Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Anne L. Thatcher, DNP, MSW, APRN, PMHNP-BC, LMSW


Anne L. Thatcher, DNP, MSW, APRN, PMHNP-BC, LMSW

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Sally Haywood, MPA


Background: Adolescent substance use (SU) is a major health concern. Most youth who engage in alcohol and other SU do not meet criteria for SU disorder (SUD). Nonetheless, evidence shows SU during adolescence impacts cognitive, social, and emotional development, increases risk of physical injury, and may progress to SUD in adulthood. Only half of clinicians properly screen adolescents for SU; those identified with SUD often receive no intervention. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention to address this problem. The purpose of this project was to evaluate implementation of SBIRT using CRAFFT 2.1+N, a SU screening tool for adolescents, as the new standard of care in a behavioral health urgent care (BHUC) in a suburban area of a Midwestern state.

Method: This quality improvement (QI) project was a prospective record review collecting data three months after SBIRT implementation from self-administered screening forms completed by adolescents ages 12-18. Behavioral health (BH) therapists administered SBIRT and reported interventions delivered.

Results: Out of 235 adolescents, 118 (50.2%) received screening using the CRAFFT 2.1+N. Therapists reported interventions for 100 clients (85%). Of these, 74% received at least one brief intervention (BI), and 15% were referred to treatment for any BH concern.

Conclusion: SBIRT implemented at this BHUC improved identification of SU risk and provided a model to deliver specialized interventions. Recommendations include using a multi-disciplinary team approach and electronic medical record (EMR) integration to enhance SBIRT delivery for youth in a BHUC setting.