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Date of Graduation
7-31-2026
Semester of Graduation
Summer
Degree Name
Educational Specialist (EdS)
Department
Department of Graduate Psychology
First Advisor
Deborah Kipps-Vaughan
Second Advisor
Tammy Gilligan
Third Advisor
Joseph LeBlanc
Abstract
As substance use remains a pressing public concern for adolescents, the academic, social, and neurological consequences are extensive. Schools are uniquely situated to support large populations of youth during their critical developmental periods, and schools act as the ideal location for substance use prevention and intervention. This study explored the prevalence and influence of substance use on adolescents, the role of school climate in prevention and intervention efforts, and assessed the model Screening, Brief Intervention, and Referral to Treatment (SBIRT) as a suitable framework for school-based interventions. Following a structured search across two databases, 20 studies met inclusion criteria and were analyzed using a structured thematic analysis. Findings were organized by two research questions addressing the effectiveness and feasibility of SBIRT implementation in school settings. Results indicated that school-based SBIRT produces modest but meaningful reductions in substance use quantity and intoxication among actively using adolescents, with brief interventions performing comparably to more intensive treatment for most students. Provider attitudes toward SBIRT were largely favorable, yet implementation consistently broke down between the screening and brief intervention stages, reflecting insufficient motivational interviewing training rather than a lack of provider motivation. Structural barriers such as limited adolescent-appropriate referral networks, electronic health record systems unequipped to document SBIRT activity, high caseloads, and unstable funding further constrained full model delivery independent of provider skill or willingness. The school setting itself functioned as both an asset and an obstacle, offering universal access to adolescents during a critical developmental window while introducing concerns with disciplinary policies and confidentiality. Students generally reported favorable views of SBIRT, but those with the greatest need for intervention were the least likely to disclose honestly. Implications for school providers are discussed, including the value of electronic screening tools, sustained motivational interviewing training over one-time workshops, and intentional relationship-building to support honest student disclosure. Future research should prioritize longitudinal designs evaluating SBIRT's preventive effects in middle school populations, differential responsiveness analyses across student risk profiles, and greater attention to cultural, geographic, and socioeconomic diversity in implementation contexts.
Included in
Counseling Commons, Curriculum and Instruction Commons, Educational Assessment, Evaluation, and Research Commons, School Psychology Commons
