Although screening, brief intervention, and referral to treatment (SBIRT) has been a popular model to address potential substance abuse issues in primary care, there is a need for innovative approaches for training providers and staff on SBIRT protocols. An interdisciplinary approach to SBIRT training, named ICARE, was implemented at 3 different medical settings. The ICARE team trained 85 employees at an academic family medicine residency center and 37 employees across 2 rural community health care clinics. Using an innovative "learner-driven" approach, the authors implemented a combination of didactic and interactive training strategies that included on-site coaching, patient simulation exercises, as well as large- and small-group learning.

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Background: Adolescent substance use continues to rise in the United States, and innovative interventions are needed to increase treatment outcomes. The need for innovative, complementary approaches to adolescent addiction treatment is felt. Equine facilitated psychotherapy (EFP) has demonstrated to be an innovative intervention. Objectives: This study aimed to examine the impact of an innovative EFP intervention on psychosocial and behavioral outcomes of adolescents with addiction. Methods: Ten adolescents diagnosed with substance use disorder referred from local providers participated in a six-session EFP group intervention. The study utilized a quasi-experimental, pretest-posttest design. The study used the Adolescent Behavior survey, Patient Health questionnaire 9, and generalized anxiety disorder 7 scales that were completed by the participants at baseline and upon completion of the six sessions. Paired t-tests were conducted to compare the pretest and posttest scores. Results: The results demonstrated a significant increase in adolescent behaviors associated with Glasser’s connecting habits, including listening, trusting, supporting, encouraging, respecting and accepting, and negotiating differences. The results also demonstrated a significant reduction in depressive and anxiety symptoms. Conclusions: The present study demonstrated the potential efficacy of the innovative EFP intervention integrated into a choice theory-driven treatment strategy for improving psychosocial and behavioral concerns related to adolescent addiction. Future studies should consider research design alterations to increase the generalizability and interpretation of results. Further, future studies should include a qualitative or mixed-method design to elucidate the participants’ perception of the role of the equine as part of the intervention process.

This study explored treatment participation rate as a mediator between individuals' baseline alcohol use, drug use, and psychiatric issue levels and post-treatment employment status. The study sample included 106 unemployed or underemployed individuals with substance use disorders who were participants in an intensive drug abuse treatment program. Structural equation modeling was applied to examine relationships between study variables. The results showed that (a) the direct effect of individuals' baseline alcohol use, drug use, and psychiatric issue severities reduced treatment participation rate; (b) the direct effect of treatment participation rate ameliorated post-treatment employment status; and (c) the indirect effect of individuals' baseline alcohol use, drug use, and psychiatric issue severities on post-treatment employment status was mediated by treatment participation rate, which reduced the negative influence of baseline issue severity on employment. This significant mediating effect has both practical and theoretical importance in that it indicates the need for increased focus on treatment participation in practice and future research.