Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based, public health approach to the early identification of potentially risky health behaviours and provision of treatment services for individuals engaging in these behaviours. Using evidence-based screening tools, the SBIRT protocol has been adapted to identify people with problem gambling behaviours and provides recommendations for brief intervention or referral to treatment, depending on client needs (University of Toronto et al., n.d.).
This page explores the evidence for the benefits of using SBIRT as well as guidelines to identify and help clients address their problem gambling. This information is for providers of mental health and addiction services working in community healthcare organizations. It is based on a review of the literature and was reviewed by researchers and clinicians in the field.
About Screening, Brief Intervention and Referral to Treatment
The SBIRT protocol includes three steps:
- Screening. The clinician uses a standardized screening tool to determine if the client engages in risky gambling (University of Toronto et al., n.d.).
- Brief Intervention. If the screening results show moderate risk, the clinician may use a brief intervention to raise the client’s awareness of the potential consequences of their gambling and explore their motivation to change. Brief interventions can last from five to 15 minutes (Abbott et al., 2018; Petry et al., 2009; Petry et al., 2017; Toneatto, 2016).
- Referral to Treatment. If the screening results show the client is at high risk, the clinician may provide a referral to specialized treatment according to the client’s specific needs (University of Toronto et al., n.d.).
What does the evidence say?
While there is limited evidence on the benefits of using SBIRT for problem gambling, it has been shown to be effective in reducing substance use in a variety of client populations (O’Donnell et al., 2014; Platt et al., 2016; Tanner-Smith et al., 2015).
Screening measures for problem gambling are well established, especially among people seeking or receiving treatment for mental health and/or substance use (see Screening and Assessment; Dowling et al., 2018).
Brief interventions have been shown to reduce gambling frequency and prevent relapses, and the benefits appear to be as good as those achieved with longer interventions (Abbott et al., 2018; Petry et al., 2009; Petry et al., 2017; Toneatto, 2016).
How do I put the evidence into practice?
To learn how you can apply the SBIRT protocol when working with clients who may be experiencing a gambling problem, see SBIRT for Problem Gambling – a Toolkit for Community and Healthcare Settings.
The following video demonstrates the second step of a brief intervention. The focus of this step is to provide feedback on the results of a full gambling screen completed by the client.
Abbott, M., Hodgins, D.C., Bellringer, M., Vandal, A.C., Palmer Du Preez, K., Landon, J., et al. (2018). Brief telephone interventions for problem gambling: A randomized controlled trial. Addiction, 113 (5), 883–895. Available: https://doi.org/10.1111/add.14149. Accessed March 10, 2021.
Dowling, N.A., Merkouris, S.S., Manning, V., Volberg, R., Lee, S. J., Rodda, S. N. et al. (2018). Screening for problem gambling within mental health services: A comparison of the classification accuracy of brief instruments. Addiction, 113 (6), 1088–1104. Available: https://- doi.org/10.1111/add.14150. Accessed March 10, 2021.
O’Donnell, A., Anderson, P., Newbury-Birch, D., Schulte, B., Schmidt, C., Reimer, J. et al. (2014). The impact of brief alcohol interventions in primary healthcare: A systematic review of reviews. Alcohol and Alcoholism, 49 (1), 66–78. Available: https://doi.org/10.1093/alcal- c/agt170. Accessed March 10, 2021.
Petry, N.M., Rash, C.J. & Alessi, S.M. (2017). A randomized controlled trial of brief interventions for problem gambling in substance use treatment patients. Journal of Consulting and Clinical Psychology, 84 (10), 874–886. Available: https://doi.org/10.1037/ccp0000127. Accessed March 10, 2021.
Petry, N.M., Weinstock, J., Morasco, B.J. & Ledgerwood, D.M. (2009). Brief motivational interventions for college student problem gamblers. Addiction, 104 (9), 1569–1578. Available: https://doi.org/10.1111/j.1360-0443.2009.02652.x. Accessed March 10, 2021.
Platt, L., Melendez-Torres, G.J., O’Donnell, A., Bradley, J., Newbury-Birch, D., Kaner, E. et al(2016). How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metare- gression analysis. BMJ Open, 6 (8), e011473. Available: https://doi.org/10.1136/bmjopen-2016-011473. Accessed March 10, 2021.
Tanner-Smith, E.E., Steinka-Fry, K.T., Hennessy, E.A., Lipsey, M.W. & Winters, K.C. (2015). Can brief alcohol interventions for youth also address concurrent illicit drug use? Results from a meta-analysis. Journal of Youth and Adolescence, 44 (5), 1011–1023. Available: https://- doi.org/10.1007/s10964-015-0252-x. Accessed March 10, 2021.
Toneatto, T. (2016). Single-session interventions for problem gambling may be as effective as longer treatments: Results of a randomized control trial. Addictive Behaviors, 52, 58–65. Available: https://doi.org/10.1016/j.addbeh.2015.08.006. Accessed March 10, 2021.
University of Toronto, Campbell Family for Mental Health Research, Centre for Addiction and Mental Health & GREO Knowledge Hub, (n.d.). SBIRT for problem gambling: A toolkit for community and healthcare settings. Available: https://learn.problemgambling.ca/PD- F%20library/SBIRT-manual-version-2.0-090418.pdf. Accessed February 24, 2021.