1. Raise the Subject | SBIRT Toolkit

# Step 1: Raise the Subject

# Key objectives:

Ask for permission to discuss gambling behaviours.
Be respectful of the client and convey empathy.
Acknowledge the client’s autonomy and respect their choices.

WARNING

The first step sets the tone for your rapport with a client and the success of the brief intervention. Asking for permission emphasizes the client’s sense of control over the conversation.

Objectives	Actions / Examples
Establish Rapport	Explain your role “Hello, I am _____. Would you mind taking a few minutes to discuss gambling?” Normalize conversation “We ask these questions with all of our clients to inform our services, and make sure we’re providing you with the best care.” Ask for permission “I’d like to take a moment to ask about how gambling has impacted your life, and to explore whether you’d like to make any changes in your gambling. Would that be okay?”
Raise Subject	Engage client “Your responses to the questionnaire we asked you to complete earlier suggest that you may be having some difficulties with gambling. Research has shown that having a brief conversation about how gambling fits into your life and considering reasons to change can have a lasting, positive effect.”
Respect Client Autonomy	Reinforce client’s choice to discuss their behaviours “It is your choice to take this opportunity. This is an important time to begin thinking about reasons to change, as you may be at risk of worsening gambling problems if you were to continue with the same patterns. I would like to be able to discuss this further with you, but change is ultimately a personal process, and if you do not want to continue with this conversation, that is okay.”

Objectives

Actions / Examples

Establish Rapport

Explain your role
“Hello, I am _____. Would you mind taking a few minutes to discuss gambling?”

Normalize conversation
“We ask these questions with all of our clients to inform our services, and make sure we’re providing you with the best care.”

Ask for permission
“I’d like to take a moment to ask about how gambling has impacted your life, and to explore whether you’d like to make any changes in your gambling. Would that be okay?”

Raise Subject

Engage client
“Your responses to the questionnaire we asked you to complete earlier suggest that you may be having some difficulties with gambling. Research has shown that having a brief conversation about how gambling fits into your life and considering reasons to change can have a lasting, positive effect.”

Respect Client Autonomy

Reinforce client’s choice to discuss their behaviours
“It is your choice to take this opportunity. This is an important time to begin thinking about reasons to change, as you may be at risk of worsening gambling problems if you were to continue with the same patterns. I would like to be able to discuss this further with you, but change is ultimately a personal process, and if you do not want to continue with this conversation, that is okay.”