one of the things that howard university and howard university hospital has identified was that we have a large population of at-risk drinkers, substance abuse patients, and that we wanted to find a way to try to really help our population. we didn't have enough social workers or frontline people to do it. so what we had done was put together a proposal to train our residents. and samhsa was very helpful in that and provided us with a grant to train our residents and our staff about screening, brief intervention, and referral for treatment. so when a patient comes in on whatever service... they may not have come in for an alcohol or substance abuse problem, but the results of the discussion may have been screening that patient just to see, is this person at risk? and once you have done that, you really go through a process of educating the residents and staff about how you can have open-ended questions, affirmative listening, reflective listening, that really allows a person to open up and tell you what is going on. now we know physicians and health care personnel are very busy, so the