Drinking, Collegiate Life, and Attrition: Is There a Connection?

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In the article, Is Heavy Drinking Really Associated with Attrition from College?  The Alcohol-Attrition Paradox, Martinez, Sher, and Wood (Psychology of Addictive Behavior; 2008 September; 22(3): 450–456) report on heavy collegiate drinking and attrition.  Historically this connection is one that many have suspected yet until fairly recently, it has been difficult to document.  This is among the first research articles to suggest a statistical connection between heavy drinking and completing a college degree. See

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673793/pdf/nihms-104555.pdf

This article is interesting (see the discussion section if not interested in the technical information on research methodology) in that for the first time, to my knowledge, a link between heavy drinking and attrition is documented statistically.  This is of significance as it is something to which those concerned about high-risk and dangerous collegiate drinking can refer when arguing our point about increased administrative and financial support for prevention.  More to the point, with senior administrators frequently driven by fiscal “bottom lines” and boards of trustees more concerned with business models than academic missions, linking “high-risk and dangerous drinking” to “attrition,” that is “income,” can be an important step forward for our field.

Related to this, we know that using Prochaska’s Transtheoretical Model of Counseling (see http://www.uri.edu/research/cprc/TTM/StagesOfChange.htm)—with its value rooted in recognizing the significance of approaching individuals in their existing stage of readiness to change and then mounting motivational interventions designed to enhance movement towards change based on that awareness—is effective clinically.  When this model is used to approach institutional change, the principles remain the same…change results as decision makers are guided through their successive stages of readiness to make such changes based upon effective interventions.  For those administrators at the earlier stages of readiness to change, "consciousness raising" and "awareness" oriented interventions are most effective in motivating movement to the preparation and action stages of readiness to change; Martines, Sher, and Wood's article permits this be done.

In the case of senior administrators, boards of trustees, many faculty, and various other parties with vested interests in how higher education is managed, although they are aware that “collegiate drinking is an issue,” they tend to see it as more the results of student developmental issues and/or “the rites of passage” that “have always been and will always be.”  Consequently, the fact that high-risk and dangerous drinking is among the top public health issues affecting contemporary collegians is lost on the very individuals who are the most influential in making the campus policy and fiscal decisions that ultimately determine higher education’s ability to address this issue.

To definitively link heavy drinking to attrition presents an opportunity to both argue the importance of moving collegiate drinking in general and high-risk and dangerous collegiate drinking specifically to a position of greater significance and appropriateness for funding.  In short, if a registered student represent 10s of thousands of dollars annually in an institution’s fiscal bottom line, then demonstrating the role of heavy drinking, in concert with the events that students attend, plays in reducing that revenue is likely to garner greater interest when we make our pitch for prevention and intervention.

In conclusion, irrespective of the changes that senior administrators do or do not make regarding this subject, the findings reported in the research cited above also provide valuable insight for us as prevention specialists to better target our efforts and increase the effectiveness of the evidence-based best practices we are currently employing as we address heavy collegiate drinking.  In short, it is not just “heavy drinkers” that we need to target with our prevention efforts, but heavy drinkers who attend specific types of collegiate events. 

It will be interesting to see if Martinez, Sher, and Wood’s findings are replicated and if their recommendations for additional research are heeded, but irrespective of the future, there is interesting “food for thought” in this provocative article.

What do you think?

Dr. Robert

Self-disclosing vs. Self-involving Statements in Counseling

Counselors must exercise caution when using self-disclosure as a therapeutic technique, especially early in a counseling relationship. Self-disclosure can pose a problem or even sabotage a relationship when a practitioner conveys a message that the client perceives as implying what “should/should not be done.” Premature practitioner self-disclosure can even prompt clients to entertain self-demeaning thoughts, as they believe that change is elusive yet something the counselor has mastered. 

 

An effective counselor can likely accomplish much of what is attractive about self-disclosure—the humanness of sharing oneself, engaging the client in a collaborative relationship, empowering the client, and personalizing the collaborative relationship—by employing techniques associated with reflective listening. Remember that most counselors considering self-disclosure want their client to “feel better/safer/more accepted,” yet doing this without the self-disclosure and focusing instead on supporting the client is a safer and more proactive way of accomplishing this objective. The technical term to describe this alternative is self-involving statements. In such statements, the counselor can “speak from the heart” yet stop short of sharing his or her life story.

 

For example, when a client shares about a personal trauma to which the counselor can relate, instead of sharing the details associated with this fact, the counselor might say, “I can tell how difficult it is for you to talk about this. I know the courage it takes to do so, essentially with a stranger, and I appreciate your trust. Sharing like this with me suggests the progress you are making in counseling and leads me to believe that our treatment goals and objectives continue to be appropriate,” or something like this.

 

Notice how the counselor can infuse the dialogue with a distinctly personal air without having to “self-disclose” personal information. This enables the counselor to be “in the moment” and become personal while continuing to establish and maintain appropriate boundaries with a client. Further, such statements become very important when self-disclosing “my story” could superimpose a set of “how-it-should-be-done” expectations or standards on the client.

 

A good example of this is the counselor who is in his or her recovery, perhaps from a substance use disorder, and attends 12-step meetings regularly. As much as the counselor believes that sharing their story in response to a client’s fear that “things will never change” and “I guess my father was right when he called me a loser,” what the client may hear when told the counselor’s story is, “unless you go to AA/NA and stay involved with AA/NA, nothing is going to change.”  This may not be an issue for the client who views 12-step programs as beneficial or at least a “non-issue.” Still, for the client who wants no part of such a recovery, at least right now, this self-disclosure could inadvertently alienate the client who now believes that the counselor will sooner or later suggest AA and impose “his/her way” of recovery.

 

A challenge that recovering practitioners who are active in AA or NA face is how to differentiate between “sponsoring” and “counseling.” Establishing a relationship with “a sponsor” in AA or NA is a cornerstone of recovery in 12-step programs and, for many, a key component of its success. In such relationships, sponsors intentionally focus on themselves as they share “what it was like, what happened, and what it’s like now.” In 12-step parlance, sponsors share their experience, strength, and hope, essentially their personal stories of dependence and recovery with the individual they sponsor. This is essentially the antithesis of what effective counselors learn when trained to engage someone in a clinical relationship. 

 

Consequently, the recovering practitioner must understand the difference between the relationship one establishes with another 12-step member and the relationship professional counselors and therapists develop with their clients. This is not an easy task, especially for the recovering practitioner who recognizes that their recovery is due in large part to their involvement in a 12-step program. For this reason, supervisors should consider broaching this subject with their recovering supervisees and discussing the use of self-involving statements to covey their presence with clients as a possible alternative to the self-disclosure that is the hallmark of sponsorship, at least in the earlier stages of a clinical relationship.

 

What do you think?

Dr. Robert