BRief Intervention and Treatment for Elders
Funded by the SAMHSA/Center for
Substance Abuse Treatment
The mission of the Brief Intervention and
Treatment for Elders (BRITE) project is to serve individuals 55 years and older
to identify non-dependent substance use or prescription medication issues and
to provide effective service strategies prior to their need for more extensive
or specialized substance abuse treatment.
BRITE implements the Screening, Brief Intervention,
and Referral to Treatment (SBIRT) initiative of the
BRITE clients were offered
screening, brief intervention, and brief treatment by these generalist
providers or were referred to more intensive care by a substance abuse
specialist provider agency. Providers were selected through a competitive
process requiring “requests for proposals” submitted to the Florida Department of Children and Families Substance Abuse Program
Office (DCF/SAPO).
BRITE services were
offered in places such as retirement communities, senior centers, general and
trauma hospitals, primary care and urgent care clinics, VA medical facilities,
and federally qualified health centers (FQHCs). Since the CSAT grant began, there have been 31
Florida BRITE provider agencies in 18 counties conducting screenings in more
than 70 different locations. By the end
of the grant in September 2011, over 91,000 people were screened. Most were adults
ages 55 and older (93.3%). The remainder were adults under the age of 55 (6.7%)
identified and served by sites in Orlando, Ft. Lauderdale, and Pensacola under
separate funding from the Florida Department of Children and Families (beginning
in 2010) who were screened at federally qualified health centers (FQHCs).
Conference Presentations
Results have been
presented at the annual conferences of the Gerontological Society of America,
the Florida Conference on Aging, and at the annual SBIRT grantees meetings in
Bethesda and Rockville, MD.
Nationally, SBIRT programs typically are
located in medical settings such as emergency departments and primary care
practices. In many states, all admissions to the medical setting are screened
for substance abuse and then given a brief intervention if there are signs of problems
that are related to substance use. Duration for a typical session in an E.R.
might be no more than 20 minutes, but research indicates substantial reduction
in harmful behaviors. Examples of such brief approaches presented as videotaped
vignettes can be found at the Boston University Medical Center’s website: http://www.ed.bmc.org/sbirt/cases.php.
The Florida BRITE
Project is the first federally funded SBIRT project that focuses specifically
on the older adult. In addition to medical settings, BRITE screens and provides
brief interventions in aging services, retirement communities, senior housing,
at health fairs, and at other locations. This population is a high priority
age-group in Florida, given that Florida has the highest median age population
among all states in the U.S. BRITE has
also included a veterans’ initiative with the addition of the Miami Veterans
Hospital (Bruce W. Carter Department of Veterans Affairs Medical Center). Dr.
Robert Hazlett who previously worked in Pennsylvania for that state’s SBIRT
grant has provided all the training and quality assurance, and developed the
educational materials currently used by BRITE.
History: The
Pilot Project
The CSAT grant
award was built on the success of a three-year pilot project from 2004-2007
funded by DCF/SAPO conducted by Broward County Elderly and Veterans Services,
Gulf Coast Jewish Family Services (Pinellas County), Center for Drug Free
Living (Orlando), and Coastal Behavioral Health Care (Sarasota). Those four
agencies worked closely with aging services and other service providers to
screen older adults, often in the elders’ homes. Results from the pilot study
of 3,497 screenings were published in the American Journal of Public Health. That article illustrated statistically
significant reductions in use of alcohol, medications, and illicit drugs, as well
as reduced symptoms of depression. The provider agencies in that pilot study
not only offered in-home screening, but also brief intervention and brief
treatment for problems related to alcohol, illicit substances, and prescription
and over-the-counter medications. The original four agencies were the first to
be part of the five-year CSAT grant and began using the new protocols in
January 2007. Dr. Robert Hazlett, who
had previously worked on Pennsylvania’s SBIRT project in the first cohort
receiving these CSAT grants, developed the protocols that allowed BRITE to
shift from a pilot project to the requirements for the federal grant.
For
information about BRITE, please contact:
Larry Schonfeld,
Ph.D.,
Professor and Interim Executive Director, Florida Mental Health Institute,
University of South Florida, Tampa, FL 33612 (co-Evaluator)
·
Phone: (813) 974-1946
·
Email: schonfeld@fmhi.usf.edu
Locations
The Florida BRITE Project provider agencies
were headquartered in the sites represented by the red stars in the map below.
Cumulatively, these agencies screened in more than 70 different locations
including hospitals, urgent care centers, trauma centers, aging services,
health fairs, and numerous other locations.
Florida BRITE Project Provider Locations
The Florida BRITE
Project operate in over 70 different sites under contracts with the following
agencies in the Florida Department of Children and Families’ circuits (service
areas):
1st Circuit
Lakeview
Center, Inc. Baptist Hospital Emergency Room, Pensacola
1000 West Moreno St., Pensacola, FL 32501
(850) 434-4011
4thCircuit
Urban Jacksonville/Shands
Contact: Hannah Hackworth,
Program Coordinator
Email: hhackworth@urbanjax.com
Phone: (904) 807-1230
http://urbanjacksonville.com/mentwelldept.html
Urban Jacksonville Aging Services
Contact: Hannah Hackworth,
Program Coordinator
Email: hhackworth@urbanjax.com
Phone: (904) 807-1230
http://urbanjacksonville.com/mentwelldept.html
Shands Jacksonville Level 1 Trauma
Center
655 West
8th Street
Jacksonville,
FL 32209
Contact:
Britnee Bell, BRITE Administrative Coordinator
Email:bskinner@urbanjax.com
Phone: (904)807-1228
Shands Ambulatory Care Center
655 West
8th Street
Jacksonville,
FL 32209
Contact:
Brian Hultgren, BRITE Outreach Coordinator
Email:bhultgren@urbanjax.com
Phone: (904)807-1228
5th Circuit - 2 sites:
Lake
Regional Urgent Care Center - Two sites:
Contact:
Raymond Dominic, M.D., Director of Operations
Email: lruc@comcast.net Phone: (352) 315-8881
Lake Regional Urgent Care -
Leesburg
8404 Hwy 441
Phone: (352) 315-8881
The Villages, FL 32162
Phone: (352)
259-4322
9th Circuit
The Center For Drug Free Living Inc.
(2 Programs)
BRITE Program in
BRITE Program in
Contact:
Victoria Adams, LPN, CCJS, MAC, Lead Health Educator
Email:
vadams@cfdfl.com
Phone: (407)
245-0010 ex: 267
Aloma Urgent Care
Suite
103
Contact: SRee Gunge, Executive Director
Email: sgunge@alomaurgentcare.com
Phone:
(407) 215-6370
Clermont Walk-In Clinic
Clermont FL 34711
Contact: SRee Gunge, Executive Director
Email: sgunge@alomaurgentcare.com
Phone: (407) 215-6369
Longwood Walk-In Clinic
458 S. Milwee St
Contact: SRee Gunge, Executive Director
Email: sgunge@alomaurgentcare.com
Phone: (407) 215-6397
10th Circuit
Florida Hospital Heartland Division Sebring – Emergency Department
4200 Sun 'n Lake Boulevard
Sebring, FL 33870
Contact: Mark W. Medick, BRITE Healthcare Educator
Email: medick.mark@ahss.org
Phone: (863) 314-4357 (Office)
Florida Hospital
Heartland - Lake Placid
1210 US Highway 27
Lake Placid, FL 33852
Contact: Keith Edwards, Executive Director
Email: keithedwards@ahss.org
Phone: 863-386-5687
Winter Haven
Hospital
200 Avenue F NE
Winter Haven, FL 33881
863-293-1121
Jenny Blank, Vice-President Patient Care
jenny.blank@winterhavenhospital.org
Julie Kwilinski, BRITE Coordinator
Phone: 863-293-1121 Ext. 4465
11th Circuit
Jackson Memorial Hospital
Lynne Roberts,
BRITE Program Manager
Email: lroberts@um-jmh.org
Phone:
305-355-8034
Grace Carbonell, BRITE Supervisor.
901 NW 17th Street, Ste G, Miami, FL
33136-1038
Phone: (305) 355-4741
Jackson North Community Mental Health Center
Windi Donald,
BRITE Program Manager (JNCMHC)
Email: wdonald@um-jmh.org
Phone: (786)
466-2826
Fax: (786)
466-2925
Catholic Charities of the Archdiocese of Miami
Contact: Dr. Martin Terris, Director of Grants and
Research
Email:
mterris@ccam.org
Phone: (305)
762-3050
(Miami Veterans Health Care System)
Bruce W. Carter Department of Veterans
Affairs Medical Center
1201 N.W. 16th St. (116A)
Miami, Florida 33125
Contact: Julie
E. Malphurs, PhD, Assistant Professor of Research
Mental Health & Behavioral Science
Service
Email:
julie.malphurs@va.gov
Phone:
number (305) 575-7000 ext 3048
12th Circuit
Coastal Behavioral Healthcare, Inc. (
7810 S. Tamiami Trail,
Contact: Amy Thatcher, LSW, Team
Leader: CCST SOUTH
Email: athatcher@coastalbh.org
Office (941) 492-4300 x130
FAX. (941) 492-2170
http://www.coastalbh.org/saadultsgeriatric.htm
13th Circuit
Abigail Alexander, Director of Research and
Training.
Email: Alexander@gcjfs.org
Phone:
305 805-5060
http://www.gcjfs.org/brite.htm
Centre for Women
Contact: Denise Dydowicz, LCSW
Director of Behavioral Health Services
Email: ddydowicz@cfwtampa.org
Phone: (813) 251-8437 ext 241
http://www.centreforwomen.net/brite/help_seniors_brite.swf
Drug Abuse Comprehensive
Coordinating Office, Inc.
Contact: Sherri Kincaid, Project Coordinator
Email: sherrik@dacco.org
Phone: (813) 984-1818
http://www.dacco.org/program.html
15th Circuit
Palm Beach County Division
of Senior Services
Contact: Sharon Richardson,
Operations Supervisor
Email: Srichard@pbcgov.org
Phone (561) 355-4759
Fax (561) 355-3222
Hanley Center- Lakeside
Hospital
Hanley Center
933 45th Street
West Palm Beach, FL 33407
Contact: Laurie Belleer, BRITE Coordinator
Email: lbeller@hanleycenter.org
Phone: (561) 841-1081
17th Circuit
Contact: Raul Gordillo, PsyD, BRITE Project
Supervisor;
Email:
rgordillo@broward.org
Phone:
954-537-2936 Extension 12930
http://www.broward.org/eldervets/welcome.htm
Broward
County VA Outpatient Center (Miami VA Healthcare System)
9800 West Commercial Blvd.
Sunrise, FL
33351
(954) 475-5500
Contact:
Lynette Claude, BRITE Health Educator
Email:
Lynette.Claude@va.gov
Phone: (954) 475-5500 Ext. 8604
20th Circuit
Contact: Barbara
Davis, BRITE Coordinator
Email: bdavis@swfas.org
Phone: (239)
332-6937 ext. 110
http://swfas.org/us/content/prevprogs.html
The
The
Florida BRITE Project collects prescreening, screening, and assessment data
using instruments required by SAMHSA’s Center for Substance Abuse Treatment
(the funding source for the project) and educational materials developed by Dr.
Hazlett. These are as follows.
Required CSAT GPRA Instruments:
- Go to SAMHSA’s “Services
Accountability Improvement System or “SAIS” at https://www.samhsa-gpra.samhsa.gov/home/index.htm
- At the bottom of the page click
on the box that says: “CSAT-GPRA”
this will take you to another webpage.
- Click on “GO” and this will
take you to the CSAT GPRA page
- On the far left side of the
page, click on the “Data Collection Tools”
- This will open another header
“Services” click on that
- Select the English or Spanish
language instructions for the GPRA assessments as required.
----------------------------------------
Online
Training for Florida BRITE Project Providers (only)
Southern
Coast Addiction Technology Transfer Center (Southern Coast ATTC)
Dr. Hazlett
conducted training for all BRITE sites.
Videotaped versions of his training are available via registration with
the Southern Coast ATTC. To access the
course, users need to go to the SCATTC Distance Education website and set up an
account:
1.
Go
to the website: www.scattc.net
2. In
the course listing, click on DCF Provider Training. In that listing users will
see the Florida BRITE Project: Screening and Brief Intervention course. When
users click on the course, they will be asked to register and set up an account
(user name and password)
3. This
course requires an "Enrollment Key". Users will be prompted to
contact LaShanda Farmer at SCATTC for the enrollment Key- lfarmer@scattc.org
4.
Users can then log into the course with their user name, password and
enrollment Key at any time they like.
The
course is self-paced which means that users can watch the videos in their own
time and take as long as they want to complete the course. Twelve
(12)
continuing education credits/contact or clock hours are provided for the
course. This course has an examination to test proficiency upon completion.
Users must pass the test by 70% in order to receive the Certificate of
Completion and the continuing education hours.
------------------------------------------------------
Procedures
for Initiating and Sustaining the Florida BRITE Project
Authored
by Robert W.
Hazlett, Ph.D, CAC, CCS
Florida BRITE
Project “Business Process Analysis” – This is a guide for BRITE providers to
use to obtain information about a clinic or hospital unit’s operating routine.
It guides the BRITE team’s effort to design a protocol to implement BRITE in a
specific setting, while being sensitive to the workflow and logistical support
issues of that particular setting.
Florida BRITE Project
“Initial Training Manual” – this manual provides training to site
personnel for screening of potential substance use, abuse and dependence
disorders in a hospital, primary care or clinic setting and how to apply brief
intervention strategies matched to the patient’s severity of use/abuse of
alcohol and other drugs (AOD).
Florida
BRITE Project “Sustainability Manual” – This is a guide to understanding
what is involved in the process of developing a sustainability plan for SBIRT
services even after federal grant funding ends. It is a framework that allows
for flexibility and change in your agency’s local environment, and that
considers elements that may impact that environment.
Assessment
Instruments and Educational Materials for BRITE
Some materials are
in the public domain and available from CSAT and other selected instruments
developed for BRITE can be accessed by emailing Dr. Robert Hazlett: robert_hazlett@dcf.state.fl.us
Screening Instruments
- BRITE Prescreening Instrument –
NOTE: You are required to complete the demographics section of GPRA Screen
Part A as well
- Short Geriatric Depression
Scale (S-GDS) – Administer if the person responds “YES” to either of the
two prescreening items on depression.
- GPRA Screen Part A –
Demographics only:
- BRITE Screening GPRA –
Part A (English) = Page 2 of GPRA (demographics)
- BRITE Screening GPRA –
Part A (Spanish) = Page 2 of GPRA (demographics)
- Required
instruments available from CSAT or the World Health Organization (WHO0
- Florida BRITE Providers may
download the following items from either the respective websites:
Educational Materials
- Handouts to be distributed to
professionals and clients of the BRITE Project are available in both
English and Spanish.
- Crack and Cocaine
(English)
- Crack and Cocaine
(Spanish)
- Methamphetamine
(English)
- Methamphetamine
(Spanish)
- Stimulants
(English)
- Stimulants
(Spanish)
- Curricula
- Brief Intervention:
1.
BRITE Health Promotion
Workbook (English)
2.
BRITE Health Promotion
Workbook (Spanish)
3.
Brief Intervention for
Problematic Use: Guidelines for Use in
Primary Care (from World Health Organization)
- Brief Treatment:
Substance Abuse Relapse
Prevention for Older Adults (from SAMHA/CSAT 2005). Order hard
copies from SAMHSA’s clearinghouse by at NCADI website: http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=17179
- Supplemental Materials for
Brief Intervention and Brief Treatment
- How to Prevent
Alcohol-Related Problems (English)
- How to Prevent
Alcohol-Related Problems (Spanish)
- All Purpose Coping Plan
(English)
- All Purpose Coping Plan
(Spanish)
- AOD Refusal Skills
Homework (English)
- AOD Refusal Skills Homework
(Spanish)
- Coping Tool for Homework
(English)
- Coping Tool for Homework
(Spanish)
- Functional Analysis(English)
- Functional Analysis
(Spanish)
- Short-Term Goal Work
Sheet (English)
- Short-Term Goal Work
Sheet (Spanish)
- Long-Term Goal Work
Sheet (English)
- Long-Term Goal Work
Sheet (Spanish)
- Managing Availability
Homework (English)
- Managing Availability
Homework (Spanish)
- Reminder Sheet for
Problem Solving (English)
- Reminder Sheet for
Problem Solving (Spanish)
- Risk Reduction Worksheet
(English)
- Risk Reduction Worksheet
(Spanish)
- Seemingly Irrelevant
Decisions Tool (English)
- Seemingly Irrelevant
Decisions Tool (Spanish)
- Support Plan
(English)
- Support Plan (Spanish)
Training Resources:
Webinars are
offered by the Florida Alcohol and Drug Abuse Association (www.fadaa.org) on
the SBIRT model as applied to BRITE. See
webpage: http://www.fadaa.org/services/resource_center/PD/WebEx/index.asp
The webinars
related to BRITE on this site are as follows:
Dr. Robert
Hazlett: Motivational Techniques for
Brief Interventions and Brief Treatment - September 27, 2007
Dr. Kristen L.
Barry and Dr. Lawrence Schonfeld: Brief
Interventions and Brief Treatments: Approaches for Varied Service Settings -
January 17, 2008
Dr. Robert
Hazlett: New Pre-screening Procedures
and Brief Advice for Brief Intervention Techniques - April 30, 2008
Dr. Christy K.
Scott (click here): Proactive Strategies for
Designing and Implementing Six Month Follow-up - November 13, 2008
Dr. Maria
Llorente, M.D., Use and Misuse of Prescription
Medications among Older Adults – March 19, 2009. View Recorded Event
David Duresky, M.A., Motivational Interviewing Techniques: Beyond the Basics,
June 18, 2009. View
Recorded Event
In the News:
Information about the
American Society on Aging
newsletter: Aging Today
CSAT Announcement on Florida
BRITE Project
DCF Announcement about Florida BRITE Project
For more information about the Florida BRITE Project,
please contact:
Darran M. Duchene, Section Chief
Florida DCF
Substance Abuse/Mental Health Program Office
Phone: (850) 717-4409
Email: Darran_Duchene@dcf.state.fl.us