Table 1.

Activities described in interviews as composing the content of brief treatment (BT) sessions

Activity	# of FQHCs where activity was discussed	# of interviewees discussing activity	Thematic definition	Example quote
Motivational interviewing	4	6	Initiating client-centered discussions to help patients identify connections between personal areas of concern and their substance use.	I do a lot of the motivational interviewing, so it is really kind of breaking down where are they at in their phase of change.
Planning	4	6	Developing concrete plans to guide treatment and/or relapse prevention strategies.	…that would be the topic, you know, substance abuse, you know, going to meetings, relapse prevention skills, utilizing, you know, your recovery support. Developing a relapse prevention plan.
Screen/Assess	3	3	Collecting information in early BT sessions to understand the patient’s current substance use, mental health, physical health, and/or social situations.	…in the first session…I’m going to do the initial depression, anxiety, SBIRT, all those screeners.
Checking in on quality of life	3	6	Getting updates regarding various areas of patients’ lives (e.g., mental/emotional, health, physical health, substance use, family).	…then we’re going to go through areas of rating their individual components of their life: mood, diet, exercise, sleep, pain.
Rapport building	2	2	Establishing a relationship with patients to improve their comfort levels with the treatment being provided and/or changing their behaviors related to substance use.	And you know, [you] want them to open up, and so maybe if we’re kind of noticing that there is push back, [I] try not to focus too much on how much they use or what they’re using.
Educate	2	2	Providing information to patients.	I’d always say, you know, can I provide you some education, or can I provide some information on that.
Skill building	2	3	Building coping/relapse prevention skills either in sessions or through homework.	[We] talk about that and work on “what are your coping skills, what are your mechanisms”.
Goal setting	2	3	Identifying areas of their life that patients want to improve.	…going through, what are their goals. So, if their goals are to decrease use, we can focus on that….
Connect to external resources/ services	2	3	Making patients aware of or providing a direct referral to additional resources or services outside of BT.	If they need more residential [services] or they need more intensive [services]…a lot of time our services are not enough for someone who is trying to maintain their sobriety.