Keeping it Green:
Maintaining a Positive Focus as a Professional Counselor
The issue—or some might say problem—of managing frustration and avoiding cynicism as a counseling professional is one that may be more pervasive than many in higher education imagine. Addressing the issues of high-risk student behaviors like underage and dangerous drinking, indiscriminate use of illicit substances, or unprotected sexual activity to mention but a few of the more frequently cited examples from the media, is enough to dampen the spirits of even the most stalwart counseling professional. Not only can media-reported national stats about percentages of high-risk drinkers and untoward incidents related to alcohol or other drug use on campus prove to be frustrating for counseling professionals, the potential threat to their optimism in and efficacy regarding the COUNSELING profession would appear to be an all too likely consequence of a steady diet of bad news from the media and personal stories of heartache resulting from high-risk student behavior on their individual campuses. At times it may seem that practitioners are like the knot in the middle of a rope in a huge tug-of-war with individual clients refusing to change their individual behaviors on one end and national trends regarding high-risk or "dangerous" drinking on the other. Yet not only do we not see COUNSELING professionals leaving the field in droves, unlike many religious orders, the number of vocations that attract young professionals to a calling to work in counseling in higher education are encouraging.
It would seem that regardless if individual counseling professionals weather the problems on their individual campuses or know something the media seems to be oblivious to that allows them to keep their collective heads above water, it would appear that as much—if not more—of the frustration and cynicism experienced by some counseling practitioners results from their personal perceptions on the issues that arise when working in this field. In other words, dealing with high-risk students and their behaviors may be an occupational hazard associated with being a counseling professional, but that does not mean that each professional in the field will experience the chronic frustration and institutional cynicism. As with so many things in life, one tends to find what is expected. The practitioner that expects to see new prevention strategies fail or individual students refuse to change, regardless of the evidence presented to them supporting such, will likely find evidence to support this belief.
If this sounds vaguely familiar, I suggest you dust off your old notebooks from undergraduate social psych and review "confirmation bias" and "illusory correlation." Because one thinks something is true, the relatively few cases experienced that support the belief held are touted as proof that the hypothesis IS true. The classic example of this in addiction counseling is the belief that effective addictions counseling necessitates breaking through a client's denial with directive confrontation (some call this "attack therapy") in order to enable clients to improve. True, some clients exposed to such counseling techniques respond and get sober, this being the illusion of support for the practice that has become the mainstay of the addictions treatment industry for 30 years. Unfortunately, most clients introduced to treatment via attack therapy drop out prematurely. Ironically, these clients are deemed "not ready" to get sober so the client is blamed for the failure to improve when it is more than likely that an inappropriate treatment choice was made by the counselor. This is also roughly similar to what we have seen over that past several years in the published research from the Harvard School of Public Health. This research reports on the steady if not increasing rates of "binge drinking" and then assigns "blame" to social norms and other proactive strategies as being ineffective and unsubstantiated. NOTE: Unsubstantiated does not mean "ineffective," it simply means the technique has yet to be substantiated, but this is another essay :)
So how does the counseling practitioner keep from burning out or becoming so cynical about addressing high-risk student behavior as to consider a career change to welding? There are numerous ways to accomplish this and here is a representative sample:
1. Like the bumper sticker on a liberal's hybrid gas-electric powered auto might suggest, "Think globally, but act locally." Counseling professionals know what they are doing on their individual campuses. They all know the prevention programs, therapy groups, policy reforms, and environmental changes they have been able to affect. We still confer virtually and in person regarding the field, including the "bad news" nationally, but we do so knowing that we make a difference. Just as people do not change by dwelling on mistakes and missed opportunities or by obsessing on the final goal, counseling professionals realize that change is a process rather than an event; they know that on their best days they can help others, but we cannot save them.
2. Many in the Counseling field have come to realize many think and believe as they do. This realization results in most of these professionals seeking out these "others" and conversing with them. The best antidote for the "six o'clock news syndrome" is to speak with others about what is really going on. Just like we all know that not" all 16 to 25 year old members of a particular racial group" are doing what the six o'clock news constantly suggests is the norm, so SA aware of the myriad opportunities to receive various points of view. To paraphrase Woody Guthrie, "Let them that have eyes see and them that have ears hear!" With online news services like JoinTogether.com, newsletters like NASPA’s AOD Knowledge Community and The Network's News From the Front; conventions, workshops, and seminars like the U.S. Department of Education’s National Meeting the field has access to "what's what." This is a powerful antidote to the media's constant barrage of, "We’ve got trouble, right here in River City, and that starts with "T" and that rhymes with "B" and that stands for BOOZE."
3. We are also becoming more sophisticated as a field. Many (most?) have become familiar with Prochaska's Transtheoretical model of counseling with its view of readiness to change occurring on a continuum (see http://robertchapman.net/treatingaddictions.htm for additional information). The appropriateness of meeting someone on this change continuum where he or she is and working to motivate movement to the next stage of readiness rather than instantly trying to move that person to the last stage is very empowering and a powerful inoculation against burnout. To read more, see my essay "IF It Walks Like a Duck and Looks Like a Duck, Why Should I Be Surprised When it Quacks?" - http://www.robertchapman.net/essays/essay.htm click on "Preventing burnout when working with substance abusers."
Counseling professionals are a resilient bunch. We know how important our work is. We know that academic success cannot occur until and unless addressing the issues of students outside the classroom. This does not mean that every student that enrolls in college or university will receive a degree after completing the requisite number of courses. Likewise, anticipating and addressing every high-risk student behavior before it results in a tragedy is unrealistic. That said, it does mean that counseling professionals need to be cognizant of where they seek information lest they inadvertently place themselves on an informational junk food diet. Just as too much fast food can result in hardening of the arteries, too much fast information can result in hardening of the attitudes, a condition just as prone to shortening careers.
Robert
31 December 2009
16 December 2009
Intervening with Individuals with Addictions Always Works...100% of the Time
I believe that every intervention with addicted individuals always works, 100% of the time…never fails. I cannot prove this, I just know it.
I learned this in the 1970s when I would call at the Olean (NY) City Jail each morning and interview anyone intoxicated when arrested the night before. The entire interview might last 5-minutes, which was just enough time to introduce myself and convey the message, “You do not have to feel this way anymore…there is something you can do.” I would like to say that most interviewees had a “Paul on the road to Damascus” epiphany and immediately asked for help; that was the rare exception rather than the rule. There was, however, one gentleman who showed up in my office the better part of a year later, with a crumpled up copy of my business card in his hand, asking if I remembered speaking with him in the jail many months before. Of course I did not, but this was one of those occasions when God lets us tell a lie and still leaves open the gate to Heaven…"yes," I respond, “I remember.” He proceeded to share about what those in AA refer to as having become, “sick and tired of being sick and tired”; he went into treatment.
It was at this point that I realized that any and every effort made to proffer assistance works because although it may take 50 crises, interventions, and “trips to the bottom,” there could not be the 50th event that resulted in change had there not been the 25th…the 10th…the first! We never know…and whether we mount intervention #1 and never see the person again or intervention #50 and shepherd the individual to recovery, there could be no "final intervention" if there was no "initial intervention."
A related experience involved a student I saw when working in a university counseling center. I had conducted an assessment, shared my concerns — rather bluntly I might add — and proffered assistance. The student politely declined and left. A number of years went by before this student returned…quite a number of years. He asked to see me and told me that he left my office that day and went back out and “did his thing” until he hit that final brick wall; he turned to AA; he got sober. He then reached in his pocket and took out his 5-year brass medallion celebrating his 5-years of sobriety in AA and gave it to me saying that his process of change started the day we had our last session when I shared that, “what causes a problem is a problem when it causes problems” and he wanted me to have it as his way of saying thank you. You just never know…
By way of closing — and to not extend this post too much — I include two web links to further experiences I have had that serve to ground my belief that interventions always work. I share them as I know you will appreciate them:
• http://bit.ly/Hvq1h
• http://bit.ly/8IpGJ4 - scroll down to “Rain in My Heart” (this is an earlier post recorded on this blog)
Robert
I believe that every intervention with addicted individuals always works, 100% of the time…never fails. I cannot prove this, I just know it.
I learned this in the 1970s when I would call at the Olean (NY) City Jail each morning and interview anyone intoxicated when arrested the night before. The entire interview might last 5-minutes, which was just enough time to introduce myself and convey the message, “You do not have to feel this way anymore…there is something you can do.” I would like to say that most interviewees had a “Paul on the road to Damascus” epiphany and immediately asked for help; that was the rare exception rather than the rule. There was, however, one gentleman who showed up in my office the better part of a year later, with a crumpled up copy of my business card in his hand, asking if I remembered speaking with him in the jail many months before. Of course I did not, but this was one of those occasions when God lets us tell a lie and still leaves open the gate to Heaven…"yes," I respond, “I remember.” He proceeded to share about what those in AA refer to as having become, “sick and tired of being sick and tired”; he went into treatment.
It was at this point that I realized that any and every effort made to proffer assistance works because although it may take 50 crises, interventions, and “trips to the bottom,” there could not be the 50th event that resulted in change had there not been the 25th…the 10th…the first! We never know…and whether we mount intervention #1 and never see the person again or intervention #50 and shepherd the individual to recovery, there could be no "final intervention" if there was no "initial intervention."
A related experience involved a student I saw when working in a university counseling center. I had conducted an assessment, shared my concerns — rather bluntly I might add — and proffered assistance. The student politely declined and left. A number of years went by before this student returned…quite a number of years. He asked to see me and told me that he left my office that day and went back out and “did his thing” until he hit that final brick wall; he turned to AA; he got sober. He then reached in his pocket and took out his 5-year brass medallion celebrating his 5-years of sobriety in AA and gave it to me saying that his process of change started the day we had our last session when I shared that, “what causes a problem is a problem when it causes problems” and he wanted me to have it as his way of saying thank you. You just never know…
By way of closing — and to not extend this post too much — I include two web links to further experiences I have had that serve to ground my belief that interventions always work. I share them as I know you will appreciate them:
• http://bit.ly/Hvq1h
• http://bit.ly/8IpGJ4 - scroll down to “Rain in My Heart” (this is an earlier post recorded on this blog)
Robert
04 December 2009
How do you spell “addiction”?
________________________________________
"Addiction" may not be what most people think it is at first glance. Most of us "know" what addiction is "when we see it," but too often this recognition is of the disorder in its latter stages.
Can someone be addicted when not using a drug? Can someone be physically dependent on a substance, but not be addicted to it? Is there one all encompassing definition that would address the beliefs of all who wish to describe an addiction or more importantly, diagnose an addicted individual? These are questions that have not been answered with anything approaching a consensus in the “helping professions” so I do not expect that we will reach a consensus this semester where the fields of medicine, psychology, biology, sociology, and numerous other disciplines have failed to accomplish such to date.
This post attempts to expand on what you have hopefully begun to recognize as the foundation for your approach to “understanding addiction,” namely, a personal consideration of the etiology or “origins” of an addictive disorder. This is of the utmost importance for the counselor providing counseling services to the addicted client and her/his family.
If a counselor is unable to explain the diagnosis to the diagnosed individual’s satisfaction (understanding), it will be difficult if not impossible to engage that individual in the recommended course of treatment. If you tell me, assuming I’m your client, that after having conducted an assessment, it is your opinion that my presenting problem involves the abuse of or dependence on substance “X,” but you are unable to help me understand what that means other than the judgmental meaning ascribed by "the public," I am not very likely to embrace the treatment suggestions that you might make. And if you can explain an addictive disorder, but that explanation is steeped in hearsay rather than documented fact, then your efforts to “get the horse to drink” once you have led it to the water is rather slim.
In this post you are invited to consider some of the major models that have been used to explain the etiology or “origins” of an addictive disorder. Reviewing these models and determining which has the greatest utility in effectively treating an individual's addiction, is a crucial piece in engaging that person in treatment. If your he or she hears you calling him a bum or her a tramp when you suggest that s/he is an “alcoholic” or an “addict,” then that client will resist your treatment efforts if not refuse to work with you altogether. Remember: just as you and I have formulated an opinion of what an addiction is and what an addicted person is like from our “observations on life,” so have our clients. Many “hear” addict/alcoholic/etc and think “failure,” "loser," "degenerate," etc.
As you read the assigned material this week (http://wings.buffalo.edu/aru/ARUreport04.html), I would like you to identify which outlined model most closely captures your understanding of the etiology of an addictive disorder. Consider posting your comments on this topic/reading, be prepared to explain: 1) what is attractive about the model you most strongly related to; and/or 2) what argument might you mount if you were to use this model in order to explain it to a client you have diagnosed as having an addiction. NOTE: In responding to your positions, I may pretend to be your client, listening to your explanation of my addiction in the context of your model. I will then “give you feedback” as I would anticipate a resistant client might do in response to your explanation :)
Later in this series of posts we will talk about “premature” treatment, that is, suggesting action oriented treatment before the client has made a commitment to change. For now, however, we will assume that the client is at least willing to consider changing in order to improve—although that does not mean this change will automatically include a willingness to abstain from “X” simply because you have suggested it.
If you have the time, you may enjoy this review of various models that are used to explain addictive disorders - http://www.indiana.edu/~engs/cbook/chap1.html
________________________________________
"Addiction" may not be what most people think it is at first glance. Most of us "know" what addiction is "when we see it," but too often this recognition is of the disorder in its latter stages.
Can someone be addicted when not using a drug? Can someone be physically dependent on a substance, but not be addicted to it? Is there one all encompassing definition that would address the beliefs of all who wish to describe an addiction or more importantly, diagnose an addicted individual? These are questions that have not been answered with anything approaching a consensus in the “helping professions” so I do not expect that we will reach a consensus this semester where the fields of medicine, psychology, biology, sociology, and numerous other disciplines have failed to accomplish such to date.
This post attempts to expand on what you have hopefully begun to recognize as the foundation for your approach to “understanding addiction,” namely, a personal consideration of the etiology or “origins” of an addictive disorder. This is of the utmost importance for the counselor providing counseling services to the addicted client and her/his family.
If a counselor is unable to explain the diagnosis to the diagnosed individual’s satisfaction (understanding), it will be difficult if not impossible to engage that individual in the recommended course of treatment. If you tell me, assuming I’m your client, that after having conducted an assessment, it is your opinion that my presenting problem involves the abuse of or dependence on substance “X,” but you are unable to help me understand what that means other than the judgmental meaning ascribed by "the public," I am not very likely to embrace the treatment suggestions that you might make. And if you can explain an addictive disorder, but that explanation is steeped in hearsay rather than documented fact, then your efforts to “get the horse to drink” once you have led it to the water is rather slim.
In this post you are invited to consider some of the major models that have been used to explain the etiology or “origins” of an addictive disorder. Reviewing these models and determining which has the greatest utility in effectively treating an individual's addiction, is a crucial piece in engaging that person in treatment. If your he or she hears you calling him a bum or her a tramp when you suggest that s/he is an “alcoholic” or an “addict,” then that client will resist your treatment efforts if not refuse to work with you altogether. Remember: just as you and I have formulated an opinion of what an addiction is and what an addicted person is like from our “observations on life,” so have our clients. Many “hear” addict/alcoholic/etc and think “failure,” "loser," "degenerate," etc.
As you read the assigned material this week (http://wings.buffalo.edu/aru/ARUreport04.html), I would like you to identify which outlined model most closely captures your understanding of the etiology of an addictive disorder. Consider posting your comments on this topic/reading, be prepared to explain: 1) what is attractive about the model you most strongly related to; and/or 2) what argument might you mount if you were to use this model in order to explain it to a client you have diagnosed as having an addiction. NOTE: In responding to your positions, I may pretend to be your client, listening to your explanation of my addiction in the context of your model. I will then “give you feedback” as I would anticipate a resistant client might do in response to your explanation :)
Later in this series of posts we will talk about “premature” treatment, that is, suggesting action oriented treatment before the client has made a commitment to change. For now, however, we will assume that the client is at least willing to consider changing in order to improve—although that does not mean this change will automatically include a willingness to abstain from “X” simply because you have suggested it.
If you have the time, you may enjoy this review of various models that are used to explain addictive disorders - http://www.indiana.edu/~engs/cbook/chap1.html
23 November 2009
What is addiction?
As you can surmise from the title of this post, Understanding Addictions, the intent is to invite exploration of addictive disorders and their treatment. But what is addiction?
Everyone – literally EVERYONE – has an understanding of what addiction is as a “problem” and who addicts are as individuals. The problem, however, is that these personal definitions of addiction are fraught with “facts” born of the “nudge, nudge; wink, wink” personal descriptions of addiction and addicted individuals, often based on “Hollywood’s” spin on these disorders. Consequently, every person on the street has an opinion about what an addiction is and how to "spot an addict." Have you seen Train Spotting, Leaving Las Vegas, or When a Man Loves a Woman? Did you have any doubt about who was addicted and who was not? But while any observant human being may be able to identify the individual in the later stages of dependence, i.e., the classic symptoms of physical withdrawal, serious medical complications resulting from chronic abuse, and the litany of socioeconomic problems associated with addiction, it takes a trained counselor to recognize the problems of abuse and dependence in their earliest stages so as to increase the likelihood of effective treatment. This is not easy to accomplish without a clear understanding of what an addiction is and how it evolves.
As you can image, “street definitions” may not be the most accurate source of information about addictive disorders on which a professional counselor can base a diagnosis and develop an effective treatment plan. Unfortunately, relatively few counseling and medical professionals have much if any direct education about or training in understanding addictions and their treatment.
The Assignment
To learn more visit the online article on addiction by Howard Schaffer. Consider his attempt to answer the question, “What is an addiction”? Think about how like/unlike Dr. Schaffer’s position is from your “preexisting” beliefs.
In addition, also read Peter Cohen's essay on addiction—I think you will find this essay interesting as it argues there is no such thing as addiction, suggesting instead that addiction is a “social construction.”
As will become clearer when you dig deeper into the issue of addictions, rarely does someone present at a counselor’s office saying, “The war’s over, I lost and am ready to do whatever you say to get better.” In fact, most clients do not even realize the extent to which their use of alcohol, other drugs, or involvement in compulsive behaviors such as gambling affect their lives and those of their significant others. It is our job as professional counselors to invite our clients to consider what one mentor of mine used to suggest…“what causes a problem is a problem because it causes problems.”
Robert J. chapman
As you can surmise from the title of this post, Understanding Addictions, the intent is to invite exploration of addictive disorders and their treatment. But what is addiction?
Everyone – literally EVERYONE – has an understanding of what addiction is as a “problem” and who addicts are as individuals. The problem, however, is that these personal definitions of addiction are fraught with “facts” born of the “nudge, nudge; wink, wink” personal descriptions of addiction and addicted individuals, often based on “Hollywood’s” spin on these disorders. Consequently, every person on the street has an opinion about what an addiction is and how to "spot an addict." Have you seen Train Spotting, Leaving Las Vegas, or When a Man Loves a Woman? Did you have any doubt about who was addicted and who was not? But while any observant human being may be able to identify the individual in the later stages of dependence, i.e., the classic symptoms of physical withdrawal, serious medical complications resulting from chronic abuse, and the litany of socioeconomic problems associated with addiction, it takes a trained counselor to recognize the problems of abuse and dependence in their earliest stages so as to increase the likelihood of effective treatment. This is not easy to accomplish without a clear understanding of what an addiction is and how it evolves.
As you can image, “street definitions” may not be the most accurate source of information about addictive disorders on which a professional counselor can base a diagnosis and develop an effective treatment plan. Unfortunately, relatively few counseling and medical professionals have much if any direct education about or training in understanding addictions and their treatment.
The Assignment
To learn more visit the online article on addiction by Howard Schaffer. Consider his attempt to answer the question, “What is an addiction”? Think about how like/unlike Dr. Schaffer’s position is from your “preexisting” beliefs.
In addition, also read Peter Cohen's essay on addiction—I think you will find this essay interesting as it argues there is no such thing as addiction, suggesting instead that addiction is a “social construction.”
As will become clearer when you dig deeper into the issue of addictions, rarely does someone present at a counselor’s office saying, “The war’s over, I lost and am ready to do whatever you say to get better.” In fact, most clients do not even realize the extent to which their use of alcohol, other drugs, or involvement in compulsive behaviors such as gambling affect their lives and those of their significant others. It is our job as professional counselors to invite our clients to consider what one mentor of mine used to suggest…“what causes a problem is a problem because it causes problems.”
Robert J. chapman
09 November 2009
Home for the Helidays
In just over 2 weeks, student from alcohol & other drug dependent families will head home for T-giving and Christmas breaks. It is that time of the year again…time to share a reminder of The Network’s brochure, Home for the Helidays. This brochure presents an overview of what students face during this time of the year when preparing to return to an alcohol or other drug dependent family. There are several suggestions proffered regarding how to help students prepare and cope with what can be an extremely trying experience.
Please consider referring students to the brochure online or printing copies for those students you know may appreciate such…if not all students you know who can “pass it on” to quote an old AA slogan. And please feel free to pass this along to others who may be able to share this information with students if not be able to use it themselves.
The brochure can be found in PDF format on The Network addressing collegiate alcohol and other drug issues web page and is based on an essay I wrote some years ago with the same title.
Robert
In just over 2 weeks, student from alcohol & other drug dependent families will head home for T-giving and Christmas breaks. It is that time of the year again…time to share a reminder of The Network’s brochure, Home for the Helidays. This brochure presents an overview of what students face during this time of the year when preparing to return to an alcohol or other drug dependent family. There are several suggestions proffered regarding how to help students prepare and cope with what can be an extremely trying experience.
Please consider referring students to the brochure online or printing copies for those students you know may appreciate such…if not all students you know who can “pass it on” to quote an old AA slogan. And please feel free to pass this along to others who may be able to share this information with students if not be able to use it themselves.
The brochure can be found in PDF format on The Network addressing collegiate alcohol and other drug issues web page and is based on an essay I wrote some years ago with the same title.
Robert
04 November 2009
Fake IDs: Who Values Them Most
The issue of false identification, A.K.A. "Fake Ids" is not news, especially when considering the importance of alcohol and drinking as icons of contemporary collegiate life. A recent article in the Roanoke Times outlines this issue and hints at both its prevalence and the sophistication of these IDs in the 21st century.
This post is not so much intended to comment on Fake IDs as a contemporary social problem as to shine some light on the underage individuals who most highly prize possessing such identification. More to the point, some students value fake id as not only a status symbols or an accoutrement of the savvy, well prepared collegian, but as an absolute necessities to salvage a successful collegiate social life.
When conducting qualitative research on collegiate drinking, both as part of a formal research methodology in the mid 1990s and unofficially in conversations with underage collegians from the late 1980s throughout the 1990s (and on to the present) I had expected the 18- or 19-year-old first-year student to be at the head of the pack in advocating the importance of the "fake id"; I was surprised to learn that I was wrong.
Although fake id, especially "good" fake id, is prized by entering college students, they were not seriously inconvenienced if they did not have access to identification that could stand the scrutiny of trained "gatekeepers" at licensed drinking establishments. Many of these students told me that they did most of their collegiate drinking with friends and acquaintances at clandestine locations, often the "$X at the door, all you can drink" house party where there was no id check or if ids were required, a "note from your mother" was sufficient for entry.
For these entering collegians, it was the ability to produce fake id and display it, like the "condom in the wallet" of the 1960s male, that was significant. It was a trophy or talisman of sorts, that evoked awe and respect from other "less fortunate" underage collegians. And even if the entering student had a "high quality" piece of fake id, the chances are that it would be used far less frequently that either "we" or its owner would have thought because the venues desired for collegiate socializing by entering or "inexperienced" first-year students were the clandestine sites frequented by friends and these simply did not require id.
Surprisingly, it was the 20-year old junior or senior student who not only coveted "quality" false identification, but who recognized that her or his ability to socialize, and do so with specific friends who were of age, depended on such. Many junior and senior students--students I refer to as "experienced" students--realize what in the literature is referred to as the "maturing out phenomenon." For these students, the allure of the keg party attended by "100 of your closest friends" has passed. Juniors and Seniors report that they prefer to go out in small groups and frequent establishments where alcohol is served and frequently is not the focal point, i.e., "the entertainment." Such students of age, planning to go to a club requiring id, will inadvertently present their 20-year old friends with a dilemma...either talk the group into a different social venue or secure quality false identification that will ensure entry to the club. It is this student, the 20-year-old junior or senior, for whom fake id is an issue of social primacy.
It would seem that false identification has always been an issue for "underage" students, but as the sophistication of such identification has increased and its importance for specific underage students is recognized, we can begin to appreciate why some students will go to great ends and invest significant amounts of money and resources in securing "quality" fake id.
Robert
The issue of false identification, A.K.A. "Fake Ids" is not news, especially when considering the importance of alcohol and drinking as icons of contemporary collegiate life. A recent article in the Roanoke Times outlines this issue and hints at both its prevalence and the sophistication of these IDs in the 21st century.
This post is not so much intended to comment on Fake IDs as a contemporary social problem as to shine some light on the underage individuals who most highly prize possessing such identification. More to the point, some students value fake id as not only a status symbols or an accoutrement of the savvy, well prepared collegian, but as an absolute necessities to salvage a successful collegiate social life.
When conducting qualitative research on collegiate drinking, both as part of a formal research methodology in the mid 1990s and unofficially in conversations with underage collegians from the late 1980s throughout the 1990s (and on to the present) I had expected the 18- or 19-year-old first-year student to be at the head of the pack in advocating the importance of the "fake id"; I was surprised to learn that I was wrong.
Although fake id, especially "good" fake id, is prized by entering college students, they were not seriously inconvenienced if they did not have access to identification that could stand the scrutiny of trained "gatekeepers" at licensed drinking establishments. Many of these students told me that they did most of their collegiate drinking with friends and acquaintances at clandestine locations, often the "$X at the door, all you can drink" house party where there was no id check or if ids were required, a "note from your mother" was sufficient for entry.
For these entering collegians, it was the ability to produce fake id and display it, like the "condom in the wallet" of the 1960s male, that was significant. It was a trophy or talisman of sorts, that evoked awe and respect from other "less fortunate" underage collegians. And even if the entering student had a "high quality" piece of fake id, the chances are that it would be used far less frequently that either "we" or its owner would have thought because the venues desired for collegiate socializing by entering or "inexperienced" first-year students were the clandestine sites frequented by friends and these simply did not require id.
Surprisingly, it was the 20-year old junior or senior student who not only coveted "quality" false identification, but who recognized that her or his ability to socialize, and do so with specific friends who were of age, depended on such. Many junior and senior students--students I refer to as "experienced" students--realize what in the literature is referred to as the "maturing out phenomenon." For these students, the allure of the keg party attended by "100 of your closest friends" has passed. Juniors and Seniors report that they prefer to go out in small groups and frequent establishments where alcohol is served and frequently is not the focal point, i.e., "the entertainment." Such students of age, planning to go to a club requiring id, will inadvertently present their 20-year old friends with a dilemma...either talk the group into a different social venue or secure quality false identification that will ensure entry to the club. It is this student, the 20-year-old junior or senior, for whom fake id is an issue of social primacy.
It would seem that false identification has always been an issue for "underage" students, but as the sophistication of such identification has increased and its importance for specific underage students is recognized, we can begin to appreciate why some students will go to great ends and invest significant amounts of money and resources in securing "quality" fake id.
Robert
28 October 2009
All College Students Drink the Same...or Is that a Myth?
College students drink. And that, it is safe to say, is not news. But how many people know that one-third of the students consume three-quarters of the booze on American campuses?
Why is it that these intelligent people put themselves at risk, and what can be done about it?
My university counseling experience and time in the classroom has taught me that most students believe they are immune to the consequences of heavy drinking. Students claim that alcohol related tragedies are results of “bad luck” or that they occur because the victims were “stupid.” In short, they cannot imagine themselves experiencing a similar tragedy. Even when students would see me when referred by the University judicial system after a crisis resulting from a bout of heavy drinking, they often used the same reasoning to explain their own experience: “I have the worst luck” or “I was just stupid.”
This attitude is similar to social psychology’s just world hypothesis. This phenomenon suggests that "people get what they deserve"...good things happen to good people and bad things happen to bad people. Applying this to college students, most feel immune to danger when engaged in high-risk behavior because they believe that they are good people, and therefore bad things will not happen to them...they are "bullet proof" as one student informed me. So, even when students have been educated about the risks of alcohol abuse, it comes as no surprise that they often experience serious, and sometimes tragic, consequences from excessive alcohol consumption.
Another contributing phenomenon that may help explain why some engage in excessive consumption also comes from social psychology; Groupthink. This phenomenon occurs when the leader of a cohesive group influences the other members, often resulting in poor decision making during stressful situations. The hallmarks of such flawed decision making include a group’s belief that it is invincible and has a moral responsibility to act in a particular fashion. There is also a tendency to view individuals outside the group as "others" and to justify this by using stereotypes. The group employs a buffer that insulates it from outside influence and censors contrary or alternative views to those expressed by the group. As a result, individual members are led to support the group’s decision. This may explain the hazing phenomenon seen in some collegiate groups or lend an explanation to the violence that can emerge when rival groups, for example, Greek lettered organizations, clash following an evening of drinking.
Taking these phenomena into consideration, it is helpful to recognize that the beliefs and perspectives of students who do not drink or who do so moderately are a valuable source of information about campus culture. It is important to understand why these students act responsibly, and then apply this understanding in approaches to programming. For instance, many first-year students tell me that they arrive on campus believing alcohol is integral to an active collegiate social life. This is important to know because it provides an indication as to what these students expect of a successful university experience. To the extent that students expect drinking to be associated with collegiate life, they are primed to pursue that expectation. Recognizing this allows us to develop proactive means for confronting these student misperceptions. It is important to alert students to the myth of collegiate drinking: that not everyone drinks and for those who do, not everyone gets drunk. This may shift the desire from conformity through alcohol abuse to abstinence or moderation, teaching students that just because they are sober, their collegiate experience is not wasted.
Robert
College students drink. And that, it is safe to say, is not news. But how many people know that one-third of the students consume three-quarters of the booze on American campuses?
Why is it that these intelligent people put themselves at risk, and what can be done about it?
My university counseling experience and time in the classroom has taught me that most students believe they are immune to the consequences of heavy drinking. Students claim that alcohol related tragedies are results of “bad luck” or that they occur because the victims were “stupid.” In short, they cannot imagine themselves experiencing a similar tragedy. Even when students would see me when referred by the University judicial system after a crisis resulting from a bout of heavy drinking, they often used the same reasoning to explain their own experience: “I have the worst luck” or “I was just stupid.”
This attitude is similar to social psychology’s just world hypothesis. This phenomenon suggests that "people get what they deserve"...good things happen to good people and bad things happen to bad people. Applying this to college students, most feel immune to danger when engaged in high-risk behavior because they believe that they are good people, and therefore bad things will not happen to them...they are "bullet proof" as one student informed me. So, even when students have been educated about the risks of alcohol abuse, it comes as no surprise that they often experience serious, and sometimes tragic, consequences from excessive alcohol consumption.
Another contributing phenomenon that may help explain why some engage in excessive consumption also comes from social psychology; Groupthink. This phenomenon occurs when the leader of a cohesive group influences the other members, often resulting in poor decision making during stressful situations. The hallmarks of such flawed decision making include a group’s belief that it is invincible and has a moral responsibility to act in a particular fashion. There is also a tendency to view individuals outside the group as "others" and to justify this by using stereotypes. The group employs a buffer that insulates it from outside influence and censors contrary or alternative views to those expressed by the group. As a result, individual members are led to support the group’s decision. This may explain the hazing phenomenon seen in some collegiate groups or lend an explanation to the violence that can emerge when rival groups, for example, Greek lettered organizations, clash following an evening of drinking.
Taking these phenomena into consideration, it is helpful to recognize that the beliefs and perspectives of students who do not drink or who do so moderately are a valuable source of information about campus culture. It is important to understand why these students act responsibly, and then apply this understanding in approaches to programming. For instance, many first-year students tell me that they arrive on campus believing alcohol is integral to an active collegiate social life. This is important to know because it provides an indication as to what these students expect of a successful university experience. To the extent that students expect drinking to be associated with collegiate life, they are primed to pursue that expectation. Recognizing this allows us to develop proactive means for confronting these student misperceptions. It is important to alert students to the myth of collegiate drinking: that not everyone drinks and for those who do, not everyone gets drunk. This may shift the desire from conformity through alcohol abuse to abstinence or moderation, teaching students that just because they are sober, their collegiate experience is not wasted.
Robert
22 October 2009
Pursuing a Graduate Degree in Counseling
A student recently wrote to thank me for assisting him in a course he was taking and to ask about graduate schools...and whether I thought the rewards were worth the investment of time, money, and effort. I share my reply here...
Emails like yours bring a smile to a professor’s face because they mean that what you have accomplished in “all” your education to date is exactly what should happen in all educational opportunities...that you had most of the questions you brought to the course answered only to be replaced by 1.5 times as many new questions. Of course, these new questions mean that you need to return to the classroom — or read more books and journals or attend workshop or apprenticeship or “whatever" — to get those new questions answered. Of course, as you can see by the formula outlined at the start of this missive, you will always have more questions than when you started, but the trick is to ensure that these are “new questions” that result from the answers you received to your “old questions.” In short, this make learning a life-long commitment that is never completed, and this, in part, is the joy of learning...and the pursuit of wisdom. My efforts to articulate this are likely a bit boring and perhaps difficult to follow so I suggest you read the lyrics to Dan Fogelburg’s song, “The Higher You Climb” – click on http://bit.ly/1D0GN and to listen to the cut from the Dan Fogelberg "High Country Snow" album, http://bit.ly/1OWeHB.
Regarding your questions about graduate schools, I suggest several questions for your consideration:
Why do you want a doctoral degree? There are many reasons for pursuing a doctorate and all are good reasons because they are your reasons. This question is not intended to discourage you, but sharpen your focus. Once you know “why” you want a doctorate, this can help inform the final decision you make as to what type of program you will pursue.
What would you like to do with this doctorate? I am assuming you are interested in a doctoral degree in behavioral health or counseling or some related human service. If you want to teach, you are likely looking at a PhD rather than a PsyD or EdD, although both of these doctorates will enable one to secure a teaching position, although both tend to be more “applied” degrees than “academic” degrees — the exception is EdD when teaching teachers, but I do not suspect that is what interests you. You can always teach adjunct with any terminal degree, but a tenure-track position is likely going to require a PhD.
Why do you want to go directly from a bachelor’s program to a doctoral program? This can significantly increase the difficulty of finding entrance to a program, especially if you are interested in a doctorate in counseling. The competition is immense for PhD programs in clinical and counseling psychology and you will be competing with individuals for admission who have already earned a master’s degree as many people earn master’s degrees in counseling and then pursue the PhD. The upside is that an earned master’s plus any published writing or research completed while earning that degree — not to mention the grades earned that will likely surpass those earned in one’s bachelor’s program — can make the applicant more attractive to a doctoral program. The down side, of course, is that it could be 2 to 3 years to get the master’s and then another 4 to 5 to get the PhD, depending on how many of the master’s credits can be transferred into the doctoral program. NOTE: Some doctoral programs allow a student to pick up a master’s on the way to the doctorate, which can be useful in that the faculty making decisions about who gets into the doctoral program know the applicant who did his master’s in that program.
What do you want your doctorate in? There are a number of degrees that can prepare one for teaching and/or applied work in behavioral health. Which type of degree to pursue goes back to questions 1 & 2 above. You can do a PhD in clinical or counseling Psych; a PsyD in Psych; a PhD or EdD in Counselor Education; a DSW in social work, just for some examples. What degree you pursue should be a function of what you want to ultimately do professionally...and to a lesser, but nonetheless important degree, what you want to study. For example, my PhD is in Counselor Education. That degree, from Syracuse, was awarded by the school of education. Although I was taught “about” counseling, the focus was on “teaching” counseling to future counselors rather than “practicing” counseling — my master’s degree is an applied master’s, i.e., “how to do counseling.” I did not want to be a psychologist so I was not drawn to a doctorate in psychology. Because my interest was not there I never would have been able to remain focused and driven to do the work that was required to accomplish a doctoral degree had that been in psychology.
In summary, the decision to pursue an advanced degree or degrees (master’s and doctorate) is wonderful. Having come to that conclusion, you now need to zero in on just how to pursue your dream and that should be rooted in what “you” want to do...and become. Remember there is no wrong decision, just various forms of the right decision.
Dr. Robert
A student recently wrote to thank me for assisting him in a course he was taking and to ask about graduate schools...and whether I thought the rewards were worth the investment of time, money, and effort. I share my reply here...
Emails like yours bring a smile to a professor’s face because they mean that what you have accomplished in “all” your education to date is exactly what should happen in all educational opportunities...that you had most of the questions you brought to the course answered only to be replaced by 1.5 times as many new questions. Of course, these new questions mean that you need to return to the classroom — or read more books and journals or attend workshop or apprenticeship or “whatever" — to get those new questions answered. Of course, as you can see by the formula outlined at the start of this missive, you will always have more questions than when you started, but the trick is to ensure that these are “new questions” that result from the answers you received to your “old questions.” In short, this make learning a life-long commitment that is never completed, and this, in part, is the joy of learning...and the pursuit of wisdom. My efforts to articulate this are likely a bit boring and perhaps difficult to follow so I suggest you read the lyrics to Dan Fogelburg’s song, “The Higher You Climb” – click on http://bit.ly/1D0GN and to listen to the cut from the Dan Fogelberg "High Country Snow" album, http://bit.ly/1OWeHB.
Regarding your questions about graduate schools, I suggest several questions for your consideration:
Why do you want a doctoral degree? There are many reasons for pursuing a doctorate and all are good reasons because they are your reasons. This question is not intended to discourage you, but sharpen your focus. Once you know “why” you want a doctorate, this can help inform the final decision you make as to what type of program you will pursue.
What would you like to do with this doctorate? I am assuming you are interested in a doctoral degree in behavioral health or counseling or some related human service. If you want to teach, you are likely looking at a PhD rather than a PsyD or EdD, although both of these doctorates will enable one to secure a teaching position, although both tend to be more “applied” degrees than “academic” degrees — the exception is EdD when teaching teachers, but I do not suspect that is what interests you. You can always teach adjunct with any terminal degree, but a tenure-track position is likely going to require a PhD.
Why do you want to go directly from a bachelor’s program to a doctoral program? This can significantly increase the difficulty of finding entrance to a program, especially if you are interested in a doctorate in counseling. The competition is immense for PhD programs in clinical and counseling psychology and you will be competing with individuals for admission who have already earned a master’s degree as many people earn master’s degrees in counseling and then pursue the PhD. The upside is that an earned master’s plus any published writing or research completed while earning that degree — not to mention the grades earned that will likely surpass those earned in one’s bachelor’s program — can make the applicant more attractive to a doctoral program. The down side, of course, is that it could be 2 to 3 years to get the master’s and then another 4 to 5 to get the PhD, depending on how many of the master’s credits can be transferred into the doctoral program. NOTE: Some doctoral programs allow a student to pick up a master’s on the way to the doctorate, which can be useful in that the faculty making decisions about who gets into the doctoral program know the applicant who did his master’s in that program.
What do you want your doctorate in? There are a number of degrees that can prepare one for teaching and/or applied work in behavioral health. Which type of degree to pursue goes back to questions 1 & 2 above. You can do a PhD in clinical or counseling Psych; a PsyD in Psych; a PhD or EdD in Counselor Education; a DSW in social work, just for some examples. What degree you pursue should be a function of what you want to ultimately do professionally...and to a lesser, but nonetheless important degree, what you want to study. For example, my PhD is in Counselor Education. That degree, from Syracuse, was awarded by the school of education. Although I was taught “about” counseling, the focus was on “teaching” counseling to future counselors rather than “practicing” counseling — my master’s degree is an applied master’s, i.e., “how to do counseling.” I did not want to be a psychologist so I was not drawn to a doctorate in psychology. Because my interest was not there I never would have been able to remain focused and driven to do the work that was required to accomplish a doctoral degree had that been in psychology.
In summary, the decision to pursue an advanced degree or degrees (master’s and doctorate) is wonderful. Having come to that conclusion, you now need to zero in on just how to pursue your dream and that should be rooted in what “you” want to do...and become. Remember there is no wrong decision, just various forms of the right decision.
Dr. Robert
11 October 2009
Rain in My Heart: Understanding the Affects of Alcoholism
Shortly after I started to work in the addictions field in January of 1974, a colleague in social services, what was then called the "welfare department," suggested that I shadow him on house calls as he would visit his case load. He introduced me to 4 alcoholic gentlemen whom I befriended...his clients. They all lived in what used to be called a “flop house,” up over a paint store on North Union St. in Olean, NY. Each had one room, which consisted of a bed, a table, a hot plate, and a chair; there was a communal bath on the floor. There was exposed wiring in the halls and rooms, a single light bulb hanging on a wire from the ceiling, and these gentlemen would cook on and heat the room with the hot plate - NOTE: this was rural Western NY where it was not uncommon for the temperature in the winter to reach –30’ F...why the building never burned down was beyond me.
These gentlemen were all acquaintances and would, on occasion, drink together. They generally drank muscatel (a fortified wine), usually 3 to 4 bottles a day each, and as many as 8 (each) on a bender when they had the money. One shared his room from time to time with an alcoholic woman, but unfortunately I never got to know her or her story very well. In the winter I would visit with them in their rooms...in the warmer weather I would visit them as the drank in the tall grass by the railroad tracks as they sat on the switch box for the Erie Lackawanna Railroad in a “bottle gang.” I did not know it at the time, but I was conducting ethnographic research. The gentlemen came to trust me and accepted me as I would listen to their stories about their “early days” of drinking and try to understand the etiology of their alcoholism. They would always pass the bottle to me, inviting me to drink with them as the bottle made its rounds in the group...I always passed the bottle along w/o imbibing. I remember being floored by their candor as every one of these gentlemen readily admitted that he was an alcoholic and when I would proffer help, that he had no desire to quit. It was as if they had resigned themselves to the fact that life had passed them by and there was no hope for any of them...life would just run its course and they would eventually die of their alcoholism.
I can remember calling on them on occasion when they were in much the same shape as the alcoholic individuals in the BBC documentary, “Rain in My Heart,” which is available online along with commentary (http://news.bbc.co.uk/2/hi/programmes/newsnight/7140605.stm)...eyes yellow with jaundice, unable to leave their beds, hardly eating and only drinking.
The first gentleman to expire due to his alcoholism died, if I remember correctly almost 35 years later, from massive organ failure, a complication of his long drinking history; he was in his 30s. The 2nd was stomped and beaten so severely by the 3rd, over a bottle of wine, that he was admitted to hospital and never left...he died of the beating. I can remember visiting him in the hospital and watching as he smoked cigarettes through the tracheotomy tube in his throat...the first time I ever saw that...yet another addiction he had--yes, patients were permitted to smoke in their rooms 35 years ago. The gentleman who put "Lavern" there was convicted of manslaughter and sentenced to Attica, where he died before completing his sentence—a side bar story is “Don’s” stories about making alcohol in prison when previously incarcerated...he would ferment peach juice he would get by bartering with trustees working in the kitchen where large cans of peaches would be used to serve inmates. The recipe for the "prison hooch" was peach juice, water, and bread (for yeast), and place the mix behind the dryers in the laundry to ferment.
The 4th gentleman, “Francis” had peripheral neuropathy so advanced that he could not walk...but, believe it or not, he could ride a bike! It was quite amazing to watch "Francis" ride all over town, but when he would stop his bike, he could hardly move. When he was the only one of the group left, he went on a bender one time and found himself in a sever alcohol-induced crisis. I managed to play a role in getting him admitted to a local hospital to be detoxed—keep in mind that in 1975 in Olean, NY there were no such thing as a detox unit. Individuals had to be "dried out" in a med-surge ward under a general med diagnosis in what was affectionately known as “scatter bed detox”—and while he was being dried out I arranged for him to go to the Alcohol Rehab Unit at Gowanda State Hospital, south of Buffalo NY. Interestingly, he linked up with some other patients, got involved in AA and managed to stay sober after discharge—although some would have argued he was little more than “dry.”
These 4 gentleman, plus the 100s of AA meeting I attended and about 4 or 5 other specific “late stage” or “sever alcoholics” as they were referred to in the BBC documentary, "Rain in My Heart," were clients I recall vividly. These individuals thought me as much about alcoholism as any book, workshop, or training program I ever attended. What moved me most about the BBC documentary was that “I knew these people” and I had worked with each of the 4 individuals whose stories were chronicled. Although the documentary was made in Kent, England in the UK, I had nonetheless known each of these individuals and had dealt with the same issues as were documented in the film. If anything, the film falls short of portraying the extent of devastation that can be caused by late stage alcoholism because you can only see and hear what was going on...you could not smell, taste, or touch the consequences of alcoholism as it would permeate the very environment in which they were living and drinking and, unfortunately, dying.
The entire documentary, about 90+ minutes, can be viewed on YouTube in 10 installment. The first can be found at http://www.youtube.com/watch?v=NP0InrPZpjg From there, just click on links to #2, 3, etc. NOTE: This is NOT an easy film to watch, but it is “spot on” in its portrayal of alcoholism and its impact on late stage alcoholic individuals and their families.
Robert
Shortly after I started to work in the addictions field in January of 1974, a colleague in social services, what was then called the "welfare department," suggested that I shadow him on house calls as he would visit his case load. He introduced me to 4 alcoholic gentlemen whom I befriended...his clients. They all lived in what used to be called a “flop house,” up over a paint store on North Union St. in Olean, NY. Each had one room, which consisted of a bed, a table, a hot plate, and a chair; there was a communal bath on the floor. There was exposed wiring in the halls and rooms, a single light bulb hanging on a wire from the ceiling, and these gentlemen would cook on and heat the room with the hot plate - NOTE: this was rural Western NY where it was not uncommon for the temperature in the winter to reach –30’ F...why the building never burned down was beyond me.
These gentlemen were all acquaintances and would, on occasion, drink together. They generally drank muscatel (a fortified wine), usually 3 to 4 bottles a day each, and as many as 8 (each) on a bender when they had the money. One shared his room from time to time with an alcoholic woman, but unfortunately I never got to know her or her story very well. In the winter I would visit with them in their rooms...in the warmer weather I would visit them as the drank in the tall grass by the railroad tracks as they sat on the switch box for the Erie Lackawanna Railroad in a “bottle gang.” I did not know it at the time, but I was conducting ethnographic research. The gentlemen came to trust me and accepted me as I would listen to their stories about their “early days” of drinking and try to understand the etiology of their alcoholism. They would always pass the bottle to me, inviting me to drink with them as the bottle made its rounds in the group...I always passed the bottle along w/o imbibing. I remember being floored by their candor as every one of these gentlemen readily admitted that he was an alcoholic and when I would proffer help, that he had no desire to quit. It was as if they had resigned themselves to the fact that life had passed them by and there was no hope for any of them...life would just run its course and they would eventually die of their alcoholism.
I can remember calling on them on occasion when they were in much the same shape as the alcoholic individuals in the BBC documentary, “Rain in My Heart,” which is available online along with commentary (http://news.bbc.co.uk/2/hi/programmes/newsnight/7140605.stm)...eyes yellow with jaundice, unable to leave their beds, hardly eating and only drinking.
The first gentleman to expire due to his alcoholism died, if I remember correctly almost 35 years later, from massive organ failure, a complication of his long drinking history; he was in his 30s. The 2nd was stomped and beaten so severely by the 3rd, over a bottle of wine, that he was admitted to hospital and never left...he died of the beating. I can remember visiting him in the hospital and watching as he smoked cigarettes through the tracheotomy tube in his throat...the first time I ever saw that...yet another addiction he had--yes, patients were permitted to smoke in their rooms 35 years ago. The gentleman who put "Lavern" there was convicted of manslaughter and sentenced to Attica, where he died before completing his sentence—a side bar story is “Don’s” stories about making alcohol in prison when previously incarcerated...he would ferment peach juice he would get by bartering with trustees working in the kitchen where large cans of peaches would be used to serve inmates. The recipe for the "prison hooch" was peach juice, water, and bread (for yeast), and place the mix behind the dryers in the laundry to ferment.
The 4th gentleman, “Francis” had peripheral neuropathy so advanced that he could not walk...but, believe it or not, he could ride a bike! It was quite amazing to watch "Francis" ride all over town, but when he would stop his bike, he could hardly move. When he was the only one of the group left, he went on a bender one time and found himself in a sever alcohol-induced crisis. I managed to play a role in getting him admitted to a local hospital to be detoxed—keep in mind that in 1975 in Olean, NY there were no such thing as a detox unit. Individuals had to be "dried out" in a med-surge ward under a general med diagnosis in what was affectionately known as “scatter bed detox”—and while he was being dried out I arranged for him to go to the Alcohol Rehab Unit at Gowanda State Hospital, south of Buffalo NY. Interestingly, he linked up with some other patients, got involved in AA and managed to stay sober after discharge—although some would have argued he was little more than “dry.”
These 4 gentleman, plus the 100s of AA meeting I attended and about 4 or 5 other specific “late stage” or “sever alcoholics” as they were referred to in the BBC documentary, "Rain in My Heart," were clients I recall vividly. These individuals thought me as much about alcoholism as any book, workshop, or training program I ever attended. What moved me most about the BBC documentary was that “I knew these people” and I had worked with each of the 4 individuals whose stories were chronicled. Although the documentary was made in Kent, England in the UK, I had nonetheless known each of these individuals and had dealt with the same issues as were documented in the film. If anything, the film falls short of portraying the extent of devastation that can be caused by late stage alcoholism because you can only see and hear what was going on...you could not smell, taste, or touch the consequences of alcoholism as it would permeate the very environment in which they were living and drinking and, unfortunately, dying.
The entire documentary, about 90+ minutes, can be viewed on YouTube in 10 installment. The first can be found at http://www.youtube.com/watch?v=NP0InrPZpjg From there, just click on links to #2, 3, etc. NOTE: This is NOT an easy film to watch, but it is “spot on” in its portrayal of alcoholism and its impact on late stage alcoholic individuals and their families.
Robert
05 October 2009
Harm Reduction:
Managing One's Use of Psychoactive Substances
________________________________________
Marijuana, along with alcohol, nicotine, and caffeine, are among the most widely used drugs of choice by collegiate students in the U.S. Although U.S. policy regarding drugs is driven by a definition of drugs as being illicit substances and its overarching objective when establishing public policy regarding such drugs is interdiction, all four of these substances, plus prescription medications and many over-the-counter compounds (OTC) available without prescription include psychoactive compounds.
These four common drugs of use for college students should be viewed with equity when discussing substance use with contemporary collegians, especially if a Student Affairs professional is discussing the results of the substance use assessment with an individual student. This is meant to suggest that students need to be asked about their use of these legal substances and their declaration of "in moderation" when acknowledging use, of whichever substances are reported, be discussed from a "harm reduction" point of view. Although few readers will likely have a problem with talking about "low risk" use of caffeine, some, I suspect, will question doing this with alcohol and many will likely question the appropriateness of doing so with marijuana and tobacco…let alone other real drugs. Keep in mind, however, that when doing this I use my definition of low risk and not the client's, and I have yet to find a reasonable definition of "no risk" for any of these substances. In short, the consumption of any psychoactive substance—but especially these four psychoactive substances—all include risk, be that health, legal, social, vocational, personal (a.k.a., impaired judgment) or whatever.
Now, when talking about the management of psychoactive substances, there are certain guidelines, or as an old friend of mine who first introduced me to these guidelines almost 30 years ago called them, "rules for psychoactive management" (Weitzel, 1981) that need to be heeded. These include:
1. When there is an opportunity or inclination to consume a psychoactive, especially in order to feel good or get high, consider zero consumption. As a matter of fact there are clear indications when no use is responsible use, e.g., alcohol and driving, Central Nervous System depressant substances and operating machinery, e.g., antihistamines, or tobacco when being treated for asthma.
2. When a decision to consume has been made, consume as LITTLE as necessary, rather than AS MUCH as possible.
3. Discuss the sought after effects of the substance being used with another
4. Research the side effects and discuss with others
5. Include, among those with whom you discuss these effects, non-consumers of the substance you are considering using.
(NOTE: These suggestions were first presented by William Weitzel at workshop at the PA "Governor's Council" Drug & Alcohol Conference, Oct. 28, 1981)
We need to be careful in our rush to "do the right thing" that we do not close the door on the one place that students can turn to get objective information, us. If we are perceived as "narcs" or the "campus DEA," as students wish to discuss the dangers of drugs, we will only have mandated conversations with closed mouthed students. Student Affairs professionals and faculty ARE the appropriate individuals on campus with whom students should be discussing issues of drug use, and this means open and frank discussions.
Of course, as professionals working in higher education, we should not advocate the use of any drug, licit or illicit, for any reason. Rather, we should recognize that many students do use drugs, especially the "big four" mentioned above, frequently with minimal risk. Does this mean we should say, "Hey, if it feels good and you're not hurting anyone, go for it?” absolutely not. If anything we should be inviting students to review the first rule mentioned above" and the risks associated with ANY psychoactive use in order to make objective decision based on accurate facts. A likely motto for the effective Student Affairs professional in higher education may well be, "Good decisions begin with accurate information."
It is entirely possible that there is a continuum for marijuana use just as there is for alcohol, caffeine, or other drug use. This continuum runs from "no risk," i.e. abstinence, to "guaranteed risk," i.e., dependence. I believe it is part of our responsibility to invite students to consider this fact and to make decisions accordingly. Students have come to expect our professional reaction to a discussion of psychoactive use to only include the "no risk" end of the continuum. If we act as they expect we all but guarantee failure in affecting the decisions our students/clients are making as regards drug use as we argue with each other from across the resulting abyss.
When inviting students to look at "the big picture," which includes the risk end of the continuum, we may well be confronted, sometimes quite bluntly, with a student’s perception that we are being subjective and trying to tell them how to live their lives. Be this as it may, there are students who have decided to continue to smoke pot - drink caffeine/alcohol, smoke tobacco, use OTC compounds contrary to directions, etc. - even after our conversations. What is interesting, however, is that they frequently do so, but on a level of significant reduction in frequency and quantity from that presented when seeking counsel or feedback from a professional familiar with the rules outlined above. Is this a no-risk decision? Again, this is absolutely not true. But is it a more proactive approach to engaging contemporary collegians in a discussion about the choices they make? You decide.
To close as I began, often we are the source of accurate information and to deliver that information requires that we recognize that sometimes to deliver "all" of the information necessitates that we include "some" of the information that, in and of itself, we do not condone.
What do you think?
Managing One's Use of Psychoactive Substances
________________________________________
Marijuana, along with alcohol, nicotine, and caffeine, are among the most widely used drugs of choice by collegiate students in the U.S. Although U.S. policy regarding drugs is driven by a definition of drugs as being illicit substances and its overarching objective when establishing public policy regarding such drugs is interdiction, all four of these substances, plus prescription medications and many over-the-counter compounds (OTC) available without prescription include psychoactive compounds.
These four common drugs of use for college students should be viewed with equity when discussing substance use with contemporary collegians, especially if a Student Affairs professional is discussing the results of the substance use assessment with an individual student. This is meant to suggest that students need to be asked about their use of these legal substances and their declaration of "in moderation" when acknowledging use, of whichever substances are reported, be discussed from a "harm reduction" point of view. Although few readers will likely have a problem with talking about "low risk" use of caffeine, some, I suspect, will question doing this with alcohol and many will likely question the appropriateness of doing so with marijuana and tobacco…let alone other real drugs. Keep in mind, however, that when doing this I use my definition of low risk and not the client's, and I have yet to find a reasonable definition of "no risk" for any of these substances. In short, the consumption of any psychoactive substance—but especially these four psychoactive substances—all include risk, be that health, legal, social, vocational, personal (a.k.a., impaired judgment) or whatever.
Now, when talking about the management of psychoactive substances, there are certain guidelines, or as an old friend of mine who first introduced me to these guidelines almost 30 years ago called them, "rules for psychoactive management" (Weitzel, 1981) that need to be heeded. These include:
1. When there is an opportunity or inclination to consume a psychoactive, especially in order to feel good or get high, consider zero consumption. As a matter of fact there are clear indications when no use is responsible use, e.g., alcohol and driving, Central Nervous System depressant substances and operating machinery, e.g., antihistamines, or tobacco when being treated for asthma.
2. When a decision to consume has been made, consume as LITTLE as necessary, rather than AS MUCH as possible.
3. Discuss the sought after effects of the substance being used with another
4. Research the side effects and discuss with others
5. Include, among those with whom you discuss these effects, non-consumers of the substance you are considering using.
(NOTE: These suggestions were first presented by William Weitzel at workshop at the PA "Governor's Council" Drug & Alcohol Conference, Oct. 28, 1981)
We need to be careful in our rush to "do the right thing" that we do not close the door on the one place that students can turn to get objective information, us. If we are perceived as "narcs" or the "campus DEA," as students wish to discuss the dangers of drugs, we will only have mandated conversations with closed mouthed students. Student Affairs professionals and faculty ARE the appropriate individuals on campus with whom students should be discussing issues of drug use, and this means open and frank discussions.
Of course, as professionals working in higher education, we should not advocate the use of any drug, licit or illicit, for any reason. Rather, we should recognize that many students do use drugs, especially the "big four" mentioned above, frequently with minimal risk. Does this mean we should say, "Hey, if it feels good and you're not hurting anyone, go for it?” absolutely not. If anything we should be inviting students to review the first rule mentioned above" and the risks associated with ANY psychoactive use in order to make objective decision based on accurate facts. A likely motto for the effective Student Affairs professional in higher education may well be, "Good decisions begin with accurate information."
It is entirely possible that there is a continuum for marijuana use just as there is for alcohol, caffeine, or other drug use. This continuum runs from "no risk," i.e. abstinence, to "guaranteed risk," i.e., dependence. I believe it is part of our responsibility to invite students to consider this fact and to make decisions accordingly. Students have come to expect our professional reaction to a discussion of psychoactive use to only include the "no risk" end of the continuum. If we act as they expect we all but guarantee failure in affecting the decisions our students/clients are making as regards drug use as we argue with each other from across the resulting abyss.
When inviting students to look at "the big picture," which includes the risk end of the continuum, we may well be confronted, sometimes quite bluntly, with a student’s perception that we are being subjective and trying to tell them how to live their lives. Be this as it may, there are students who have decided to continue to smoke pot - drink caffeine/alcohol, smoke tobacco, use OTC compounds contrary to directions, etc. - even after our conversations. What is interesting, however, is that they frequently do so, but on a level of significant reduction in frequency and quantity from that presented when seeking counsel or feedback from a professional familiar with the rules outlined above. Is this a no-risk decision? Again, this is absolutely not true. But is it a more proactive approach to engaging contemporary collegians in a discussion about the choices they make? You decide.
To close as I began, often we are the source of accurate information and to deliver that information requires that we recognize that sometimes to deliver "all" of the information necessitates that we include "some" of the information that, in and of itself, we do not condone.
What do you think?
24 September 2009
The “Bic Syndrome”
There is a phenomenon in contemporary American culture that appears to be at least 20 years old. As a counselor who both teaches and practices the art of counseling, I have observed this phenomenon in both my students and the individuals with whom I do counseling throughout this period. I refer to this “quirk” in contemporary human behavior as the "Bic Syndrome."
While I must admit that I most frequently observe this phenomenon in clients who seek counseling to address a personal problem or students in the classroom who are more interested in a degree than the knowledge afforded by education, I have also noted the Bic Syndrome in part time employees in entry level positions, couples in relationships where the initial passion of the pursuit gives way to the challenges of learning to live together, and even those who believe that life’s offerings by a particular birthday are not fulfilling, boring, or just plain dull. The "Bic Syndrome" takes its name from the popular disposable razor so successfully marketed for the past 15 to 20 years.
The beauty of the disposable razor is that its relative economy allows one to simply discard the razor when it is perceived to be dull and replace it with another "new" and sharper one. There's no muss, no fuss, and no one thinks twice about the practice. Now with razors--and cigarette lighters for that matter--this may be convenient and economical. It would seem, however, that we have become something of a "disposable" society. It often seems easier and more convenient to discard an item that becomes “dull” or is “old” when compared to the latest model. Sometimes it even seems that we would rather discard and replace an item than invest the effort or time necessary to properly maintain or fix it. If this is true on any level, does it suggest that we have become a pleasure-seeking culture that believes it is somehow our right to expect immediate gratification and not have to tolerate things “inconvenient, dull or tedious”? To discard razors and lighters may be a relatively harmless practice in the grand scheme of things, but what happens if this “consumer’s view” of convenience affects our commitment to jobs, friends, or relationships, especially at those times that will always surface when they become dull or tedious or are in need of maintenance?
To a large extent, we humans know what we have learned and learn what we have been taught. Now, this does not mean that one cannot predetermine her/his own course in life and pursue the learning that permits the pursuit of a dream, but if one is overly involved in the Bic Syndrome, the desire for the newest, sharpest, brightest reality can undermine one's resolution to work on a problem relationship rather than to simply discard it and move one.
I have often overheared the rumblings of students about "how hard" school is and how "professors should know we have jobs and personal lives" when receiving an assignment that requires significant reading, field work, or unyielding demands for quality in papers or other assignments that require significant investments of time or effort. The expectation is that professors should "lighten-up" and required standards should be driven by the convenience of the student rather than the professor’s expectation of scholarship. While this may be a minority of students, I question if the "Bic Syndrome" has not affected our next generation of students. And what of the impact of the Bic Syndrome on relationships? What relationship maintains the same level of passion and intensity through month and years of togetherness that was present when the parties first became involved? How is it possible to avoid differences of opinion or the problems related to blending two independent personalities into the intimacy of a maturing relationship?
There is something to be said for the old "straight edge and razor strop" approach to maintaining the edge on one’s personal relationships. Richard Bach perhaps said it best in his book, Illusions, “There is no such thing as a problem without its gift inside. The reason we have problems is because we need their gifts.” To discover that my Bic razor no longer has an edge and I risk cutting myself if I shave with it may justify discarding the blade and replacing with a new one. But if I discover that my relationship with my kids or spouse or lover is strained or dull or requires maintenance, I think I will consider the lesson of the straight-edge and barber’s strop.
What do you think?
There is a phenomenon in contemporary American culture that appears to be at least 20 years old. As a counselor who both teaches and practices the art of counseling, I have observed this phenomenon in both my students and the individuals with whom I do counseling throughout this period. I refer to this “quirk” in contemporary human behavior as the "Bic Syndrome."
While I must admit that I most frequently observe this phenomenon in clients who seek counseling to address a personal problem or students in the classroom who are more interested in a degree than the knowledge afforded by education, I have also noted the Bic Syndrome in part time employees in entry level positions, couples in relationships where the initial passion of the pursuit gives way to the challenges of learning to live together, and even those who believe that life’s offerings by a particular birthday are not fulfilling, boring, or just plain dull. The "Bic Syndrome" takes its name from the popular disposable razor so successfully marketed for the past 15 to 20 years.
The beauty of the disposable razor is that its relative economy allows one to simply discard the razor when it is perceived to be dull and replace it with another "new" and sharper one. There's no muss, no fuss, and no one thinks twice about the practice. Now with razors--and cigarette lighters for that matter--this may be convenient and economical. It would seem, however, that we have become something of a "disposable" society. It often seems easier and more convenient to discard an item that becomes “dull” or is “old” when compared to the latest model. Sometimes it even seems that we would rather discard and replace an item than invest the effort or time necessary to properly maintain or fix it. If this is true on any level, does it suggest that we have become a pleasure-seeking culture that believes it is somehow our right to expect immediate gratification and not have to tolerate things “inconvenient, dull or tedious”? To discard razors and lighters may be a relatively harmless practice in the grand scheme of things, but what happens if this “consumer’s view” of convenience affects our commitment to jobs, friends, or relationships, especially at those times that will always surface when they become dull or tedious or are in need of maintenance?
To a large extent, we humans know what we have learned and learn what we have been taught. Now, this does not mean that one cannot predetermine her/his own course in life and pursue the learning that permits the pursuit of a dream, but if one is overly involved in the Bic Syndrome, the desire for the newest, sharpest, brightest reality can undermine one's resolution to work on a problem relationship rather than to simply discard it and move one.
I have often overheared the rumblings of students about "how hard" school is and how "professors should know we have jobs and personal lives" when receiving an assignment that requires significant reading, field work, or unyielding demands for quality in papers or other assignments that require significant investments of time or effort. The expectation is that professors should "lighten-up" and required standards should be driven by the convenience of the student rather than the professor’s expectation of scholarship. While this may be a minority of students, I question if the "Bic Syndrome" has not affected our next generation of students. And what of the impact of the Bic Syndrome on relationships? What relationship maintains the same level of passion and intensity through month and years of togetherness that was present when the parties first became involved? How is it possible to avoid differences of opinion or the problems related to blending two independent personalities into the intimacy of a maturing relationship?
There is something to be said for the old "straight edge and razor strop" approach to maintaining the edge on one’s personal relationships. Richard Bach perhaps said it best in his book, Illusions, “There is no such thing as a problem without its gift inside. The reason we have problems is because we need their gifts.” To discover that my Bic razor no longer has an edge and I risk cutting myself if I shave with it may justify discarding the blade and replacing with a new one. But if I discover that my relationship with my kids or spouse or lover is strained or dull or requires maintenance, I think I will consider the lesson of the straight-edge and barber’s strop.
What do you think?
16 September 2009
Changing collegiate drinking is a lot like ridding a lawn of dandelions: nothing changes until you address the taproot.
There is an interesting piece on collegiate drinking in the latest edition of Hazelden’s Recovery Matters – see http://www.hazelden.org/web/public/prev70430.page It is “sort of” right, in MHO :) To a certain extent, the article proffers what those of us familiar with the field of collegiate drinking might tend to view as “same ole, same ole.” The impetus for changing collegiate drinking is placed on changing the campus culture that supports that drinking. This is, as far as it goes, fine and not something of concern to me...there are things that campuses and communities can and should be doing to address this concern. What is of greater concern to me is the fact that the focus for such interventions and strategies to affect change is placed on external factors controlled by the administrators and other “adults,” that is, the “dominant culture” on campus, e.g., environmental management, and again this is good. But to solve the collegiate drinking problem is for “us” (adults) to change “them” (students)—and to suggest that all collegiate drinking is a problem necessitating a solution is perhaps misguided and another argument I have outlined in my 3rd monograph on collegiate drinking, “Is Collegiate Drinking the Problem We Think It Is?” (see http://bit.ly/DeeCg).
Although what is suggested in the Hazelden article is sound and appropriate to pursue, it is not all there is that needs to be pursued regarding high-risk and dangerous collegiate drinking. My argument has been that until and unless we understand: (1) the symbolic meaning that alcohol and drinking hold for contemporary collegians, (2) the process by which that meaning is ascribed by students...and more to the point, re-ascribed, and (3) how to employ that information to hasten the process by which students pass through the period of high-risk and dangerous drinking, “the problem” is not going to change. Because students essentially disagree with us that “any” drinking is a problem they will resist efforts by schools and their administrators to change their involvement in this behavior. And because what administrators are trying to change and what students perceived administrators trying to change are two different things, there will be continued resistance.
We need individual-based, campus-based, and community-based intervention as suggested in the article, but until and unless we acknowledge that what students perceive alcohol and drinking to be as icons of collegiate life and recognize the different from what administrators and parents and law enforcement professionals perceive them to be, we will continue to generate more heat than light when attempting to change the campus culture.
It is hubris on the part of administrators to think that they can ever end the use of all alcohol by college students--change how and when and where it is used, yes, but end it, not likely. And it is naïve to state that students do not arrive on campus already prepped if not preordained to engage in the type of drinking that has come to be described as “binge drinking.” The irony is that the very factor that fans the flames of collegiate drinking goes unnoticed if not ignored as an important determinant of this collegiate behavior. It is like the conflict that has existed in PA for sometime regarding efforts to regulate gun sales in Philadelphia.
For 20-years, the City of Philadelphia has tried to regulate the sale of guns. Each time this happens, Philly is told by Harrisburg that such regulation is not within the City’s purview. When the issue is then introduced in Harrisburg by Philly legislators, such efforts are soundly defeated. It would seem that “Philly” hates guns and “Harrisburg” loves them, but that is a biased and overly simplistic assessment of the difference. The issue is that Philly views guns as “weapons,” which it seeks to regulate for purposes of public safety, and Harrisburg views them as “recreational equipment” that are a right for residents to possess, use, and enjoy.
The language used by the legislators in Philly and in Harrisburg is the same, but the perception of these legislators as regards the symbolic meaning of the term being debated is different. A “gun” in Philly is used to break the law and reek havoc on the public whereas in most of the rest of PA, a gun is a sporting person's recreational device used in licensed hunting and recreational target shooting. In short, a gun is what the person referring to it says it is. This understanding will, in turn, affect how that person uses the gun and also how that individual responds to the efforts of another to “change the culture” surrounding the gun and its users. It is no different when we look at alcohol, drinking, and collegiate life.
It would seem logical that we can operationally define “alcohol” and “consumption/drinking,” but we would be wrong. Ask students, as I have for the past 20-years, what alcohol is and what drinking is and what these icons of collegiate life are and how they affect one’s collegiate experience and you will discover a different perspective than if asking student affairs professionals, law enforcement professionals, parents, and residents whose properties are contiguous to campus or student-occupied housing.
To end as I began, I do not take exception with most of what is suggested in the Hazelden article. What I suggest is that it does not look at the root of the issue. Like trying to clear your lawn of dandelions by just picking the blossoms, the next day the lawn is again full of dandelions. Until and unless the taproot is addressed, nothing changes...and the number of dandelions may actually expand. The “taproot” in collegiate drinking is the meaning students give to alcohol and drinking and therefore, the way to change the campus drinking culture is to change this meaning. Study what these icons of collegiate life mean, understand the dynamic that generates that meaning so we can better affect it and you will see a change in student behavior and many such individual changes equals a change in the campus culture. The irony is, this happens naturally in the maturing out phenomenon—I write about this in the 2nd of the 3 monographs I have written on collegiate drinking (see http://bit.ly/qrpJA). The problem is that this maturing out takes 2 to 3 years and a lot of the untoward consequences of collegiate drinking that are showcased on the NIAAA web page cited in the Hazelden article can happen during that time. If we can hasten this process we will not only reduce the untoward consequences, but change the campus culture. As experienced students change their behavior sooner they will influence less experienced students and instead of the negative peer pressure mentioned in the article, positive peer pressure can increase the likelihood of moderating behavior, a.k.a., change the campus drinking culture.
There is an interesting piece on collegiate drinking in the latest edition of Hazelden’s Recovery Matters – see http://www.hazelden.org/web/public/prev70430.page It is “sort of” right, in MHO :) To a certain extent, the article proffers what those of us familiar with the field of collegiate drinking might tend to view as “same ole, same ole.” The impetus for changing collegiate drinking is placed on changing the campus culture that supports that drinking. This is, as far as it goes, fine and not something of concern to me...there are things that campuses and communities can and should be doing to address this concern. What is of greater concern to me is the fact that the focus for such interventions and strategies to affect change is placed on external factors controlled by the administrators and other “adults,” that is, the “dominant culture” on campus, e.g., environmental management, and again this is good. But to solve the collegiate drinking problem is for “us” (adults) to change “them” (students)—and to suggest that all collegiate drinking is a problem necessitating a solution is perhaps misguided and another argument I have outlined in my 3rd monograph on collegiate drinking, “Is Collegiate Drinking the Problem We Think It Is?” (see http://bit.ly/DeeCg).
Although what is suggested in the Hazelden article is sound and appropriate to pursue, it is not all there is that needs to be pursued regarding high-risk and dangerous collegiate drinking. My argument has been that until and unless we understand: (1) the symbolic meaning that alcohol and drinking hold for contemporary collegians, (2) the process by which that meaning is ascribed by students...and more to the point, re-ascribed, and (3) how to employ that information to hasten the process by which students pass through the period of high-risk and dangerous drinking, “the problem” is not going to change. Because students essentially disagree with us that “any” drinking is a problem they will resist efforts by schools and their administrators to change their involvement in this behavior. And because what administrators are trying to change and what students perceived administrators trying to change are two different things, there will be continued resistance.
We need individual-based, campus-based, and community-based intervention as suggested in the article, but until and unless we acknowledge that what students perceive alcohol and drinking to be as icons of collegiate life and recognize the different from what administrators and parents and law enforcement professionals perceive them to be, we will continue to generate more heat than light when attempting to change the campus culture.
It is hubris on the part of administrators to think that they can ever end the use of all alcohol by college students--change how and when and where it is used, yes, but end it, not likely. And it is naïve to state that students do not arrive on campus already prepped if not preordained to engage in the type of drinking that has come to be described as “binge drinking.” The irony is that the very factor that fans the flames of collegiate drinking goes unnoticed if not ignored as an important determinant of this collegiate behavior. It is like the conflict that has existed in PA for sometime regarding efforts to regulate gun sales in Philadelphia.
For 20-years, the City of Philadelphia has tried to regulate the sale of guns. Each time this happens, Philly is told by Harrisburg that such regulation is not within the City’s purview. When the issue is then introduced in Harrisburg by Philly legislators, such efforts are soundly defeated. It would seem that “Philly” hates guns and “Harrisburg” loves them, but that is a biased and overly simplistic assessment of the difference. The issue is that Philly views guns as “weapons,” which it seeks to regulate for purposes of public safety, and Harrisburg views them as “recreational equipment” that are a right for residents to possess, use, and enjoy.
The language used by the legislators in Philly and in Harrisburg is the same, but the perception of these legislators as regards the symbolic meaning of the term being debated is different. A “gun” in Philly is used to break the law and reek havoc on the public whereas in most of the rest of PA, a gun is a sporting person's recreational device used in licensed hunting and recreational target shooting. In short, a gun is what the person referring to it says it is. This understanding will, in turn, affect how that person uses the gun and also how that individual responds to the efforts of another to “change the culture” surrounding the gun and its users. It is no different when we look at alcohol, drinking, and collegiate life.
It would seem logical that we can operationally define “alcohol” and “consumption/drinking,” but we would be wrong. Ask students, as I have for the past 20-years, what alcohol is and what drinking is and what these icons of collegiate life are and how they affect one’s collegiate experience and you will discover a different perspective than if asking student affairs professionals, law enforcement professionals, parents, and residents whose properties are contiguous to campus or student-occupied housing.
To end as I began, I do not take exception with most of what is suggested in the Hazelden article. What I suggest is that it does not look at the root of the issue. Like trying to clear your lawn of dandelions by just picking the blossoms, the next day the lawn is again full of dandelions. Until and unless the taproot is addressed, nothing changes...and the number of dandelions may actually expand. The “taproot” in collegiate drinking is the meaning students give to alcohol and drinking and therefore, the way to change the campus drinking culture is to change this meaning. Study what these icons of collegiate life mean, understand the dynamic that generates that meaning so we can better affect it and you will see a change in student behavior and many such individual changes equals a change in the campus culture. The irony is, this happens naturally in the maturing out phenomenon—I write about this in the 2nd of the 3 monographs I have written on collegiate drinking (see http://bit.ly/qrpJA). The problem is that this maturing out takes 2 to 3 years and a lot of the untoward consequences of collegiate drinking that are showcased on the NIAAA web page cited in the Hazelden article can happen during that time. If we can hasten this process we will not only reduce the untoward consequences, but change the campus culture. As experienced students change their behavior sooner they will influence less experienced students and instead of the negative peer pressure mentioned in the article, positive peer pressure can increase the likelihood of moderating behavior, a.k.a., change the campus drinking culture.
08 September 2009
Conducting Assessments of Drinking/Substance Use
A reader contacted me asking my thoughts on conducting assessment and which instruments I might recommend...good topic and question, although I may not have “the” answer...I do have an opinion and a couple thoughts...
I find the BASICS (Brief Alcohol Screening and Intervention with College Students) approach to provide the best “assessment.” Although it does not yield a “likelihood” of a particular pathology or individual scales that can be indicative of co-occurring issues like the SASSI (Substance Abuse Subtle Screening Inventory), its opportunity to provide genuine feedback in a “what do you think” manner open more conversations and ultimate referrals than other “instruments.” That said, I do like the ASI (Addiction Severity Index) as it is relatively non-invasive when administered by a trained practitioner and its results tie in nicely with the development of a formal treatment plan, although it is something of a bear to administer and can take time. It is also not likely that a pre-contemplative or even a contemplative (early stage of readiness to change) client will be very helpful/compliant in completing the ASI.
I have found that the old standards work quite well too – MAST, CAGE, etc. — but I have modified their use. Instead of ask the questions associated with these screening tools, I answer them for the client after having invited the client to share his/her story. This “narrative” approach accomplished 2 things: (1) it recognizes that clients are “more willing to share their stories” with someone willing to listen than to “tell an ‘interrogator’ their business” and, (2) I can always answer questions like the closed-ended MAST or CAGE based on a history in which the client has addressed these “areas” in response to individual open-ended questions intended to facilitate conversation. Coincidentally, by the time I have listened to a client’s story, perhaps through 2 sessions, I have often earned my “street creds” that enable me to provide the feedback, including an interpretation of the MAST and CAGE without having the client, “up and run.”
Almost as an aside, how one looks at assessments is as important a determinant affecting outcome as is what is done during the assessment. For example, if I am interested in uncovering pathology and categorizing problems, I will approach the individual with whom I am working in a different manner than if I am interested in encouraging that individual to look at the “facts” in his or her life from a different perspective in order to better answer the basic question, “Is what I am getting worth what I have to pay to get it.” The “old objective” suggests that it is “me,” the practitioner, who needs to know what is really going on with a client so that I can then “fix the problem.” This works well when the ‘patient’ has shoulder problems and a diagnosis of a torn rotator cuff is made and a surgical intervention is planned to fix the problem. Such an approach, I believe, is not quite so well suited to interacting with a substance using individual in order to “address the drug problem.”
We know from the literature and research done on Motivational Interviewing that the old “you have a problem and I know this because of these diagnostic symptoms and this is how you can fix it” approach does not work well...as a matter of fact this results in counseling being more about “wrestling” with clients than “dancing” with them to borrow from Wm. Miller’s metaphor. If I approach assessment as not so much the pursuit of what “I need” to “fix your problem,” but rather a process by which I invite the individual to consider the facts related to personal use in such as to more accurately answer the question, “is what you get worth what it costs you to get it,” then the outcome can be much different. It is something akin to the City Slicker’s experience in this old “Pa and Pa Kettle” movie clip from the 40s – see http://www.youtube.com/watch?v=yG7vq0EMvgE In the clip Ma & Pa argue their position much like individuals with no intention of changing behavior argue theirs, in other words, like many collegians when approached about their drinking...I do not need to change because you are wrong in your assertion that a problem exists. If the goal of counseling is to show the client the errors of his or her way, then this is a contest where someone can only win by someone else losing. Traditional assessment tools often facilitate this “battle of the wills” approach to addressing questions related to drinking “problems.”
To summarize, we professional counselors have to assess client needs before attempting to treat them. But the onus is on us to determine why we are doing this. If it is so I know if John or Mary has problem “X” or not, that may yield an entirely different result—mind you, not necessarily “wrong,” just different—than if my quest is to invite John and Mary to looks at the facts in their lives from a different perspective. Remember Sandra Anise Barnes’ quote, “It’s so hard when I have to, and so easy when I want to.” It is like someone living in Boston considering how to get to Philadelphia...is I-95 always (ever?) the best way? The answer is, “it depends.” If the assessment process helps us better articulate the variables that affect the admonition, “it depends,” I submit that the assessment process will be beneficial. If, however, the assessment is to stockpile facts and evidence to prove why the client is wrong or quantify “the problem,” I am not so sure the result is the same.
What do you think?
A reader contacted me asking my thoughts on conducting assessment and which instruments I might recommend...good topic and question, although I may not have “the” answer...I do have an opinion and a couple thoughts...
I find the BASICS (Brief Alcohol Screening and Intervention with College Students) approach to provide the best “assessment.” Although it does not yield a “likelihood” of a particular pathology or individual scales that can be indicative of co-occurring issues like the SASSI (Substance Abuse Subtle Screening Inventory), its opportunity to provide genuine feedback in a “what do you think” manner open more conversations and ultimate referrals than other “instruments.” That said, I do like the ASI (Addiction Severity Index) as it is relatively non-invasive when administered by a trained practitioner and its results tie in nicely with the development of a formal treatment plan, although it is something of a bear to administer and can take time. It is also not likely that a pre-contemplative or even a contemplative (early stage of readiness to change) client will be very helpful/compliant in completing the ASI.
I have found that the old standards work quite well too – MAST, CAGE, etc. — but I have modified their use. Instead of ask the questions associated with these screening tools, I answer them for the client after having invited the client to share his/her story. This “narrative” approach accomplished 2 things: (1) it recognizes that clients are “more willing to share their stories” with someone willing to listen than to “tell an ‘interrogator’ their business” and, (2) I can always answer questions like the closed-ended MAST or CAGE based on a history in which the client has addressed these “areas” in response to individual open-ended questions intended to facilitate conversation. Coincidentally, by the time I have listened to a client’s story, perhaps through 2 sessions, I have often earned my “street creds” that enable me to provide the feedback, including an interpretation of the MAST and CAGE without having the client, “up and run.”
Almost as an aside, how one looks at assessments is as important a determinant affecting outcome as is what is done during the assessment. For example, if I am interested in uncovering pathology and categorizing problems, I will approach the individual with whom I am working in a different manner than if I am interested in encouraging that individual to look at the “facts” in his or her life from a different perspective in order to better answer the basic question, “Is what I am getting worth what I have to pay to get it.” The “old objective” suggests that it is “me,” the practitioner, who needs to know what is really going on with a client so that I can then “fix the problem.” This works well when the ‘patient’ has shoulder problems and a diagnosis of a torn rotator cuff is made and a surgical intervention is planned to fix the problem. Such an approach, I believe, is not quite so well suited to interacting with a substance using individual in order to “address the drug problem.”
We know from the literature and research done on Motivational Interviewing that the old “you have a problem and I know this because of these diagnostic symptoms and this is how you can fix it” approach does not work well...as a matter of fact this results in counseling being more about “wrestling” with clients than “dancing” with them to borrow from Wm. Miller’s metaphor. If I approach assessment as not so much the pursuit of what “I need” to “fix your problem,” but rather a process by which I invite the individual to consider the facts related to personal use in such as to more accurately answer the question, “is what you get worth what it costs you to get it,” then the outcome can be much different. It is something akin to the City Slicker’s experience in this old “Pa and Pa Kettle” movie clip from the 40s – see http://www.youtube.com/watch?v=yG7vq0EMvgE In the clip Ma & Pa argue their position much like individuals with no intention of changing behavior argue theirs, in other words, like many collegians when approached about their drinking...I do not need to change because you are wrong in your assertion that a problem exists. If the goal of counseling is to show the client the errors of his or her way, then this is a contest where someone can only win by someone else losing. Traditional assessment tools often facilitate this “battle of the wills” approach to addressing questions related to drinking “problems.”
To summarize, we professional counselors have to assess client needs before attempting to treat them. But the onus is on us to determine why we are doing this. If it is so I know if John or Mary has problem “X” or not, that may yield an entirely different result—mind you, not necessarily “wrong,” just different—than if my quest is to invite John and Mary to looks at the facts in their lives from a different perspective. Remember Sandra Anise Barnes’ quote, “It’s so hard when I have to, and so easy when I want to.” It is like someone living in Boston considering how to get to Philadelphia...is I-95 always (ever?) the best way? The answer is, “it depends.” If the assessment process helps us better articulate the variables that affect the admonition, “it depends,” I submit that the assessment process will be beneficial. If, however, the assessment is to stockpile facts and evidence to prove why the client is wrong or quantify “the problem,” I am not so sure the result is the same.
What do you think?
30 August 2009
IN-Patient Treatment for Internet Addiction?
Last week, Mashable.com reported, "First U. S. Rehab Center for Internet Addiction Opens Its Doors." In the story, the case of a 19-year-old male who "could not remove himself from World of Warcraft," a popular online multi-player war game, was used to segue to an essay on inpatient treatment for Internet addiction. This prompted a rather provocative question from a reader: "I'm not sure I buy it. I spent two years in grad school reading books 16 hours a day and not going out in the 'real world.' Should I have ponied up $15k for some 'education' rehab?"
The “treatment” provided the 19-year-old is treatment for what is referred to as a “process addiction,” something akin to gambling or sex “addiction.” As with any addiction, a diagnosis can only be made when several diagnostic criteria have been met…and as the article reports, these have yet to be quantified in the Diagnostic and Statistical Manual of Mental Diseases for Internet addiction. Generally, the “non-scientific” diagnostic criteria for addiction include: (1) compulsive behavior that is (2) chronic and (3) continues in spite of known associated negative consequences, and (4) attempts at changing the behavior result in relapse (meaning a return to the compulsive behavior). With gambling and sexual addictions, which not only meet these criteria, but result in demonstrable chemical changes in the brain, a key element in discerning why process addictions are considered by many to be true “addictions" even though the individual does not consume a psychoactive substance (see "Gamblers's Brains") is met.
Clearly the jury is still out on this with many behaviorally oriented practitioners seeing process addiction as being more the result of “cognition and/or learned behavior” than “organic and/or physical processes." That said, there are demonstrable chemical changes (able to be documented with PET scans) that occur when addicted individuals are presented non-substance related stimuli. This means that the reward pathway in the brain is activated by behavior in a similar fashion to when psychoactive substances--or anticipation of their use--are administered (see Drugs Alter the Brain's Reward Pathway). In the case of the experienced user, it is the anticipation of the chemical that results in these chemical changes in the brain; in the gambler—and perhaps the video gamer cited in the article—it is the behavior that results in the stimulation of the chemical rewards that translate into “addiction,” i.e., “compulsion,” “chronicity,” and “relapse.”
Although one may have spent 16-hours a day reading and studying when in grad schools, the reasons for doing so were different than those of the 19-year old “addicted” to War Craft. In addition, once an individual completed his or her degree—the reason those hours were spent studying—the “studying behavior" changed without negative consequences, i.e., “withdrawal.” True, the student may have learned to enjoy this studying behavior/pattern and may continue that behavior to this day, but likely in a significantly different way, not to mention that the change was not marked by repeated failures to realize the change. In short there is a difference between engaging in a behavior because you “cannot not” stop and continuing a behavior because it is a means to a desired end. Eating is a good example of this.
Compulsive eaters, a.k.a., "food addicts," cannot not eat—or cannot not binge and purge, etc. Their treatment does not have the same goal, however, as treatment for a cocaine or alcohol dependency—abstinence, although some still argue that abstinence is not necessary as a condition of change when treating substance use disorders, but this is a topic for another discussion. The objective of treatment for this individual is to establish a new and different “relationship with food,” a constructive rather than destructive relationship. Whereas one can live without alcohol or heroin, one cannot live without food, hence, the objective of treatment for the two similar disorders is different. What is not clear in the cited Mashable article is if the objective of the treatment is abstinence from the Internet or learning to use it constructively; I suspect that the objective is similar to that in treating gambling…abstinence.
In short, I am not sure, yet, where I stand on the need for in-patient treatment or 12-step groups for Internet Addicted individuals. I do embrace the argument that “treatment” in the form of counseling and behaviorally oriented skills training can be useful, but then I believe that most people can benefit from “counseling’ where the focus is either overcoming obstacles that preclude success in a particular area of one’s life and/or learning new skills that allow one to move towards realizing a stated goal.
I suspect that as we learn more about dependence (a.k.a. addiction) we will learn that there are behavioral stimuli that initiate the same physiological and neurological responses seen in individuals addicted to psychoactive substances. I have watched the addictions field progress far in the last 35 years and it is likely that we have but "merely opened the book" on what there is to be known. There is compelling information to argue that "Internet addiction" is a real disorder, but documenting that--and more importantly--identifying the best course of treatment remains to be seen.
What do you think? Leave a comment.
Last week, Mashable.com reported, "First U. S. Rehab Center for Internet Addiction Opens Its Doors." In the story, the case of a 19-year-old male who "could not remove himself from World of Warcraft," a popular online multi-player war game, was used to segue to an essay on inpatient treatment for Internet addiction. This prompted a rather provocative question from a reader: "I'm not sure I buy it. I spent two years in grad school reading books 16 hours a day and not going out in the 'real world.' Should I have ponied up $15k for some 'education' rehab?"
The “treatment” provided the 19-year-old is treatment for what is referred to as a “process addiction,” something akin to gambling or sex “addiction.” As with any addiction, a diagnosis can only be made when several diagnostic criteria have been met…and as the article reports, these have yet to be quantified in the Diagnostic and Statistical Manual of Mental Diseases for Internet addiction. Generally, the “non-scientific” diagnostic criteria for addiction include: (1) compulsive behavior that is (2) chronic and (3) continues in spite of known associated negative consequences, and (4) attempts at changing the behavior result in relapse (meaning a return to the compulsive behavior). With gambling and sexual addictions, which not only meet these criteria, but result in demonstrable chemical changes in the brain, a key element in discerning why process addictions are considered by many to be true “addictions" even though the individual does not consume a psychoactive substance (see "Gamblers's Brains") is met.
Clearly the jury is still out on this with many behaviorally oriented practitioners seeing process addiction as being more the result of “cognition and/or learned behavior” than “organic and/or physical processes." That said, there are demonstrable chemical changes (able to be documented with PET scans) that occur when addicted individuals are presented non-substance related stimuli. This means that the reward pathway in the brain is activated by behavior in a similar fashion to when psychoactive substances--or anticipation of their use--are administered (see Drugs Alter the Brain's Reward Pathway). In the case of the experienced user, it is the anticipation of the chemical that results in these chemical changes in the brain; in the gambler—and perhaps the video gamer cited in the article—it is the behavior that results in the stimulation of the chemical rewards that translate into “addiction,” i.e., “compulsion,” “chronicity,” and “relapse.”
Although one may have spent 16-hours a day reading and studying when in grad schools, the reasons for doing so were different than those of the 19-year old “addicted” to War Craft. In addition, once an individual completed his or her degree—the reason those hours were spent studying—the “studying behavior" changed without negative consequences, i.e., “withdrawal.” True, the student may have learned to enjoy this studying behavior/pattern and may continue that behavior to this day, but likely in a significantly different way, not to mention that the change was not marked by repeated failures to realize the change. In short there is a difference between engaging in a behavior because you “cannot not” stop and continuing a behavior because it is a means to a desired end. Eating is a good example of this.
Compulsive eaters, a.k.a., "food addicts," cannot not eat—or cannot not binge and purge, etc. Their treatment does not have the same goal, however, as treatment for a cocaine or alcohol dependency—abstinence, although some still argue that abstinence is not necessary as a condition of change when treating substance use disorders, but this is a topic for another discussion. The objective of treatment for this individual is to establish a new and different “relationship with food,” a constructive rather than destructive relationship. Whereas one can live without alcohol or heroin, one cannot live without food, hence, the objective of treatment for the two similar disorders is different. What is not clear in the cited Mashable article is if the objective of the treatment is abstinence from the Internet or learning to use it constructively; I suspect that the objective is similar to that in treating gambling…abstinence.
In short, I am not sure, yet, where I stand on the need for in-patient treatment or 12-step groups for Internet Addicted individuals. I do embrace the argument that “treatment” in the form of counseling and behaviorally oriented skills training can be useful, but then I believe that most people can benefit from “counseling’ where the focus is either overcoming obstacles that preclude success in a particular area of one’s life and/or learning new skills that allow one to move towards realizing a stated goal.
I suspect that as we learn more about dependence (a.k.a. addiction) we will learn that there are behavioral stimuli that initiate the same physiological and neurological responses seen in individuals addicted to psychoactive substances. I have watched the addictions field progress far in the last 35 years and it is likely that we have but "merely opened the book" on what there is to be known. There is compelling information to argue that "Internet addiction" is a real disorder, but documenting that--and more importantly--identifying the best course of treatment remains to be seen.
What do you think? Leave a comment.
24 August 2009
Keeping Up with The Field
My grandfather used to say, “Wisdom is the gift received when recognizing the limits of one’s knowledge.” The more aware I became of the limits of my knowledge related to addiction and AOD issues in general, the more I sought out direct and indirect sources of that information. When first entering the field of addiction treatment in the early 70s I invested time in several activities that continue to pay dividends to this day. This entry is intended to share a few of this "FYI."
(1)Attend open 12-step meetings. It is at such meetings that one can learn about addiction and recovery (and the “early years,” perhaps before addiction, which can be useful when doing counseling with collegians).
(2)Training opportunities where funding may very well support doing so, but also look into “free” workshops and seminars that were available in the community. In the 21st century, this is somewhat easier in that there are online seminars and discussion groups as well as workshops run by different treatment programs and such. NOTE: Addiction treatment programs or hospitals in your area sponsor free monthly free workshops. NOTE: Not only are such workshops useful for what can be learned, but also (and perhaps more importantly) for who you can meet professionally.
(3) Read as much as you can on the topic(s) of your choice. Although no one can ever read “everything” that is available to be read, here are some tricks you can try to increase the amount of information you can expose yourself to. For example, you can do a key word search for journal articles that have several keywords that related to a topic of interest. For example, you can search “collegiate drinking,” “prevention” and “strategies.” You can do this at http://scholar.google.com (or just plain google.com) or one of the online databases, for example, project CORK at Dartmouth (http://www.projectcork.org/) or NIAAA’s ETOH database (see http://etoh.niaaa.nih.gov/). If you search at a database and get “X” hits, read the abstracts for the more interesting ones or just the first 5 or 10 or however many. These abstracts give you a sense of what is happening as well as what is being published.
For those abstracts you find interesting (or for anything else you may find online that is interesting and in print form) you can download the .doc or .pdf (or “.whatever” text file) and then convert it to a mp3 audio file at http://zamzar.com and then listen to it on you mp3 player when commuting or exercising, etc. NOTE: It takes a few minutes to get used to listening to the computerized “text-to-speech” syntax, but once you catch on, it is an easy way to “read" more stuff related to a topic of interest.
(4) As they say in AA, look around for someone who has what you want and then get to know that person. In AA it is called “getting a sponsor”; in professional development it is called finding a mentor(s). Ask that person if you can meet and chat. Invite the person to coffee. Ask if you can exchange emails. In short, do what you can to learn from that individual(s). You may need to invest some time in traveling to that person’s office or suggested location, but once a month or however often you do this can be a small investment for what you get in return…and you are not restricted to one mentor at a time
(5) Join several listserv discussion groups and/or sign up for daily or weekly email reports on “what’s what” in your chose field. For example, you can get daily news from http://www.JoinTogether.org or “drug and alcohol findings” at http://findings.org.uk/ In short, there are likely “countless” places where you can have folks send you snippets of information on a regular basis and you read what you have time/interest to read. Add to this the countless blogs and pod
casts that are available and you have more than enough to keep you busy with your “knowledge quest” for years to come
If you have additional suggestions,please leave a comment.
Robert
My grandfather used to say, “Wisdom is the gift received when recognizing the limits of one’s knowledge.” The more aware I became of the limits of my knowledge related to addiction and AOD issues in general, the more I sought out direct and indirect sources of that information. When first entering the field of addiction treatment in the early 70s I invested time in several activities that continue to pay dividends to this day. This entry is intended to share a few of this "FYI."
(1)Attend open 12-step meetings. It is at such meetings that one can learn about addiction and recovery (and the “early years,” perhaps before addiction, which can be useful when doing counseling with collegians).
(2)Training opportunities where funding may very well support doing so, but also look into “free” workshops and seminars that were available in the community. In the 21st century, this is somewhat easier in that there are online seminars and discussion groups as well as workshops run by different treatment programs and such. NOTE: Addiction treatment programs or hospitals in your area sponsor free monthly free workshops. NOTE: Not only are such workshops useful for what can be learned, but also (and perhaps more importantly) for who you can meet professionally.
(3) Read as much as you can on the topic(s) of your choice. Although no one can ever read “everything” that is available to be read, here are some tricks you can try to increase the amount of information you can expose yourself to. For example, you can do a key word search for journal articles that have several keywords that related to a topic of interest. For example, you can search “collegiate drinking,” “prevention” and “strategies.” You can do this at http://scholar.google.com (or just plain google.com) or one of the online databases, for example, project CORK at Dartmouth (http://www.projectcork.org/) or NIAAA’s ETOH database (see http://etoh.niaaa.nih.gov/). If you search at a database and get “X” hits, read the abstracts for the more interesting ones or just the first 5 or 10 or however many. These abstracts give you a sense of what is happening as well as what is being published.
For those abstracts you find interesting (or for anything else you may find online that is interesting and in print form) you can download the .doc or .pdf (or “.whatever” text file) and then convert it to a mp3 audio file at http://zamzar.com and then listen to it on you mp3 player when commuting or exercising, etc. NOTE: It takes a few minutes to get used to listening to the computerized “text-to-speech” syntax, but once you catch on, it is an easy way to “read" more stuff related to a topic of interest.
(4) As they say in AA, look around for someone who has what you want and then get to know that person. In AA it is called “getting a sponsor”; in professional development it is called finding a mentor(s). Ask that person if you can meet and chat. Invite the person to coffee. Ask if you can exchange emails. In short, do what you can to learn from that individual(s). You may need to invest some time in traveling to that person’s office or suggested location, but once a month or however often you do this can be a small investment for what you get in return…and you are not restricted to one mentor at a time
(5) Join several listserv discussion groups and/or sign up for daily or weekly email reports on “what’s what” in your chose field. For example, you can get daily news from http://www.JoinTogether.org or “drug and alcohol findings” at http://findings.org.uk/ In short, there are likely “countless” places where you can have folks send you snippets of information on a regular basis and you read what you have time/interest to read. Add to this the countless blogs and pod
casts that are available and you have more than enough to keep you busy with your “knowledge quest” for years to come
If you have additional suggestions,please leave a comment.
Robert
17 August 2009
There is an interesting article in today's Washington Post. The article, entitled, "It's Time to Legalize Drugs," by Peter Moskos and Stanford "Neill" Franklin is representative of a growing public opinion regarding drugs and more particularly, an opinion on our historically moralistic public policy on addressing their use. Although I am an advocate of changes in this policy, I am not sure the views expressed in the Post article are in our best interest as a country in the long run. Allow me to first comment on the positive points the authors make...there are two:
1. If drugs were legal then drugs could be prepared like any other commodity. This would move production out of the back alley and place it under the scrutiny of some regulatory body that could ensure that what is sold in Philly is the same as what is sold in DC as in LA, etc. In short, there is something to be said for regulating production from a harm reduction point of view...less harm to the individual who consumes the drug and less harm (most likely in the form of financial savings) to the public when it does not have to pay for the consequences of consuming “bad” drugs.
2. There is a lot of money to be saved and made by legalizing drugs. Regarding savings, the billions of dollars are no longer spent on interdiction and other law enforcement efforts to stop manufacture and distribution, to prosecute offenders, to incarcerate offenders, etc. Regarding earning, the state and federal taxes to be collected. Ironically, most drugs of abuse could be manufactured inexpensively and then taxed in an outrageous fashion and still be no more expensive to the consumer than they are now.
As attractive as these two “benefits” of legalization may be, they do not, however, off-set the potential consequences. The biggest “drug problems” we have in this country—and likely this is true around the world—is with those drugs that are already legal...alcohol (ethanol) and tobacco (nicotine). These substances are regulated and taxed yet they are together many times more costly to us as a nation than all illicit drug use combined. This is to suggest that making substances “legal” is not to redeem the country or any of its residents from the consequences associated with the use of the now legal drugs. Add to this that some of the more popular illicit drugs of abuse, namely prescription drugs taken without a prescription, are already legal and this just adds to the argument that legalization is not, in and of itself, a solution to "the drug problem."
I liken legalization of drugs as a solution to building more roads to solve the traffic problem. There may be an immediate beneficial result from the effort, but as driving becomes easier, more individuals will choose to drive and this leads to more vehicles on the road, which results eventually in a return of the original traffic problem. Legalization may appear to be a fix, but it would be a band aid on a major, hemorrhaging wound, addiction and other substance use disorders. True, marijuana would probably result in far more people “using” the substance than “abusing,” it, something on a par with alcohol, but consider that 10% of drinkers consume 50% of all alcohol consumed and you can begin to see how even small percentages of “problem users” can result in significant problems for individuals, families, and the society as a whole.
I believe a better solution is something akin to what the Netherlands did 30 years ago and Portugal, Mexico, British Columbia, and other countries are experimenting with today...decriminalization. True, this does not do much to solve the problem of “quality control” problems in the production of drugs—and this is no small problem as regulating production with something like the FDA is probably “the” strongest argument for legalization. What decriminalization does do, however, is it allows us to continue to address substance use as a public health problem where addressing the “agent” (the drugs), “host” (individual who chooses to use the drugs), and “environment” (where the drugs are used, etc.) becomes the focus and prevention of and intervention with use, not interdiction in “the war on drugs,” is the issue of primacy.
When interdiction ceases to be the predominant response to substance use disorders, prevention and treatment can take over that position. When the demand drops then the consequences associated with consumption—especially clandestine and surreptitious consumption—will likely be reduced. Just as we do not prosecute and incarcerate those who consume “trans fats” or “empty calorie” processed foods, neither should we prosecute individuals with substance use disorders.
Drugs, that is, substances with psychoactive properties have been around longer than have we humans who at times seem preoccupied with consuming them. This means that drugs are neither good nor bad, they “just are.” It is the way these drugs are used that determines if they are problematic of not, that is, “a social problem,” and as with all social problems, they are a social construction. This means that a social issue only becomes a problem when a majority of those in power in the society in which the social issue is occurring deem the issue to be problematic. For example, most people do not argue that “child abuse” or “driving while intoxicated” are “social problems.” Interestingly, though, prior to the 1960’s you did not hear about “child abuse” and prior to the 1980 you did not hear much about “drinking and driving.” This does not mean that these issues did not exist, they just were not deemed problematic by the society in which they occurred and were therefore not denoted as “social problems.”
Take “abortion” or “smoking marijuana” on the other hand and there is great debate as to whether or not either or both of these is a “social problem” because there is no consensus on either issue. Consequently, until and unless a majority of individuals in power clearly decide one way or the other, the debate will continue. Probably the clearest example of this is the slow but inexorable growth of the temperance movement in the 19th century into a movement that transformed “drunkenness” from the social problem to “alcohol itself” as the social problem and resulted in the passage of the 18th amendment in 1920. For 13 years, “alcohol” was a social problem...just as “drugs” have been since the Harrison Act was passed in the early part of the 20th century—but even that had an interesting twist in that it was not concern about the use of drugs, but racism that resulted in the passage of early drug laws...certain ethic groups tended to use certain drugs so in an effort to “get rid of the racial problem,” their drugs of choice were made illegal in order to legitimize persecution...but this is another story (see “Hooked: Illegal Drugs and How They Became That Way,” available on Youtube).
In any event, I “hear” the argument of the authors of the Post article and I “feel” their frustration, I just do not “buy” their reasoning for legalizing drugs. One thing is certain, however, and that is the old “war on drugs” approach to dealing with psychoactive substances is going to go the way of the dinosaur...its just a question if that will be with a cataclysmic event that results in mass extinction of something more “evolutionary.”
What do you think?
1. If drugs were legal then drugs could be prepared like any other commodity. This would move production out of the back alley and place it under the scrutiny of some regulatory body that could ensure that what is sold in Philly is the same as what is sold in DC as in LA, etc. In short, there is something to be said for regulating production from a harm reduction point of view...less harm to the individual who consumes the drug and less harm (most likely in the form of financial savings) to the public when it does not have to pay for the consequences of consuming “bad” drugs.
2. There is a lot of money to be saved and made by legalizing drugs. Regarding savings, the billions of dollars are no longer spent on interdiction and other law enforcement efforts to stop manufacture and distribution, to prosecute offenders, to incarcerate offenders, etc. Regarding earning, the state and federal taxes to be collected. Ironically, most drugs of abuse could be manufactured inexpensively and then taxed in an outrageous fashion and still be no more expensive to the consumer than they are now.
As attractive as these two “benefits” of legalization may be, they do not, however, off-set the potential consequences. The biggest “drug problems” we have in this country—and likely this is true around the world—is with those drugs that are already legal...alcohol (ethanol) and tobacco (nicotine). These substances are regulated and taxed yet they are together many times more costly to us as a nation than all illicit drug use combined. This is to suggest that making substances “legal” is not to redeem the country or any of its residents from the consequences associated with the use of the now legal drugs. Add to this that some of the more popular illicit drugs of abuse, namely prescription drugs taken without a prescription, are already legal and this just adds to the argument that legalization is not, in and of itself, a solution to "the drug problem."
I liken legalization of drugs as a solution to building more roads to solve the traffic problem. There may be an immediate beneficial result from the effort, but as driving becomes easier, more individuals will choose to drive and this leads to more vehicles on the road, which results eventually in a return of the original traffic problem. Legalization may appear to be a fix, but it would be a band aid on a major, hemorrhaging wound, addiction and other substance use disorders. True, marijuana would probably result in far more people “using” the substance than “abusing,” it, something on a par with alcohol, but consider that 10% of drinkers consume 50% of all alcohol consumed and you can begin to see how even small percentages of “problem users” can result in significant problems for individuals, families, and the society as a whole.
I believe a better solution is something akin to what the Netherlands did 30 years ago and Portugal, Mexico, British Columbia, and other countries are experimenting with today...decriminalization. True, this does not do much to solve the problem of “quality control” problems in the production of drugs—and this is no small problem as regulating production with something like the FDA is probably “the” strongest argument for legalization. What decriminalization does do, however, is it allows us to continue to address substance use as a public health problem where addressing the “agent” (the drugs), “host” (individual who chooses to use the drugs), and “environment” (where the drugs are used, etc.) becomes the focus and prevention of and intervention with use, not interdiction in “the war on drugs,” is the issue of primacy.
When interdiction ceases to be the predominant response to substance use disorders, prevention and treatment can take over that position. When the demand drops then the consequences associated with consumption—especially clandestine and surreptitious consumption—will likely be reduced. Just as we do not prosecute and incarcerate those who consume “trans fats” or “empty calorie” processed foods, neither should we prosecute individuals with substance use disorders.
Drugs, that is, substances with psychoactive properties have been around longer than have we humans who at times seem preoccupied with consuming them. This means that drugs are neither good nor bad, they “just are.” It is the way these drugs are used that determines if they are problematic of not, that is, “a social problem,” and as with all social problems, they are a social construction. This means that a social issue only becomes a problem when a majority of those in power in the society in which the social issue is occurring deem the issue to be problematic. For example, most people do not argue that “child abuse” or “driving while intoxicated” are “social problems.” Interestingly, though, prior to the 1960’s you did not hear about “child abuse” and prior to the 1980 you did not hear much about “drinking and driving.” This does not mean that these issues did not exist, they just were not deemed problematic by the society in which they occurred and were therefore not denoted as “social problems.”
Take “abortion” or “smoking marijuana” on the other hand and there is great debate as to whether or not either or both of these is a “social problem” because there is no consensus on either issue. Consequently, until and unless a majority of individuals in power clearly decide one way or the other, the debate will continue. Probably the clearest example of this is the slow but inexorable growth of the temperance movement in the 19th century into a movement that transformed “drunkenness” from the social problem to “alcohol itself” as the social problem and resulted in the passage of the 18th amendment in 1920. For 13 years, “alcohol” was a social problem...just as “drugs” have been since the Harrison Act was passed in the early part of the 20th century—but even that had an interesting twist in that it was not concern about the use of drugs, but racism that resulted in the passage of early drug laws...certain ethic groups tended to use certain drugs so in an effort to “get rid of the racial problem,” their drugs of choice were made illegal in order to legitimize persecution...but this is another story (see “Hooked: Illegal Drugs and How They Became That Way,” available on Youtube).
In any event, I “hear” the argument of the authors of the Post article and I “feel” their frustration, I just do not “buy” their reasoning for legalizing drugs. One thing is certain, however, and that is the old “war on drugs” approach to dealing with psychoactive substances is going to go the way of the dinosaur...its just a question if that will be with a cataclysmic event that results in mass extinction of something more “evolutionary.”
What do you think?
13 August 2009
The following is an OP-ED piece a colleague and I have written for a local Philly newspaper...I share it here FYI
Back to the Future: What’s New in Response to College Drinking
By Robert J. Chapman, PhD & Stephen F. Gambescia, PhD
Drexel University—Philadelphia, PA
College of Nursing & Health Professions
With the approach of Labor Day and its symbolic close of summer comes another annual event that hearkens the change of seasons: Back to the classroom. In colleges & universities across the country administrators are acutely aware of the perennial issue of student drinking, given its potentially adverse academic and public health consequences, not to mention being in the midst of our current economic recession, the fiscal impact—retaining students through graduation naturally makes for sound fiscal policy.
Alcohol and collegiate life have been social contemporaries since Thomas Jefferson noticed its affects on good student form at the University of Virginia and butlers distributed wine and beer to students at Yale and Harvard, which were easily dispensed from the “Buttery,” adjacent to the Commons and an integral part of colonial collegiate life. But the convivial drinking of collegians in centuries past has been replaced by the ubiquitous consumption of contemporary students, approximately 25% of which are described as “frequent” (2 or more times in a 2-week period) “binge” drinkers (having 5 or more standard drinks in an outing, 4 or more for women).
So pervasive is collegiate drinking that colleges have attempted to control consumption. One particular approach that has been effective is called, “environmental management.” Included are five strategies:
1. Offer alcohol-free social, extracurricular, and public service options
2. Create a health-promoting normative environment
3. Restrict the marketing and promotion of alcoholic beverages both on and off
campus
4. Limit alcohol availability
5. Increase enforcement of laws and policies
In short, these steps to influence the campus environment have resulted in changes in collegiate drinking; most good, but some give pause for reflection. Although campus drinking has been reduced, “frequent binge drinkers” have tended to move off-campus to avoid increased enforcement of alcohol policies. This shift increases certain other high-risk and dangerous student practices; namely, drinking and driving as well as drinking in unsupervised and clandestine locations where excessive consumption is encouraged and alcohol poisoning is not monitored. Both of these consequences may serve to alienate residents of the community in which such drinking occurs thus straining any historic “town-gown” tensions.
As college personnel have become aware of this shift in student drinking behavior, they have changed their strategies. Most effective in encouraging a proactive response is the use of campus-community coalitions. Such partnerships of administrative and student groups “on-campus” with residents, businesses, law enforcement, and public health groups “off-campus” have resulted in significant change in curbing student off-campus drinking – see http://tinyurl.com/qsdz62.
In addition to such coalitions, campus officials that hold students responsible for their behavior off-campus and subject them to the same consequences as if the drinking was done on-campus often direct these students to participate in brief motivational screening – see http://tinyurl.com/lohw6p. Other strategies are being piloted to address these issues, but like a medication that accomplishes its primary objective but necessitating a second prescription to assuage side effects, environmental management strategies have contributed significantly to affecting collegiate drinking.
With the return of students and the adverse consequences of drinking done by some of their number, new and innovative strategies have been implemented by colleges and universities to act on rather than react to this perennial vestige of collegiate life. Although alcohol and its consumption will remain regular parts of contemporary campus life, these inventive strategies will likely result in changed student behavior.
Back to the Future: What’s New in Response to College Drinking
By Robert J. Chapman, PhD & Stephen F. Gambescia, PhD
Drexel University—Philadelphia, PA
College of Nursing & Health Professions
With the approach of Labor Day and its symbolic close of summer comes another annual event that hearkens the change of seasons: Back to the classroom. In colleges & universities across the country administrators are acutely aware of the perennial issue of student drinking, given its potentially adverse academic and public health consequences, not to mention being in the midst of our current economic recession, the fiscal impact—retaining students through graduation naturally makes for sound fiscal policy.
Alcohol and collegiate life have been social contemporaries since Thomas Jefferson noticed its affects on good student form at the University of Virginia and butlers distributed wine and beer to students at Yale and Harvard, which were easily dispensed from the “Buttery,” adjacent to the Commons and an integral part of colonial collegiate life. But the convivial drinking of collegians in centuries past has been replaced by the ubiquitous consumption of contemporary students, approximately 25% of which are described as “frequent” (2 or more times in a 2-week period) “binge” drinkers (having 5 or more standard drinks in an outing, 4 or more for women).
So pervasive is collegiate drinking that colleges have attempted to control consumption. One particular approach that has been effective is called, “environmental management.” Included are five strategies:
1. Offer alcohol-free social, extracurricular, and public service options
2. Create a health-promoting normative environment
3. Restrict the marketing and promotion of alcoholic beverages both on and off
campus
4. Limit alcohol availability
5. Increase enforcement of laws and policies
In short, these steps to influence the campus environment have resulted in changes in collegiate drinking; most good, but some give pause for reflection. Although campus drinking has been reduced, “frequent binge drinkers” have tended to move off-campus to avoid increased enforcement of alcohol policies. This shift increases certain other high-risk and dangerous student practices; namely, drinking and driving as well as drinking in unsupervised and clandestine locations where excessive consumption is encouraged and alcohol poisoning is not monitored. Both of these consequences may serve to alienate residents of the community in which such drinking occurs thus straining any historic “town-gown” tensions.
As college personnel have become aware of this shift in student drinking behavior, they have changed their strategies. Most effective in encouraging a proactive response is the use of campus-community coalitions. Such partnerships of administrative and student groups “on-campus” with residents, businesses, law enforcement, and public health groups “off-campus” have resulted in significant change in curbing student off-campus drinking – see http://tinyurl.com/qsdz62.
In addition to such coalitions, campus officials that hold students responsible for their behavior off-campus and subject them to the same consequences as if the drinking was done on-campus often direct these students to participate in brief motivational screening – see http://tinyurl.com/lohw6p. Other strategies are being piloted to address these issues, but like a medication that accomplishes its primary objective but necessitating a second prescription to assuage side effects, environmental management strategies have contributed significantly to affecting collegiate drinking.
With the return of students and the adverse consequences of drinking done by some of their number, new and innovative strategies have been implemented by colleges and universities to act on rather than react to this perennial vestige of collegiate life. Although alcohol and its consumption will remain regular parts of contemporary campus life, these inventive strategies will likely result in changed student behavior.
02 August 2009
Looking at Collegiate Drinking: Part II
Deconstructing Collegiate Drinking
If what alcohol and drinking mean as icons of contemporary collegiate life are important, then such meanings likely impact the choices students make regarding drinking. And if we can understand the process by which these meanings are ascribed, then we will likely be able to move one step closer to impacting collegiate drinking.
I suspect that the importance of alcohol in collegiate life is such that it will never cease or be controlled to the extent that only those of legal age will consume and then only in accordance with medical guidelines recommended by experts—no more than 2 standard drinks per day for males, 1 for females. That said, I do believe that collegiate drinking can be influenced and in a way that sees the percentage of students that choose to drink reduced and the frequency and quantity of those who do imbibe reduced as well.
There will always be those who experience a problem with alcohol and find themselves drinking because they “cannot not drink,” a.k.a. alcohol dependence, but such drinking by college students is limited—although some (many?) may progress to “alcoholism” propelled by their collegiate experience. The number of problems, however, associated with collegiate drinking—what I call, “untoward consequences"—can be reduced below the apparently intractable numbers that have been reported consistently for years. Ironically, this will not be because of more clever policies regarding alcohol. Likewise, changes will not result from innovative programs alone or smart and witty publicity campaigns. Rather, change will come as students move through the process by which they re-ascribe meaning to alcohol and drinking that affects the choices they make regarding the use of the drug and the circumstances that warrant that use.
There is the old adage we are so familiar with as to have made it a trite cliché—“You can lead a horse to water, but you cannot make it drink.” Although this may be true, you can salt the oats. If I shift my focus from trying to “make students” do the right thing and, instead, shift that focus to affecting the reasoning they employ that results in choices to “do the wrong thing,” students may well move in the direction of change of their own volition. We know this will happen because it already has been documented in the “maturing out” process. And whether this process is learning the “cause and effect” relationship between high-risk behavior and untoward consequences or simply the result of the natural developmental as students age from late adolescence to early adulthood during the span of a traditional collegiate career is all but irrelevant. What is pertinent is that students change and they do so of their own volition. As Sandra Anise Barnes, the poet, wrote, “It is so hard when I have to, and easy when I want to.”
The challenge for those concerned about collegiate drinking is not to “reinvent the wheel” but to keep from reinventing the flat tire. We may already have the answer to reducing the unacceptable number of untoward consequences associated with drinking…we see this as students progress through the aging-out process. The challenge is to hasten this process so as to close the window of opportunity for those untoward consequences to occur.
If we study the process by which students change the meaning they ascribe to alcohol and drinking we can artificially hasten this process, and in so doing, reduce the untoward consequences. This will not necessarily reduce the number of students who choose to drink, but it is likely to affect the number who choose to drink on a given occasion and, more importantly, the way they drink.
If we can resist the temptation to use public policy exclusively as the means by which we “solve the collegiate drinking problem” and instead focus on altering the meaning students place on the drug and its consumption, it is entirely likely that students will fix “the problem” themselves.
In conclusion, we have come a long way. Environmental management strategies and programs like social norms marketing, Brief Alcohol Screening and Intervention for College Students (BASICS), Screening/Brief Intervention/Referral to Treatment (SBIRT), have done much to address high-risk and dangerous collegiate drinking. But such external programs and approaches that serve to “do something to” students are not enough to change a culture. For the culture of campus drinking to change, students must come to a point where the meaning they ascribe to alcohol and drinking change. Then and only then will the culture on American college campuses change. As in psychotherapy, effective therapists know that individual change is an “inside job.”
To read more on this topic in some detail look at When They Drink: Deconstructing Collegiate Drinking (http://www.community.rowancas.org/node/21) and When They Drink: Is Collegiate Drinking the Problem We Think It Is? (http://www.rowan.edu/cas/resources/documents/CollegiateDrinking.doc.doc)
Comments welcome at chapman.phd@gmail.com
Deconstructing Collegiate Drinking
If what alcohol and drinking mean as icons of contemporary collegiate life are important, then such meanings likely impact the choices students make regarding drinking. And if we can understand the process by which these meanings are ascribed, then we will likely be able to move one step closer to impacting collegiate drinking.
I suspect that the importance of alcohol in collegiate life is such that it will never cease or be controlled to the extent that only those of legal age will consume and then only in accordance with medical guidelines recommended by experts—no more than 2 standard drinks per day for males, 1 for females. That said, I do believe that collegiate drinking can be influenced and in a way that sees the percentage of students that choose to drink reduced and the frequency and quantity of those who do imbibe reduced as well.
There will always be those who experience a problem with alcohol and find themselves drinking because they “cannot not drink,” a.k.a. alcohol dependence, but such drinking by college students is limited—although some (many?) may progress to “alcoholism” propelled by their collegiate experience. The number of problems, however, associated with collegiate drinking—what I call, “untoward consequences"—can be reduced below the apparently intractable numbers that have been reported consistently for years. Ironically, this will not be because of more clever policies regarding alcohol. Likewise, changes will not result from innovative programs alone or smart and witty publicity campaigns. Rather, change will come as students move through the process by which they re-ascribe meaning to alcohol and drinking that affects the choices they make regarding the use of the drug and the circumstances that warrant that use.
There is the old adage we are so familiar with as to have made it a trite cliché—“You can lead a horse to water, but you cannot make it drink.” Although this may be true, you can salt the oats. If I shift my focus from trying to “make students” do the right thing and, instead, shift that focus to affecting the reasoning they employ that results in choices to “do the wrong thing,” students may well move in the direction of change of their own volition. We know this will happen because it already has been documented in the “maturing out” process. And whether this process is learning the “cause and effect” relationship between high-risk behavior and untoward consequences or simply the result of the natural developmental as students age from late adolescence to early adulthood during the span of a traditional collegiate career is all but irrelevant. What is pertinent is that students change and they do so of their own volition. As Sandra Anise Barnes, the poet, wrote, “It is so hard when I have to, and easy when I want to.”
The challenge for those concerned about collegiate drinking is not to “reinvent the wheel” but to keep from reinventing the flat tire. We may already have the answer to reducing the unacceptable number of untoward consequences associated with drinking…we see this as students progress through the aging-out process. The challenge is to hasten this process so as to close the window of opportunity for those untoward consequences to occur.
If we study the process by which students change the meaning they ascribe to alcohol and drinking we can artificially hasten this process, and in so doing, reduce the untoward consequences. This will not necessarily reduce the number of students who choose to drink, but it is likely to affect the number who choose to drink on a given occasion and, more importantly, the way they drink.
If we can resist the temptation to use public policy exclusively as the means by which we “solve the collegiate drinking problem” and instead focus on altering the meaning students place on the drug and its consumption, it is entirely likely that students will fix “the problem” themselves.
In conclusion, we have come a long way. Environmental management strategies and programs like social norms marketing, Brief Alcohol Screening and Intervention for College Students (BASICS), Screening/Brief Intervention/Referral to Treatment (SBIRT), have done much to address high-risk and dangerous collegiate drinking. But such external programs and approaches that serve to “do something to” students are not enough to change a culture. For the culture of campus drinking to change, students must come to a point where the meaning they ascribe to alcohol and drinking change. Then and only then will the culture on American college campuses change. As in psychotherapy, effective therapists know that individual change is an “inside job.”
To read more on this topic in some detail look at When They Drink: Deconstructing Collegiate Drinking (http://www.community.rowancas.org/node/21) and When They Drink: Is Collegiate Drinking the Problem We Think It Is? (http://www.rowan.edu/cas/resources/documents/CollegiateDrinking.doc.doc)
Comments welcome at chapman.phd@gmail.com
19 July 2009
Looking at Collegiate Drinking: Part I
That some college and university students choose to drink is not news. That some of these drinkers actually choose to, or unintentionally, become intoxicated when drinking alcohol and experience an array of possible untoward consequences is likewise no secret. What may be a revelation for some is learning that most publications regarding collegiate drinking focus exclusively on these untoward consequences and covertly, if not overtly, imply that they are proof that all collegiate drinking is problematic.
If “the problem” is all collegiate drinking, then there can be but one possible objective of prevention…abstinence. However, such a goal suggests two questions: First, just as there has never been a time when alcohol was not used by some college students, can there ever be a time when no collegians drink (although it is likely that current percentages of students reporting use can be lessened and the frequency of that use and quantity consumed can be reduced)? Second, has the focus of research and prevention programming been too a posteriori and should that focus be directed instead to a priori considerations of drinking? Put more succinctly, we have been more concerned about the untoward consequences after students drink than in pursuing a better understanding of the meaning students ascribe to alcohol and drinking before consumption that influence their decision to drink in the first place. One argument in this essay is that such a priori considerations of collegiate drinking are likely to shed light on factors that affect individual decisions to drink…not to mention influencing student decisions when to drink, how to drink, or determine what circumstances warrant drinking, etc.
To understand how students view alcohol as a substance and drinking as a behavior is tantamount to having an insider’s perspective from which to consider factors affecting decisions made by students regarding collegiate drinking. This would permit a greater understanding of the means by which drinking has become an integral part of the social organization and culture of contemporary collegiate life…not to mention a fresh perspective from which to consider affecting change.
Efforts to “address” collegiate drinking have been historically focused on public policy approaches to control what has been described as a “social problem.” But this is remarkably similar to what was done in the 19th and early 20th centuries to address a similar national social problem, “alcohol” as perceived by the temperance movement. What is interesting in both situations—American’s concern about alcohol as a perceived social problem and higher education’s similar concern about student use—is the perception of what constitutes a “social problem” is essentially a social construction. This means that what causes a problem in the eyes of those who hold the power in a group or social body, is deemed a problem simply because it is perceived to cause a problem by those in a position of power. Because alcohol is involved in acts of violence or is correlated with poor academic performance by some students who drink, its consumption by any student is therefore perceived as a social problem, irrespective of the fact that untoward consequences are not experienced by the majority of drinkers especially on each occasion the decision is made to drink. As a social problem--and one that has increasingly been cited as "the" social problem in higher education--it demands attention and, therefore, must be solved by the most direct means available to accomplish such a solution, namely, via public policy.
This essay is not a plea to permit collegiate drinking or deny that the drinking done by some students is a significant issue in need of immediate attention. It is, however, an invitation to consider that the problem may not be what we think it is as regards alcohol and collegiate life. If, for example, the views of the majority in a particular social group are in agreement with what constitutes a social problem, public policy efforts to address that problem, i.e., "control it," are universally supported and the consequences associated with violating such policies are sanctioned. Examples of this can be seen when considering “driving while intoxicated,” “child abuse,” or “domestic violence.” Because the majority of Americans recognize that operating a motor vehicle while intoxicated is dangerous, that physically or sexually abusing a child is reprehensible, or assaulting a domestic partner is predatory, there is little if any protest when designating these behaviors as “social problems.” The majority of the populace are in agreement and these acts are deemed social problems because they cause problems for the society in which they occur.
But to suggest that issues such as abortion, smoking marihuana, or guns represent “social problems” is to all but instantly ignite a debate that is sure to generate more heat than light. These are issues for which there are significant advocates of at least two different points of view so there can be no clear consensus as to whether the issue is or is not a “social problem.” In short, those who hold the power to affect public policy will eventually settle the decision as to what constitutes a problem, prohibition being a good example of this in 1920 and those opposed to prohibition affecting its repeal in 1933. As in recording history, it is the victor to whom go the spoils, namely the opportunity to “record the truth.”
As regards collegiate drinking, because most if not all students understand that many if not most students who choose to drink—even those who choose to or unintentionally become intoxicated—do not experience untoward consequences as the result of any given drinking occasion, they do not see collegiate drinking as a “social problem.” Yet the issue of primacy for social scientists studying collegiate drinking and student affairs professionals addressing it on a daily basis are the untoward consequences associated with collegiate drinking.
Part II of this essay will consider student meaning for alcohol and drinking and how this may shed light on the difficulty students have in accepting "collegiate drinking" as the preeminent social problem in higher education today. To read more on this topic in some detail look at When They Drink: Deconstructing Collegiate Drinking (http://www.community.rowancas.org/node/21) and When They Drink: Is Collegiate Drinking the Problem We Think It Is? (http://www.rowan.edu/cas/resources/documents/CollegiateDrinking.doc.doc)
That some college and university students choose to drink is not news. That some of these drinkers actually choose to, or unintentionally, become intoxicated when drinking alcohol and experience an array of possible untoward consequences is likewise no secret. What may be a revelation for some is learning that most publications regarding collegiate drinking focus exclusively on these untoward consequences and covertly, if not overtly, imply that they are proof that all collegiate drinking is problematic.
If “the problem” is all collegiate drinking, then there can be but one possible objective of prevention…abstinence. However, such a goal suggests two questions: First, just as there has never been a time when alcohol was not used by some college students, can there ever be a time when no collegians drink (although it is likely that current percentages of students reporting use can be lessened and the frequency of that use and quantity consumed can be reduced)? Second, has the focus of research and prevention programming been too a posteriori and should that focus be directed instead to a priori considerations of drinking? Put more succinctly, we have been more concerned about the untoward consequences after students drink than in pursuing a better understanding of the meaning students ascribe to alcohol and drinking before consumption that influence their decision to drink in the first place. One argument in this essay is that such a priori considerations of collegiate drinking are likely to shed light on factors that affect individual decisions to drink…not to mention influencing student decisions when to drink, how to drink, or determine what circumstances warrant drinking, etc.
To understand how students view alcohol as a substance and drinking as a behavior is tantamount to having an insider’s perspective from which to consider factors affecting decisions made by students regarding collegiate drinking. This would permit a greater understanding of the means by which drinking has become an integral part of the social organization and culture of contemporary collegiate life…not to mention a fresh perspective from which to consider affecting change.
Efforts to “address” collegiate drinking have been historically focused on public policy approaches to control what has been described as a “social problem.” But this is remarkably similar to what was done in the 19th and early 20th centuries to address a similar national social problem, “alcohol” as perceived by the temperance movement. What is interesting in both situations—American’s concern about alcohol as a perceived social problem and higher education’s similar concern about student use—is the perception of what constitutes a “social problem” is essentially a social construction. This means that what causes a problem in the eyes of those who hold the power in a group or social body, is deemed a problem simply because it is perceived to cause a problem by those in a position of power. Because alcohol is involved in acts of violence or is correlated with poor academic performance by some students who drink, its consumption by any student is therefore perceived as a social problem, irrespective of the fact that untoward consequences are not experienced by the majority of drinkers especially on each occasion the decision is made to drink. As a social problem--and one that has increasingly been cited as "the" social problem in higher education--it demands attention and, therefore, must be solved by the most direct means available to accomplish such a solution, namely, via public policy.
This essay is not a plea to permit collegiate drinking or deny that the drinking done by some students is a significant issue in need of immediate attention. It is, however, an invitation to consider that the problem may not be what we think it is as regards alcohol and collegiate life. If, for example, the views of the majority in a particular social group are in agreement with what constitutes a social problem, public policy efforts to address that problem, i.e., "control it," are universally supported and the consequences associated with violating such policies are sanctioned. Examples of this can be seen when considering “driving while intoxicated,” “child abuse,” or “domestic violence.” Because the majority of Americans recognize that operating a motor vehicle while intoxicated is dangerous, that physically or sexually abusing a child is reprehensible, or assaulting a domestic partner is predatory, there is little if any protest when designating these behaviors as “social problems.” The majority of the populace are in agreement and these acts are deemed social problems because they cause problems for the society in which they occur.
But to suggest that issues such as abortion, smoking marihuana, or guns represent “social problems” is to all but instantly ignite a debate that is sure to generate more heat than light. These are issues for which there are significant advocates of at least two different points of view so there can be no clear consensus as to whether the issue is or is not a “social problem.” In short, those who hold the power to affect public policy will eventually settle the decision as to what constitutes a problem, prohibition being a good example of this in 1920 and those opposed to prohibition affecting its repeal in 1933. As in recording history, it is the victor to whom go the spoils, namely the opportunity to “record the truth.”
As regards collegiate drinking, because most if not all students understand that many if not most students who choose to drink—even those who choose to or unintentionally become intoxicated—do not experience untoward consequences as the result of any given drinking occasion, they do not see collegiate drinking as a “social problem.” Yet the issue of primacy for social scientists studying collegiate drinking and student affairs professionals addressing it on a daily basis are the untoward consequences associated with collegiate drinking.
Part II of this essay will consider student meaning for alcohol and drinking and how this may shed light on the difficulty students have in accepting "collegiate drinking" as the preeminent social problem in higher education today. To read more on this topic in some detail look at When They Drink: Deconstructing Collegiate Drinking (http://www.community.rowancas.org/node/21) and When They Drink: Is Collegiate Drinking the Problem We Think It Is? (http://www.rowan.edu/cas/resources/documents/CollegiateDrinking.doc.doc)
13 July 2009
Ice Fishing
My grandfather used to tell me, "Robert, you've got to cut a hole in the ice before you can catch any fish." This was one of his folksy ways of instructing me in the need to prepare for a job in order to increase the likelihood of success. It seems the older I get and the more experience I glean as a counselor, the more I value the wisdom of this mentor with a DHW...that's, "Dr. of Hard Work." Pop seemed to be prepping me for the work I would find myself doing decades later with 18 - 22 year old students, some of whom are mandated for an alcohol or other drug assessment.
Quite by accident I found myself some years ago with 120 coffee mugs hanging on the wall of my office; they are still there today. These mementos of individual or family excursions through the years found their way to my wall when there was no more room on the book shelves to display such curios. As the number grew from a few oddities to an unmistakable collection, students would often gaze about my office when entering. A few years ago a student quipped, "Like coffee, eh doc?" to which I spontaneously responded, "Pick one."
The student pointed to a mug, quite at random, and I told her the story that accompanied that particular piece of paraphernalia used to administer my preferred drug of choice. Admittedly, the stories are not very exciting, PG rated at best--remember that many were collected while on family vacations :) However, the fact that the story was shared seemed to open a portal to conversation that became a wonderful segue to the business that brought the student to my office in the first place.
Through the years, I have used this technique whenever a student would comment on the mugs - I never force the issue. One of my greatest compliments as a counselor came from one student a couple years ago who got up to leave a session and commented, looking around an office with a "curio shop" decor, "you know doc, your office looks a lot like Robin Williams' in Good Will Hunting." As the Existential counselor I am, I have come to treasure that simple statement, one I chose to accept as a compliment.
I share this by way of inviting readers to think about strategies discovered over the years that have provided useful segues to approaching resistant, shy, closed, or even angry clients. I look forward to any responses as I am always looking to add to my "bag of tricks." I also believe that these "tricks" can be useful pedagogical tools to employ when teaching, affording students the opportunity to recognize the importance of being an affective person while at the same time striving to be an effective teacher or counselor. What do you think? Email me at: chapman.phd@gmail.com and I will post ideas and suggestions in a subsequent blog entry.
Robert
My grandfather used to tell me, "Robert, you've got to cut a hole in the ice before you can catch any fish." This was one of his folksy ways of instructing me in the need to prepare for a job in order to increase the likelihood of success. It seems the older I get and the more experience I glean as a counselor, the more I value the wisdom of this mentor with a DHW...that's, "Dr. of Hard Work." Pop seemed to be prepping me for the work I would find myself doing decades later with 18 - 22 year old students, some of whom are mandated for an alcohol or other drug assessment.
Quite by accident I found myself some years ago with 120 coffee mugs hanging on the wall of my office; they are still there today. These mementos of individual or family excursions through the years found their way to my wall when there was no more room on the book shelves to display such curios. As the number grew from a few oddities to an unmistakable collection, students would often gaze about my office when entering. A few years ago a student quipped, "Like coffee, eh doc?" to which I spontaneously responded, "Pick one."
The student pointed to a mug, quite at random, and I told her the story that accompanied that particular piece of paraphernalia used to administer my preferred drug of choice. Admittedly, the stories are not very exciting, PG rated at best--remember that many were collected while on family vacations :) However, the fact that the story was shared seemed to open a portal to conversation that became a wonderful segue to the business that brought the student to my office in the first place.
Through the years, I have used this technique whenever a student would comment on the mugs - I never force the issue. One of my greatest compliments as a counselor came from one student a couple years ago who got up to leave a session and commented, looking around an office with a "curio shop" decor, "you know doc, your office looks a lot like Robin Williams' in Good Will Hunting." As the Existential counselor I am, I have come to treasure that simple statement, one I chose to accept as a compliment.
I share this by way of inviting readers to think about strategies discovered over the years that have provided useful segues to approaching resistant, shy, closed, or even angry clients. I look forward to any responses as I am always looking to add to my "bag of tricks." I also believe that these "tricks" can be useful pedagogical tools to employ when teaching, affording students the opportunity to recognize the importance of being an affective person while at the same time striving to be an effective teacher or counselor. What do you think? Email me at: chapman.phd@gmail.com and I will post ideas and suggestions in a subsequent blog entry.
Robert
Subscribe to:
Posts (Atom)