Personal Breath Testing (PBT): A Pursuit for Higher Ed?
Because PBT devices are available on the market, is it advisable for colleges and universities to invest in such technology and provide it to students in order to monitor their consumption? Although not an option being considered by many schools, this is an approach to moderating high-risk and dangerous collegiate drinking on some campuses. Although not an expert on this topic, this post considers some of the issues if not potential risks associated with such a practice. For example:
1. If the decision is made to use some sort of PBT device, one will need to train students to use it...this will not be easy, not to mention time consuming and therefore expensive.
There a variety of personal breath testing devices available on the market and the cost will vary. As with all things in life, you get what you pay for. The more accurate and precise the device's measurement of blood alcohol level, the more costly per unit.
2. Once the decision has been made to use a “particular device,” training will need to be designed around that particular device and its limitations. For example, if the device is accurate to within “X% BAL,” then students will need to be educated to know this AND how to gage “their individual reading” and then abide by it.
3. With devices that simply indicate if the user has exceeded a particular BAL, say .05%, and do not record a “specific” BAL, will students pay attention to this? In other words, if my PBT device suggests that I am now at the .05% level, will I stop or even slow down or will I think, “okay, I am getting close to the legal limit, but I am not there yet; I can go on a bit longer.”
4. What about that particular type of student who sees this as an invitation to a new type of drinking game...who can make the PBT go off first or who can get the highest BAL before having to urinate, or whatever?
Personally, to motivate proactive decision making related to alcohol, I prefer activities that reward students for doing what is positive or protective rather than simply providing warnings or punishing them for doing something risky. For example, instead of PBTs for everyone — which I believe will be incredibly expensive when you factor in training — what about a breath testing station at each residence hall where student VOLUNTARILY can have their breath tested, have no judicial consequences irrespective of BAL (although a trip to the ER may be mandated if above “X” BAL) and anyone with a BAL under “Y” (.05%?) gets “Z,” a gift card for a free coffee/tea/hot chocolate at the campus coffee shop or gets a dining hall pass for a guest, etc.
Before anything is done, if a campus is leaning towards going with a "PBTs for everyone" decision, CONSULT YOUR ATTORNEY! I can see the law suit now if the school implements this program and John Jones or Mary Brown has a PBT and dies from an alcohol overdose. Yes, the campus can argue the PBT device was an attempt to reduce harm to help students who choose to drink, but a cleaver plaintiff’s attorney is going to argue, “Well, thank you very much, but you knew this was a high risk and all you did was provide a means to measure the risk, not address assertively or reduce it” or something like this.
As in counseling, there are two choices as to how to proceed...to move towards a desired outcome or away from a feared consequence. I suppose the PBT discussion could be framed as an example of either of these, but my personal thoughts regarding PBTs is more akin to an attempt to move away from a feared consequence.
To read more about PBT devises, visit http://bit.ly/bvmaKK or http://bit.ly/a8EmUj
What do you think?
Dr. Robert
18 July 2010
05 July 2010
Coping with Urges & Cravings
Black and white thinking is a mitigating factor that can often make urges and cravings seem "unbearable." The belief that "I cannot stand this" or "I am never going to be able change this" can, at times, be overwhelming. That said, remember the 12-step slogan, “Bring the body and the mind will follow.” What this means is that even if something does not “feel” like the small, immediate steps taken to affect change or deal with the cravings to use are producing results, "knowing" that they can and do for others in recovery, and repeating these small steps as often as is necessary to affect change, will eventually enable one’s “feelings” to catch up. “Knowing/understanding” the basic principle of cognitive therapy, namely, "you feel the way you think," allows one to appreciate the positive, proactive alternatives to the “cognitive distortions” or “irrational beliefs” (what AA calls stinkin' thinkin') that amplify the cravings to use. Knowing this enables one to continue to refute the negative automatic thoughts and (this is very important) engage in other more positive behaviors/activities, which slowly but surely begin to compete with the negative self-talk. As the negative self-talk that intensifies the cravings to use is assuaged, it becomes possible to "see past the cravings" and recognize that as difficult as this may seem at the moment, "this too shall pass" as another of AA's slogans exhorts.
It is like when you get a dumb song stuck in your head and cannot, seemingly, stop thinking about it. The more you tell yourself I should not be thinking this, the more entrenched the obdurate tune becomes. The way you “break the cycle” is to occupy the mind with other things...busy work, challenging intellectual conversation, etc. By diverting attention to the positive, the negative is eliminated. Even if the negative thought returns, then I engage in the antidote again—refocusing my attention on something else and/or simply doing something else—the negative thought is again “starved for attention” and dissipates. This does not happen “like that,” and it takes a commitment to follow through, hence the “between session practice activities” (a.k.a. Homework) counselors often prescribes for their client.
In short, trying not to think about something by telling yourself “I should not be thinking about this” or concentrating all my energy and attention on refuting the negative thought is to make the negative the issue of primacy...and it is reinforced. The way out of this cycle is to simply say, “I am not going to do this any more” and then do something else. This is why in 12-step programs they suggest the way to combat an obsession is to “don’t drink; go to a meeting; pray if you can.” Now this may seem like a rather narrow and somewhat overly simplistic as an answer to an otherwise overwhelming and frustrating problem, but it is based on a very simple but nonetheless effective premise: You cannot dwell on the negative when you are busy doing something else...even if you have to make yourself do that something else. Remember...the definition of a crisis is a period of instability and chaos sandwiched between two periods of relative stability and calm. The same is true for cravings...in the moment, it seems insurmountable, but by its definition a craving is temporary.
As silly as this exercise may seem, consider the following:
(Imagine me saying this and not writing it) - “Can you spell “Mississippi?”
Next, “Can you add: 23 + 48 + 74 + 96 + 13?”
The answer to both is yes
However, can you spell Mississippi WHILE YOU ADD—that is, at the same time as you add—23 + 48 + 74 + 96 + 13?
The answer is no, you cannot because the two separate tasks require two different mental processes that go on in 2 different areas of the brain. If “spelling Mississippi” is the equivalent of “negative automatic thoughts” or craving to use, then start “adding columns of 2-diget numbers” until the “negative automatic thought” ceases. This may not be “fun” and it may seem “silly” or “boring” or “hopeless,” but remember, “you do best what you do most.” The choice is the changer’s to make...will what I do be something that reinforces the negative or moves me in another direction? As Voltaire said in his book, Candide, “Argue for your limitations and you shall have then.”
What do you think?
Robert
Black and white thinking is a mitigating factor that can often make urges and cravings seem "unbearable." The belief that "I cannot stand this" or "I am never going to be able change this" can, at times, be overwhelming. That said, remember the 12-step slogan, “Bring the body and the mind will follow.” What this means is that even if something does not “feel” like the small, immediate steps taken to affect change or deal with the cravings to use are producing results, "knowing" that they can and do for others in recovery, and repeating these small steps as often as is necessary to affect change, will eventually enable one’s “feelings” to catch up. “Knowing/understanding” the basic principle of cognitive therapy, namely, "you feel the way you think," allows one to appreciate the positive, proactive alternatives to the “cognitive distortions” or “irrational beliefs” (what AA calls stinkin' thinkin') that amplify the cravings to use. Knowing this enables one to continue to refute the negative automatic thoughts and (this is very important) engage in other more positive behaviors/activities, which slowly but surely begin to compete with the negative self-talk. As the negative self-talk that intensifies the cravings to use is assuaged, it becomes possible to "see past the cravings" and recognize that as difficult as this may seem at the moment, "this too shall pass" as another of AA's slogans exhorts.
It is like when you get a dumb song stuck in your head and cannot, seemingly, stop thinking about it. The more you tell yourself I should not be thinking this, the more entrenched the obdurate tune becomes. The way you “break the cycle” is to occupy the mind with other things...busy work, challenging intellectual conversation, etc. By diverting attention to the positive, the negative is eliminated. Even if the negative thought returns, then I engage in the antidote again—refocusing my attention on something else and/or simply doing something else—the negative thought is again “starved for attention” and dissipates. This does not happen “like that,” and it takes a commitment to follow through, hence the “between session practice activities” (a.k.a. Homework) counselors often prescribes for their client.
In short, trying not to think about something by telling yourself “I should not be thinking about this” or concentrating all my energy and attention on refuting the negative thought is to make the negative the issue of primacy...and it is reinforced. The way out of this cycle is to simply say, “I am not going to do this any more” and then do something else. This is why in 12-step programs they suggest the way to combat an obsession is to “don’t drink; go to a meeting; pray if you can.” Now this may seem like a rather narrow and somewhat overly simplistic as an answer to an otherwise overwhelming and frustrating problem, but it is based on a very simple but nonetheless effective premise: You cannot dwell on the negative when you are busy doing something else...even if you have to make yourself do that something else. Remember...the definition of a crisis is a period of instability and chaos sandwiched between two periods of relative stability and calm. The same is true for cravings...in the moment, it seems insurmountable, but by its definition a craving is temporary.
As silly as this exercise may seem, consider the following:
(Imagine me saying this and not writing it) - “Can you spell “Mississippi?”
Next, “Can you add: 23 + 48 + 74 + 96 + 13?”
The answer to both is yes
However, can you spell Mississippi WHILE YOU ADD—that is, at the same time as you add—23 + 48 + 74 + 96 + 13?
The answer is no, you cannot because the two separate tasks require two different mental processes that go on in 2 different areas of the brain. If “spelling Mississippi” is the equivalent of “negative automatic thoughts” or craving to use, then start “adding columns of 2-diget numbers” until the “negative automatic thought” ceases. This may not be “fun” and it may seem “silly” or “boring” or “hopeless,” but remember, “you do best what you do most.” The choice is the changer’s to make...will what I do be something that reinforces the negative or moves me in another direction? As Voltaire said in his book, Candide, “Argue for your limitations and you shall have then.”
What do you think?
Robert
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