Paeds Cases · adolescent-and-young-adult-medicine
Adolescent substance-use SBIRT OSCE — screening, brief intervention and the harm bundle
Observed structured encounter testing universal substance-use screening (S2BI/CRAFFT), motivational-interviewing brief intervention, assembly of a domain-specific harm-reduction bundle, and a confidentiality decision in the fentanyl era.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a universal substance-use screen with a 15-year-old who vapes daily and uses cannabis monthly. Station B is a fentanyl-era opioid disclosure requiring a harm-reduction bundle and a confidentiality decision.
Station objectives
- Secure time alone and state conditional confidentiality with its limits. [1]
- Administer a validated universal substance-use screen (S2BI) and add CRAFFT where a positive lead appears. [1] [2] [7]
- Deliver a motivational-interviewing brief intervention matched to readiness. [5]
- Assemble a domain-specific harm-reduction bundle and handle a confidentiality decision. [3] [4]
References7ShowHide
- [1]Levy SJ, Williams JF Substance Use Screening, Brief Intervention, and Referral to Treatment. Pediatrics, 2016.PMID 27325634
- [2]Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of pediatrics & adolescent medicine, 2002.PMID 12038895
- [3]Kimmel SD, Gaeta JM, Hadland SE, Hallett E, Marshall BDL Principles of Harm Reduction for Young People Who Use Drugs. Pediatrics, 2021.PMID 33386326
- [4]Chadi N, Hadland SE Youth Access to Naloxone: The Next Frontier? The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2019.PMID 31648752
- [5]Cushing CC, Jensen CD, Miller MB, Leffingwell TR Meta-analysis of motivational interviewing for adolescent health behavior: efficacy beyond substance use. Journal of consulting and clinical psychology, 2014.PMID 24841861
- [6]Evins AE, Cather C, Reeder HT, et al. Varenicline for Youth Nicotine Vaping Cessation: A Randomized Clinical Trial. JAMA, 2025.PMID 40266580
- [7]Levy S, Weitzman ER, Marin AC, et al. Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents. Substance abuse, 2021.PMID 32814009