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Background Sentinel events are negative health-related events that trigger change in risky health behaviors. Despite its presumed major role in behavior change, the sentinel event effect has received little empirical attention. Through analysis of qualitative interviews, we explored how sentinel events trigger behavior change. Methods Thematic analysis and concept mapping were used to develop a preliminary model of the sentinel event effect among a sample of 24 adult heavy drinking Mexican-origin men previously admitted to a hospital due to injury. The model was checked against cases that did versus did not report change in alcohol use following an alcohol-related negative event. Results Findings suggest that sentinel events may arouse negative emotional reactions, encourage reflection on the negative consequences of drinking, and cause reevaluation of the severity and significance of drinking. These processes may increase motivation to change. Conclusions Findings support the concept of the sentinel event as a natural intervention, and identifies potential social-cognitive and motivational mechanisms through which it influences change. Findings stand to inform research on mechanisms underlying brief intervention effects, and research that seeks to identify treatment targets.

This chapter describes how SFBT has been used in the treatment of substance use and relies on the clinical literature to illustrate interventions. Specific ways to engage clients with substance use will be covered, including the questions to ask in order to promote change. In addition, this chapter will describe a case where SFBT has been used with a client with alcohol use disorder and explain how SFBT may be used in groups to treat substance use. Finally, this chapter will discuss the emerging outcome literature on SFBT with clients who have substance use including studies that assess substance use and trauma.