You are meeting with the treatment team to discuss a client transfer from mental health to substance abuse treatment. Below is a narrative and SBARR outline. SBARRa technique used to communicate critical information succinctly and briefly.

Tammy, a 22-year-old female, is currently seeing a mental health therapist in your clinic. The therapist has come to you because they believe Tammy would do better in the addictions program within the clinic. Tammy has been using marijuana and cocaine for the past 6 years. She started using after her parents got divorced. She is currently seeing the mental health therapist for depression and hyperarousal. In high school, Tammy found that marijuana helped her numb her feelings related to her parent's separation. Her grades slipped from As and Bs to Cs and Ds. She began missing classes and missing curfew at home. Tammy was successful in college but after graduating has not found a job yet. She is currently living with her mother. She sleeps most days and is out with friends most of the night. Tammy came into therapy originally because her mother said she had to meet with someone or she could not continue to live at home. Tammy has not changed her behaviors in spite of meeting weekly with her therapist. She continues to smoke marijuana and use cocaine, both in and outside the house. She has no intention of stopping her substance use in spite of some of the consequences she is facing. After meeting with Tammy, you note that she was calm and cooperative. She answered all questions, and you feel she is a good candidate for transfer to the SA program. Complete the following questions answer all questions).

Using the SBARR tool, assess this patient for possible substance abuse treatment. What are some of the responses you might hear from your colleagues. List at least three ethical considerations you might encounter with this case.

1. SituationWhat's going on with the patient right now? (Identify yourself, the patient, and state the problem concisely.)
2. BackgroundWhat's the background on this patient? How did we get to this point? (Review the chart. Anticipate questions. State the relevant [medical] issues.)
3. AssessmentWhat do I think the issue is? Why am I concerned? (Provide your observations and evaluations of the patient's current state.)
4. RecommendationWhat should we do to respond to the situation? (Suggest what should be done to meet the patient's immediate needs.)
5. ResponseCollaboration resulting in a plan of action. (Listen for/seek feedback to ensure responder understands the issue.)