Screening, Brief Intervention, and Referral to Treatment for Military Spouses Experiencing Alcohol and Substance Use Disorders: A Literature Review



This paper provides an overview of alcohol and substance use issues in military spouses, and explore how the screening, brief intervention, and referral to treatment (SBIRT) model may enable health care providers to identify individuals at risk for developing substance use related disorders. The information presented is based on a broad literature scan relating to the characteristics of the military lifestyle, health infrastructure, screening and intervention processes, and the uses of SBIRT in military and civilian settings. Current literature suggests that military spouses, and families, tend to be at different points in their life course than civilian families of similar ages. Marrying earlier and having children sooner coupled with military lifestyle stressors place them at increased risk for developing adverse coping mechanisms, particularly during deployment. SBIRT has been recognized as an effective method among civilian patients although there is limited research on the efficacy of SBIRT for military spouses at risk of or experiencing substance use problems.


Military Substance use Military spouses SBIRT Treatment Screening 


  1. Armed Forces Press Services. (2009). Bill to reform DOD substance abuse policies. Retrieved July 16, 2009, from
  2. Atkinson, R., Misra, S., Ryan, S., & Turner, J. (2003). Referral paths, patient profiles and treatment adherence of older alcoholic men. Journal of Substance Abuse Treatment, 25, 29–35.PubMedCrossRefGoogle Scholar
  3. Babor, T. F., Higgins-Biddle, J. F., Dauser, D., Higgins, P., & Burleson, J. (2005). Alcohol screening and brief intervention in primary care settings: Implementation models and predictors. Journal of Studies on Alcohol, 66, 361–368.PubMedGoogle Scholar
  4. Ballesteros, J., Gonzalez-Pinto, A., Querejeta, I., & Arino, J. (2004). Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women. Addiction, 99, 103–108.PubMedCrossRefGoogle Scholar
  5. Barlow, D., & Durand, V. (1999). Abnormal psychology: An integrative approach (2nd ed.). Pacific Grove, CA: Brooks Cole.Google Scholar
  6. Berg, I. K. (1995). Solution-focused brief counseling with substance abusers. In A. M. Washton (Ed.), Psychotherapy and substance abuse: A practitioner’s handbook (pp. 223–242). New York: Guilford.Google Scholar
  7. Bien, T., Miller, W., & Tonigan, J. (1993). Brief interventions for alcohol problems: A review. Addiction, 88, 315–335.PubMedCrossRefGoogle Scholar
  8. Booth, B., Falk, W. W., Segal, D. R., & Segal, M. W. (2000). The impact of military presence in local labor markets on the employment of women. Gender and Society, 14, 318–332.CrossRefGoogle Scholar
  9. Booth, B., Segal, M. W., Bell, D. B., Martin, J. A., Ender, M. G., Rohall, D., et al. (2007). What we know about army families: 2007 update. Fairfax, VA: Caliber.Google Scholar
  10. Bradley, K., Kivlahan, D., Zhou, X., Sporleder, J., Epler, A., McCormick, K., et al. (2004). Using alcohol screening results and treatment history to assess the severity of at-risk drinking in veterans affairs primary care patients. Alcohol Clinical Experimental Research, 28, 448–455.CrossRefGoogle Scholar
  11. Bray, R. M., & Hourani, L. L. (2007). Substance use trends among active duty military personnel: Findings from the United States Department of Defense Health Related Behavior Survey, 1980–2005. Addiction, 102, 1092–1101.PubMedCrossRefGoogle Scholar
  12. Bray, R. M., Marsden, M. E., Herbold, J. R., & Peterson, M. R. (1992). Progress toward eliminating drug and alcohol abuse among U.S. military personnel. Armed Forces and Society, 18, 476–496.CrossRefGoogle Scholar
  13. Brown University Center for Alcohol and Addiction Studies. DATA Digest. (2008). Brief intervention effective in reducing unhealthy drinking among at-risk emergency department patients. Brown University Digest of Addiction Theory and Application, 27, 1–8. Google Scholar
  14. Eaton, K. M., Messer, S. C., Whitt, A. A., Cabrora, O. A., McGurk, D., Hoge, C. W., et al. (2008). Prevalence of mental health problems, treatment need and barriers to care among primary-care seeking spouses of military service members involved in Iraq and Afghanistan deployments. Military Medicine, 173, 1051–1056.PubMedGoogle Scholar
  15. Essary, A. (2008). Screening abuse: Screening diagnosis, management. Clinical Watch, 21, 19–21.Google Scholar
  16. Fernandez, W. G., Hartman, R., & Olshaker, J. (2006). Brief interventions to reduce harmful alcohol use among military personnel: Lessons learned from the civilian experience. Military Medicine, 171, 538–543.PubMedGoogle Scholar
  17. Figley, C. R. (1993). Coping with stressors on the home front. Journal of Social Issues, 49, 51–71.CrossRefGoogle Scholar
  18. Fleming, M. F., Mundt, M. P., French, M. T., Manwell, L. B., Stauffacher, E. A., & Barry, K. L. (2000). Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. Medical Care, 38, 7–18.PubMedCrossRefGoogle Scholar
  19. Friedman, S., & Fanger, M. (1991). Expanding therapeutic possibilities: Getting results in brief psychotherapy. New York: Lexington Books/Macmillan, Inc.Google Scholar
  20. Friedmann, P. D. (2008). The clinician’s illusion and SBIRT. Brown University Digest of Addiction Theory and Application, 27, 1–8. Google Scholar
  21. Harrell, M. C., Lim, N., Casteneda, L. W., & Golinelli, D. (2004). Working around the military: Challenges of military spouse employment. Santa Monica, CA: RAND National Defense Research Institute.Google Scholar
  22. Hester, R., & Miller, W. (1995). Handbook of alcoholism treatment approaches: Effective alternatives (2nd ed.). Needham Heights, MA: Allyn & Bacon.Google Scholar
  23. Lande, G., Marin, B., & Ruzek, J. I. (2004). Substance abuse in the deployment environment. Iraq war clinician guide (2nd edn.). Department of Veterans Affairs, National Center for PTSD. Retrieved July 16, 2009, from
  24. Late, M. (2007). Screening detects alcohol, drug abuse problems: New codes for health providers released to improve reimbursement. Nation’s Health. Retrieved July 13, 2009, from
  25. Liese, B. (1994). Brief therapy, crisis intervention and the cognitive therapy of substance abuse. Crisis Intervention and Time-Limited Treatment, 1, 11–29.Google Scholar
  26. Lim, N., Golinelli, G., & Cho, M. (2007). Working around the military revisited: Spouse employment in the 2000 census data. Santa Monica, CA: RAND National Defense Research Institute.Google Scholar
  27. Marine Corps Community Services. (2008). The marine corps: A young and vigorous force. Personal and Family Readiness Division, Marine Corps Community Services. Retrieved July 17 2009 from
  28. McEwen, S. (2009). Substance abuse screening and brief intervention in primary care. North Carolina Medical Journal, 70, 38–42.PubMedGoogle Scholar
  29. Mersy, D. (2003). Recognition of alcohol and substance abuse. American Family Physician, 67, 1529–1532.PubMedGoogle Scholar
  30. Miller, W., & Sanchez, V. (1994). Motivating young adults for treatment and lifestyle change. In G. Howard & P. Nathan (Eds.), Alcohol use and misuse by young adults. Notre Dame, ID: University of Notre Dame Press.Google Scholar
  31. Mitchell, D., Francis, J. P., & Tafrate, R. C. (2005). The psychometric properties of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in a clinical sample of active duty military service members. Military Medicine, 170, 960–963.PubMedGoogle Scholar
  32. National Council on Disability. (2009). Invisible wounds: Serving service members and Veterans with PTSD and TBI. Retrieved July 16 2009 from
  33. National Institute on Drug Abuse. (2009). Substance abuse among the military, veterans, and their families. Retrieved July 16, 2009 from
  34. Office of the Under Secretary of Defense, Personnel, and Readiness. (2007). Population representation in the military services: Executive summary. Retrieved July 16 2009 from
  35. RTI International. (2006). 2005 Department of defense survey of health-related behaviors among active duty military personnel. Retrieved July 16, 2009, from
  36. Scott, M., Parthasarathy, S., Kohn, C., Hinman, A., Sterling, S., & Weisner, C. (2004). Adolescents with substance diagnoses in an HMO: Factors associated with medical provider referrals to substance abuse and mental health treatment. Mental Health Services Research, 6, 47–60.PubMedCrossRefGoogle Scholar
  37. Stephens, R., Roffman, R., & Curtin, L. (2000). Comparison of extended versus brief treatments for marijuana use. Journal of Consulting and Clinical Psychology, 68, 898–908.PubMedCrossRefGoogle Scholar
  38. Storer, R. M. (2003). A simple cost-benefit analysis of brief interventions on substance abuse at naval medical center Portsmouth. Military Medicine, 168, 765–768.PubMedGoogle Scholar
  39. Substance Abuse and Mental Health Services Administration. (2009). Screening, brief intervention, and referral to treatment. Retrieved July 17 2009 from
  40. TRICARE. (2009a). Understanding behavioral health: Common concerns, helpful resources, and how your benefits work for you. VA: Falls Church.Google Scholar
  41. TRICARE. (2009b). Patient priority at military treatment facilities: A guide. Retrieved July 16 2009 from
  42. U.S Census Bureau. (2000). United States Decennial Census, Public-Use Microdata. (ASCII STATA). Available from
  43. Vaca, F. E., & Winn, D. (2007). The basics of alcohol screening, brief intervention, and referral to treatment in the emergency department. Western Journal of Emergency Medicine, 8, 88–92.PubMedGoogle Scholar
  44. Zarkin, G., Bray, J., Davis, K., Babor, T., & Higgins-Biddle, J. (2003). The costs of screening and brief intervention for risky alcohol use. Journal of Studies on Alcohol, 64, 849–857.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Altarum InstituteWashingtonUSA
  2. 2.ICF InternationalFairfaxUSA

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