# About This Toolkit

This toolkit was developed as part of the Gambling CARE Knowledge Hub, funded by Gambling Research Exchange Ontario (GREO) and overseen by Lena Quilty, Senior Scientist, and Premika Premachandiran, Research Analyst, from the Campbell Family Mental Health Research Institute and Clinical Research: Addictions at the Centre for Addiction and Mental Health.

This toolkit was developed to provide community and health care organizations with the information and tools needed to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocols to identify and help individuals with problem gambling.

SBIRT protocols have been effectively applied to reduce the harms from other risky health behaviours such as alcohol use across a wide range of community and healthcare settings.^2,3 The goal of this toolkit is to extend the success of these practices to gambling.

This toolkit provides:

• information about SBIRT protocols and utility of SBIRT for problem gambling
• recommendations for screening tools for problem gambling
• recommendations for brief interventions and case examples
• recommendations for referral to treatment services for problem gambling, with a focus on Ontario services
• information on how to implement an SBIRT protocol within your organization.

# Who is this toolkit for?

This toolkit is intended to provide guidance on how to implement an SBIRT protocol for problem gambling.

Organizational mandates and activities, as well as staffing and role responsibilities, differ widely. This toolkit is intended to be used flexibly by service providers and teams working in clinical and community settings. For instance:

• If some steps are beyond a staff member’s scope of practice, they can be delegated or modified, as long as the objectives are achieved.
• If your organization does not have the capacity to implement brief interventions, you can go directly from screening to referral to treatment.

See Implementing an SBIRT Protocol for suggestions on how to start the conversation about organizing an SBIRT protocol within your institution.

# How was this toolkit developed?

This toolkit was informed by a systematic review and meta-analysis that highlighted the utility of SBIRT for the treatment of problem gambling.⁴

The feedback we received through our preliminary needs assessment and subsequent knowledge user consultations provided further guidance on the contents of the toolkit and support for the utility of this resource.

This toolkit was adapted from the following resources:

• Babor, T.F., McRee, B.G., Kassebaum, P.A., Grimaldi, P.L., Ahmed, K., & Bray, J. (2007). Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance Abuse, 28 (3), 7–30. DOI: 10.1300/J465v28n03_03
• Substance Abuse and Mental Health Services Administration – Health Resources and Services Administration (SAMHSA-HRSA). SAMHSA-HRSA Center for Integrated Health Solutions. Available at https://www.integration.samhsa.gov/clinical-practice/sbirt
• Massachusetts Screening, Brief Intervention, and Referral to Treatment Training and Technical Assistance program. (n.d.). SBIRT: A Step-By-Step Guide for Screening and Intervening for Unhealthy Alcohol and Other Drug Use. Available at https://www.masbirt.org/sites/www.masbirt.org/files/documents/toolkit.pdf
• Matua Raki. 2012. Brief Intervention Guide: Addressing Risk and Harm from Alcohol, Other Drugs and Gambling. Matua Raki, Wellington.
• Miller, W.R., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change. New York, NY: Guilford press.

Suggested citation: Quilty, L., & Premachandiran, P. (2018). The SBIRT Toolkit - A toolkit for community and healthcare settings. Toronto, ON: The Centre for Addiction and Mental Health.