Accepted for/Published in: JMIR Research Protocols
Date Submitted: Apr 7, 2025
Date Accepted: Sep 25, 2025
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Solution Focused Brief Intervention for substance use: Protocol of a multi-site RCT.
ABSTRACT
Background:
Substance use is a high-impact biopsychosocial problem in Chile. Mental health and substance use programs in Chilean primary care involve psychologists and social workers. Solution-Focused Brief Interventions (SFBI) are based on Solution-Focused Brief Therapy: a strengths-based and person-centered approach where practitioners’ stance is “not being the expert” and respect clients’ needs and perspectives.
Objective:
To evaluate the effectiveness of implementing a Solution-Focused Brief Intervention (SFBI) by psychosocial teams (psychologists and social workers) in Primary Health Clinics (PHC) with individuals with alcohol and other drug use.
Methods:
This is a randomized, controlled clinical trial (osf.io/875pj) comparing a three-session SFBI (experimental group) to a one-session of brief counselling provided as usual care (control group) in primary care. Interventions will be provided in person by a psychologist or a social worker. It is expected to recruit a total of 320 participants during preventive, routinary check-ups using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Participants will be patients who report intermediate to high-risk substance use in the ASSIST and will be randomly assigned to each group. Research assistants will apply instruments to participants at baseline, three, six, and nine-month follow-ups and will be blinded to the assigned treatments. The primary outcome assessed will be substance use patterns, while secondary outcomes include background information, depressive symptoms, anxiety symptoms and motivation to treatment. Statistical analyses such as t-tests, ANOVA, and Fisher’s exact tests will be conducted depending on the type of variables and normality. A qualitative component to assess acceptability and pertinence will include focus groups with participants and practitioners and a subsequent content analysis.
Results:
At this stage of the project, 38 practitioners from 9 PHC have been trained in the SFBI model, the recruitment phase started on January 2025, supervision sessions for strengthening fidelity started in March 2025. Process and outcome findings will be disseminated with stakeholders and in academic initiatives, as well as in journal articles.
Conclusions:
This protocol reports a study that aims strengthen the evidence of psychosocial brief interventions with individuals who use substances, specifically in PHC within the extant public policy in Chile. Additionally, it will provide new information regarding the effectiveness of SFBI with substance use and will contribute to the extant knowledge on brief interventions for substance use in this field. Clinical Trial: OSF Registries: osf.io/875pj
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