“Thank you so much for all you do,” a social worker told Diana Ling right after she introduced herself. Diana, Senior Program Manager at the Health Behavior Research and Training Institute (HBRT) at The University of Texas at Austin (UT-Austin), was exhibiting at the national conference of the National Association of Social Workers (NASW) last June on preventing prenatal alcohol exposure (PAE) and was struck by the outpouring of appreciation for the resources shared. Social workers from around the country valued the materials on PAE prevention HBRT and NASW had developed with funding from the Centers for Disease Control and Prevention (CDC). “I heard from so many social workers who told me that addressing FASD is such important work,” Diana told me.
Diana Ling has been working to address FASD for five years and has a background in education and health communications. “The conference gave me a real aha moment. I was hearing directly from social workers and it was clear to me how much they really appreciated our work to address substance use.” Diana Ling is an integral member of the incredible HBRT team of dedicated professionals who ensure that social workers are FASD-informed. “It was so rewarding hearing how PAE shows up in the day-to-day practice of these social workers, and it really reinforced for us the importance of our work, especially when it comes to delivering tools for social workers.”
In engaging social workers, HBRT exemplifies the spirit of CDC’s National Partner Network
FASD United is spotlighting each of the organizations that are part of CDC’s National Partner Network (NPN). In our latest piece, we are proud to feature two NPN partners who work in collaboration: The University of Texas at Austin and the National Association of Social Workers (NASW). Together, these two key members of the NPN are advancing the FASD field by ensuring that social workers are FASD-informed and empowered to prevent PAE and to work effectively with clients with PAE.
The NPN is an interdisciplinary collaborative of national healthcare professional organizations dedicated to advancing shared goals, including reducing PAE and substance use, enhancing support services and access to care, and improving the identification and health of children and families affected by FASDs. As a proud participant in this collaborative effort from 2022 to 2026, FASD United is excited to contribute to public education on FASD and prenatal substance exposure (PAE) alongside these exceptional partners.
I spoke with four incredible members of the team who help lead the Health Behavior Research and Training Institute (HBRT) at The University of Texas at Austin: Mary M. Velasquez, Ph.D.; Kirk von Sternberg, Ph.D.; Anna Mangum, MSW, MPH; and Diana Ling, MA.
Dr. Mary Marden Velasquez brings her motivational interviewing and FASD expertise to the largest mental health workforce in the country
A medical student made eye contact with one of the coaches and asked, “Before you knew you were pregnant, how much alcohol would you typically consume?” It was the latest round of training for these UT-Austin medical, social work, pharmacy, and nursing students, totaling about 300 each year, and Dr. Mary Velasquez was instructing them on the proven techniques of screening, brief intervention and referral to treatment (SBIRT) for alcohol. “I always talk with the students about substance exposed pregnancies,” Mary told me. Second-year medical students also go through an intensive training with a standardized patient exam and highly trained coaches. Each student gets a coach and an opportunity to work with them on motivational interviewing and SBIRT and then gets feedback on different case scenarios. “There is always an intensive case involving FASD,” Mary pointed out. HBRT is finalizing a series of engaging training videos demonstrating these case studies, which will be distributed to a network of trainers in MI, to social workers, and even more broadly.
Mary Velasquez, Director of HBRT and a principal investigator on the NPN, has a true depth of expertise in addressing FASD and PAE and is a leader in the motivational interviewing field, which she has been involved with since 1994. Mary is an expert in motivational interviewing and founding member of the Motivational Interviewing Network of Trainers (MINT).
It was evident in speaking with her just how proud Mary is of the HBRT team’s robust resources for social workers, including the depth of training in motivational interviewing and SBIRT. “Our trainings co-hosted by NASW have received great feedback. People are really interested in this training and tell us that it helps them contribute to their repertoire of helping their clients.” The team has a robust suite of blog posts, podcasts, presentations, exhibits, and more. The NASW Foundation has published many important blog posts, including Five Facts Social Workers Need to Know About Preventing FASDs and Social Work’s Critical Role in Prevention of FASDs.
“Our priority is working to reach social workers wherever they are in ways that are convenient to them, so we do a lot of outreach. We’re proud to offer many opportunities to earn complimentary continuing education credits in SBIRT. Social workers regularly tell Mary that they and the clients they work with truly appreciate the tone and language of their materials and trainings. “We emphasize having a respectful and thoughtful conversation with clients and not trying to talk someone into doing something, and we hear from social workers that they really appreciate that, given the various sensitivities around women who may consume alcohol during pregnancy.” Mary identified the issues that often arise around such as guilt, blame, fear and stigma in discussing alcohol use. “These conversations are designed to be supportive. We get a lot of feedback that social workers say their clients truly appreciate that approach.”
Anna Mangum knows the value of collaboration by healthcare professional organizations and responding to emerging substance use trends
“What about risky cannabis use?” It was a question that Anna Mangum, a population health social worker and Senior Health Strategist at HBRT, was hearing more and more when talking to other healthcare professionals about preventing PAE. She saw the landscape around cannabis use rapidly changing in terms of increasing availability and consumption, with state-level legalization being a driving factor. This has significant implications for women reproductive age, including pregnant women. “We have to make sure that we are talking about new developments in real time and as the research is developing,” Anna emphasized. The team responded quickly and produced an episode of NASW’s popular podcast on Cannabis Use in Pregnancy featuring Dr. Roger Zoorob, the Richard M. Kleberg Senior Professor and Chair of the Department of Family and Community Medicine at Baylor College of Medicine and an expert in cannabis use during pregnancy.
Another great example of the HBRT team responding to current trends comes from the COVID-19 pandemic. The team saw that alcohol use was significantly increasing during the pandemic, which HBRT made sure to specifically reference in their messaging. The team also highlighted a 2025 Surgeon General advisory discussing the link between alcohol and seven types of cancer. Alcohol consumption, in addition to being associated with PAE, is the leading preventable cause of cancer. “It’s key that we respond to these major policy developments,” Anna says.
Prior to her role at HBRT, Anna was chief of programs at NASW, which represents over 110,000 social workers, who are the largest occupation in the country specializing in mental and behavioral health. Noted Anna, “Social workers bring a distinctive skill set to working with diverse populations and play a unique role in public health and prevention.” There are over 750,000 social workers nationwide, many of whom work in health settings and work with people who may be using substances; some of these patients are pregnant. Social work is the only mental and behavioral health specialty workforce participating in the NPN.
Anna says that, “In addition to equipping social workers with skills in SBIRT, we engage them as ambassadors so they can share this information with their peers. These could be other social workers, but they could also be other healthcare professionals, since we know that social workers often work in settings with medical providers. Anna refers to NASW and HBRT as “natural partners in advancing as audacious goal of preventing substance-exposed pregnancy.”
Anna really felt the impact of her team’s work as a co-panelist in presenting a session at FASD United’s conference in Seattle on the many resources that have come out of their initiative. “We planned this session over the course of several months, to identify what initiative resources we would highlight, and what our messaging would be, and my co-panelists from other organizations appreciated having us there with our unique talking points.” The session on Unveiling the FASD National Partner Network: Key Partners, Initiatives, and Practical Tools spotlighted the CDC NPN and the collaboration and resources to help prevent alcohol and other substance use during pregnancy and support families.
Anna strongly believes that interdisciplinary collaboration is one of the strongest aspects of the NPN project. “CDC designed this initiative to include this type collaboration, which is so important and results in better outcomes.” Social workers are key members of interdisciplinary teams in a variety of settings. “The collaboration has been very gratifying and we think it’s a big strength of the initiative. This is such a useful way to approach a challenge this big.”
For Dr. Kirk von Sternberg, the NPN offers a great opportunity to continue the success of the CHOICES intervention
Dr. Kirk von Sternberg, HBRT Co-Director, sees the NPN initiative as a natural extension of Project CHOICES, which he has dedicated much of career towards building into a leader in the prevention of alcohol-exposed pregnancies. Kirk has worked for many years, with Mary Velasquez and CDC, to implement and disseminate Project CHOICES, a successful evidence-based intervention targeted towards the prevention of alcohol-exposed pregnancies. Kirk’s success with the CHOICES intervention led directly to the current CDC NPN initiative, which includes looking at the intervention through in-person clinics in comparison to a tablet-delivered intervention.
“When the CDC NPN opportunity came up, the team at HBRT knew that social workers would be ideal for delivering the kind of evidence-based interventions developed for CHOICES, and our team reached out to NASW to collaborate,” Kirk says.
Kirk spoke about continuing to look at what makes CHOICES successful, including the specific processes of behavior change that are targeted in the intervention that lead to improved impacts on families. “Our focus is on FASD prevention through motivational interviewing and SBIRT training and education,” Kirk points out, adding, “Our message to social workers is that they are uniquely equipped to be on the front lines of prevention because they are the largest group of behavioral health providers in the country.”
Kirk knows that his work is advancing the FASD community forward by targeting social workers and emphasizing universal screening for all adults. “Making screening universal helps reduce stigma, it makes it a normal process. We’ve learned a lot of lessons from how providers addressed smoking among their clients, and now we are applying these lessons to addressing alcohol.” As Kirk describes, this is marking a cultural shift, as alcohol screening becomes part of routine practice. “This reduces the stigma and effectively identifies more of those at risk,” Kirk emphasizes.
Kirk and the HBRT team are currently training social workers on the most effective techniques to use for screening and referral to treatment. “Our target audience is very broad, given that a substantial number of pregnancies are unplanned, it’s somewhere between 40-50 percent of all pregnancies. As a result, we are targeting the large population of women who use substances, including alcohol, and may become pregnant.”
Kirk emphasized how much value he gets out of the collaborative nature of the NPN initiative, in particular from his involvement in an evaluator workgroup, which has representation from each of the network partners. “This workgroup is very valuable and I love taking part in it. We have such fantastic meetings where we all share our ideas and we figure out the types of questions that we all need to have answered. It’s been great to participate with all the partners as we collectively determine what we need to do to maximize all of our services.”
Diana Ling highlights a range of tangible resources, from podcasts to policy statements, which are tailored by robust survey data
As Diana Ling was preparing for NASW’s conference last June, she collaborated with another project partner, Oak Ridge Associated Universities (ORAU) to adapt a pocket card for social workers to use for SBIRT. The card can also be used by all clinicians. “This is a very helpful resource that guides professionals through a step-by-step script on how to conduct SBIRT, specifically through a brief negotiated interview.” The pocket card goes over how to open the conversation, consider a person’s readiness for change, and identify next steps for initiating an action plan. “This resource is extremely useful for social workers and can be used by other clinicians as well,” Diana points out. The team also collaborated on a badge card to help social workers discuss alcohol use with clients.
Diana is excited to see a new series of podcasts for NASW take shape, starting with an episode featuring Anna and Mary on the importance of social workers in addressing FASD. “The podcast has over 7,000 downloads so far, so it has gained a lot of traction.” The most recent podcast episode is the one addressing the hot topic of cannabis during pregnancy. “This episode on cannabis is aimed at social workers, but is also useful to other professionals and anyone in the community because they talk in depth on the risks of cannabis to a developing baby and the importance of prevention and universal screening,” Diana says, adding that the podcast has had quite a big reach and is continuing to generate interest among various constituencies.
HBRT recently conducted a major survey and is tailoring their messaging in response to the results. “We surveyed over 2,000 social workers, with the help of NASW, to assess their knowledge and practice of SBIRT. Based on the survey results, we are tailoring our messaging to them,” Diana says. The results show that many social workers can benefit from education on what risky alcohol use looks like, especially when it comes to women, and in knowing exactly what a “standard drink” is defined as. With the survey findings, the HBRT team is able to meet social workers where they are and offer highly tailored messaging.
While the survey shows that many social workers do not feel confident in working on FASD in terms of client interaction, there is good news: Nearly everyone surveyed agrees with the high importance of addressing FASD. “We are taking the survey results and working with social workers to improve their client interactions, and improve the client’s experiences as well,” Diana says.
As the HBRT team continues to tailor their messaging, they are focusing communications around health prevention months, including FASD Awareness Month in September and Alcohol Awareness Month in April. “With each year, we try to go bigger and go better with our health observances,” Diana says, adding, “We are now folding in Birth Defects Prevention Month and Substance Use Prevention Month.” The team is working to include more and more information on other substances and working to tailor messages to what they know social workers need to hear.
The HBRT team is constantly coming out with new resources. Diana spoke about their recent publication in Oxford Bibliographies in Social Work, an online resource for clinicians, researchers and students. The team wrote a comprehensive, annotated, peer-reviewed guide to substance use disorders, with information targeted to social workers and that is also useful to the wider community. The team recently published a policy statement, “Substance Use Disorder Treatment,” in Social Work Speaks. “NASW is a standard bearer when it comes to social work policy and practice, so this statement is very important in ensuring that there is a standardization around appropriate care.”
A team dedicated to reaching social workers with the latest resources
The dedication and passion of the entire HBRT team can be felt through each and every individual that I spoke with. Mary Velasquez’s work with medical students is vital for educating the next generation of healthcare professionals in FASD. Her expertise in motivational interviewing makes such a powerful impact in the lives of social workers across the country. Anna Mangum’s keen eye for emerging trends ensures that the latest information gets into the hands of those who need it most, especially social workers on the front lines with their clients. Her passion for the social work profession comes through in her tireless pursuit of equipping them with all the tools and resources they need.
Kirk von Sternberg’s steady stewardship of the CHOICES intervention and his commitment to its expansion is an inspiring example of evidence-based public health in action. His long-term vision for the project ensures that new generations of pregnant women will get the support they need when they experience challenges with alcohol and substance use. Diana Ling’s joyful energy is such a great asset to her work in expanding the quality and the reach of HBRT’s many tangible resources and products. Her positivity and drive is empowering social workers around the country to access the tools they need to deliver meaningful solutions for their clients. Collectively, the HBRT team is a shining example of the power of public health and a testament to the enduring impact of CDC’s National Partner Network.
*This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.