist students in seeking paid employment at St. E's or elsewhere (in fact all our staff including both clinicians and non-clinicians also work pro bono), but we are more than happy to serve as a reference based on each student's documented performance as a participant in our program. Our close relationship with our screeners has strengthened their candidacies for a number of exceptional research and employment opportunities nationwide; we actively seek to maintain an ongoing relationship with all of our screeners and to assist them in their future professional development. We're always very pleased to be able to testify, "Screener X did in fact complete a cutting-edge substance use intervention training program as a Boston-area student/professional. He/she interviewed ## patients in a one-on-one encounter setting and fulfilled ### hours of service and even assisted our staff with training and outreach while balancing a demanding workload of academic and/or other obligations. She/he is one of only a handful of persons nationwide trained to perform this work and we were specifically impressed with his/her service because..."

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St. Elizabeth's Medical Center

SBIRT FAQs

Part I: Mission Statement

Part II: Outreach & Recruitment

Part III: SBIRT Screener Application

Part IV: SBIRT Training Process

Part V: Screener Expectations, Support, & Compensation

Mission Clarification

Outreach & Recruitment

SBIRT Screener Application

SBIRT Training Program

Screener Expectations, Support, & Compensation