Does Administration Bear Responsibility for Burnout in Collegiate Student Affairs Professionals?

 Google “student affairs” and “burnout” and you get 91,000 total hits; nearly 8,000 in “scholarly articles,” 3,650 published since 2017.[1] This is neither a new nor “back-water” topic in higher education.

 

Working in higher education for 30-years—as a student affairs (SA) professional for 20-years and professor of behavioral health counseling for another 10—and as a behavioral health practitioner for almost 20 years before that, the formal and informal attention this topic receives comes as no surprise. As a higher ed insider, my general thoughts on the topic start with a belief that burnout among SA professionals or what some refer to as compassion fatigue (CF), is not unlike the quality of life (QOL) issues that affect student satisfaction with their collegiate experience. These student QOL concerns are known to the administration as is their association with retention and recruitment, hence their efforts to address them. The same cannot be said, however, regarding its awareness of the association between burnout in SA professionals and their retention—when perceived workplace satisfaction is low, retention is low. Unfortunately, senior administration in higher education appears oblivious to these similar phenomena.

 

Recruiting and training qualified SA professionals is a costly proposition for institutions of higher education (IHE). Experienced SA professionals are an important factor in the calculous of improving & maintaining positive student perceptions of QOL on campus. Although recognizing student perceptions of QOL as issues of significant institutional concern rather than personal maladjustment, the administration does not appear to view employee burnout and CF similarly. By perceiving burnout and CF as individual employee issues, the administration signals a lack of awareness that these matters, like the negative perceptions of QOL by students, are more related to the environment in which employees work than to the employees themselves (Moss, 2019)[2].

 

As the result of the difference in perception of these two similar issues, the administration has failed to recognize its role in producing the very issues responsible for SA burnout and CF. Instead, it believes that stress management and wellness-oriented training are enough to prevent these personal problems experienced by SA professionals. Put succinctly, although the administration recognizes that student concerns regarding QOL is an institutional issue for which it has responsibility, it views burnout and CF as the responsibility of SA employees to address individually.

 

Although stress management and wellness-oriented training are helpful/useful, they are, at best, Band-Aids placed on a problem that is administration's to solve. By this, I suggest that institutional responsibility stems from its role in at least fostering if not creating the very burnout and CF when generating the workplace stress that leads to SA burnout and CF via heavy workloads, job insecurity, frustrating work routines, and the expectation that ALL issues outside the classroom are essentially student affairs responsibility to handle. Worse yet, the administration may believe that it has addressed these issues by its hiring of SA professionals to do the heavy lifting. Consequently, the lowest-paid professional staff members find themselves saddled with some of the more time-consuming and emotionally taxing responsibilities that occur on a college campus. Is it any wonder that SA pros burn out or experience CF?

 

So, what do we do now? Perhaps we start by reflecting on Albert von Szent-Gyorgyi’s observation that discovery consists in seeing what everyone has seen and thinking what nobody has thought.

 

 

What do you think?

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[1] As of Dec 2021

[2] (2019) Moss, Jennifer. Harvard Business Review https://hbr.org/2019/12/burnout-is-about-your-workplace-not-your-people

A Possible Reason High-risk Drinking is So Intractable in College?

Students Who Limit Their Drinking, as Recommended by National Guidelines, Are Stigmatized, Ostracized, or the Subject of Peer Pressure: Limiting Consumption Is All But Prohibited in a Culture of Intoxication - https://journals.sagepub.com/doi/full/10.1177/1178221818792414

First, I realize that this is a study conducted 3+ years ago and in New Zealand no less, however, its points seemed to resonate with me given my experience working with collegians in a small, private, urban university.

The gist of the argument presented is that the cost in social capital for students to identify, by declaration and/or behavior, as moderate drinkers or abstainers is high. In addition, "the labels" proffered by students when asked about their peers who drink, seem positive when a peer reports what we preventionist would classify as high-risk and derogatory regarding moderate or abstaining peers. There is more to the article than this but it got me thinking.

We know that student misperceptions about collegiate drinking are significant. We also have learned that when designed and conducted correctly, social norms marketing can be quite effective. We also know, however, that there is a stubborn core of high-risk drinkers that does not seem to budge no matter what preventive steps we take or programming efforts we mount. I am wondering if there is a "social capital" concern in this high-risk core regarding these negative if not derogatory labels affixed to moderate drinkers and abstainers...someone looking for a topic for a master’s thesis or doctoral dissertation? :)

Related to this stubborn core that appears immune to our prevention efforts to date, I was reading an article recently that suggested that social norms marketing can actually backfire if messages convy a social norm that is perceived by peers to be vastly out of their reach, as learning about this norm can actually discourage pursuing change. This got me thinking again...it would not surprise me to learn that the proportion of collegiate drinkers who meet the criteria for a diagnosis of an alcohol use disorder is higher in the persistent 22-23% of students reporting frequent "binge drinking" than in the general student population. If this is the case, especially if those AUD students have tried to change and were unsuccessful, might the traditional social norms marketing message that reports something like "X% of students report drinking 4 or fewer drinks when they drink" trigger a 'why bother' or what is called a "what-the-heck" reaction to our social norms messages?

The article I was reading suggested that if a target behavior is growing in popularity -- in our case, 

the number of moderate drinkers and abstainers is increasing -- especially if by modest amounts, instead of reporting actual percentages, simply report the upward trend, sans the details. So, instead of reporting that "X% of State Univ students report consuming 4 or fewer drinks if they choose to drink," reporting "for the Xth month/semester/year in a row, an increased number of State Univ students report moderating their drinking if they choose to drink." Where the 1st message could alienate high-risk drinking if construed as indicative of a peer group w/which I cannot or do not wish to identify, the 2nd is inclusive and uses positive peer pressure to affect change. True, someone who is drinking 10 drinks per outing 2X/wk and decides to "moderate use" by having 7 drinks 1X/wk is still engaging in high-risk behavior, but, hey..."any port in a storm."

Just a couple thought...what do you think?

What if Mary Poppins was a Collegiate Preventionist?

 

Imagine, if you will, that as we emerge from 17+ months of pandemic with its related lockdowns, social distancing, and virtual meetings it is a beauteous September day much like that date in the opening scenes of the 1964 Disney film, Mary Poppins. As you walk across campus after your meeting to discuss concerns about collegiate drinking and how best to prepare for the return of partying students to campus, you notice drifting down from an azure blue sky; why it is none other than Mary Poppins herself.

 

As she stands before you, quite prim and proper with her umbrella in one hand and satchel in the other, Mary Poppins announces that she is aware of the advertisement in The Chronicle of Higher Education for

an alcohol & other drug (AOD) preventionist and was on campus to apply. She adds that she is aware that your students, much like the adorable yet incorrigible Banks children, Michael and Jane for whom she had been a Nanny, have presented your Student Affairs establishment with quite the conundrum, a “can’t seem to live with them but cannot live without them” dilemma. She suggests that she just may be able to proffer some assistance in bringing resolution to the concerns you have just addressed in your meeting.

 

Your face betrays your wonderment as to just how does she know about your recent meeting let alone its focus on high-risk and dangerous collegiate drinking, but she is just assertive enough—and you are just concerned enough as the V.P. of Student Affairs has charged YOU with the responsibility to address the collegiate drinking problem—that you agree to hear her out and you invite her to your office hear her out…and for some tea.

 

I could continue this scenario and detail a hypothetical dialogue with Mary in some detail but I choose this introduction to proffer a thought not frequently considered when entertaining ideas about how best to prevent high-risk student behavior, AOD use in particular…the gamification of AOD programming.

 

Historically, prevention has focused on, as the profession’s name implies, preventing high-risk and dangerous behavior. To accomplish this objective, its efforts almost exclusively fixated on “the problem.” Such problem-focused approaches unwittingly suggested that high-risk AOD use was an all but insurmountable collegiate problem. Like a closeup photo of an object devoid of any reference in the frame for comparison, determining the extent of “collegiate drinking” as a problem becomes somewhat subjective, left to the interpretation of the observer. This, coupled with a decades-long history of preventionists almost exclusively addressing “the problem” of high-risk and dangerous drinking, has left some wondering if collegiate drinking is actually the problem we have been led to believe it is.

But back to Mary Poppins…gamification is exactly what Mary does when she assumes the responsibility of Nanny for the Banks children. To re-establish order through the introduction of routine and the instituting of basic procedures for the children to follow, she “gamifies” said routines and procedures, rules if you will, to entice compliance and, as a result, behavior change. It is, as one of the more memorable songs from the film goes, a “spoonful of sugar” that “make the medicine go down.” In that same song, Mary sings, In every job that must be done, there is an element of fun. You find the fun, and  snap! The job’s a game.[1]

 

Now I am not so naïve as to suggest that moderating student behavior is a simple matter of making low-risk decision making fun. Is there, however, a way—or are there ways—to increase the likelihood that students buy into some of our existing approaches to prevention? Can we “gamify” any of our prevention efforts?

 

To modify their behavior, students must conduct a cost-benefit analysis of any proposed change, realizing that if made, it will yield access to what they perceive as having a greater value than what they must give up to obtain it. Unfortunately, risk avoidance has not historically proven effective as such a motivator.

 

A major barrier to change is impulsivity or what Katy Milkman[2] calls present bias or the tendency to opt for the short-term reward over a longer-term benefit. For students this is avoiding the short-term reward of an “instant party”…just add alcohol…with all its social promises for the long-term benefit of better grades at the end of term. As the WWI song queried, How ya gonna keep ‘em down on the farm, after they’ve seen Parie?

 

“So,” as an effective parent says to a complaining child, “what do you propose we do?” What might the gamification of AOD prevention look like…or at least what might be a straw man to pull apart as we kick-about this idea? Again, as Katy Milkman suggests—can you tell I just read her book--

 

Gamification is another way to make goal pursuit instantly gratifying. It involves making something that isn’t a game feel more engaging and less monotonous by adding gamelike (sic) features such as symbolic rewards, a sense of competition, and leaderboards (59).

 

 

Perhaps it could involve offering “symbolic rewards” as a student “advances through successive levels” in an online alcohol awareness program. Perhaps it could involve incorporating geocaching into a social norms campaign to make it “more engaging.” Perhaps it could use a “leaderboard” to introduces a “sense of competition” between first-year resident halls for completion of a required online alcohol program. Perhaps voluntary referrals to B.A.S.I.C.S. would increase if B.A.S.I.C.S. was one stop on a term-long “campus services scavenger hunt” with an appropriately enticing prize for those who complete the hunt where a clue/direction to “the next” service came as each service is completed/visited.

 

Limits to the possibilities for the gamification of collegiate prevention efforts know no end. The creativity and resourcefulness of those who choose to incorporate the concept into a campus prevention program represents the only boundaries.

The purpose of this essay, however, is not to suggest HOW to gamify prevention—let alone suggest that any of the ideas just mentioned above are good or even likely to meet with student acceptance—but to simply ask WHAT IF we were to consider gamification as another arrow in the preventionist’s quiver? Perhaps if we were, we just might see Mary open her umbrella and drift off into the evening sky, barely audible as she hums, a spoonful of sugar…

 

What do you think?

__________

1 Milkman, Katy (2021). How to change: The science of getting from where you are to where you want to be. Penguin Random House, N.Y., N.Y.

2 Milkman, Katy (2021). How to change: The science of getting from where you are to where you want to be. Penguin Random House, N.Y., N.Y.

Harm Reduction and Substance Use Disorders

Harm reduction (HR) is an important tool for the behavioral health professional’s use when considering how best to address the issue of substance use. It is a fact, however, disturbing it may be, that we human beings have used, continue to use, and will likely always use licit and illicit substances. Although most users do so without experiencing a substance use disorder (SUD), their use, as well as the use of those who do develop a SUD too often, involves health-related risks and problems, some of which result in death.

 

HR. is essentially a collection of principles[1] that acknowledge that although substance use is and will likely continue to remain a fact of life, it is imperative for society in general and healthcare professionals specifically to champion adherence to these principles and strive to reduce the likelihood of untoward consequences resulting from the use of any psychoactive substances, licit or illicit.

 

Substance use, licit or illicit, is neither a moral nor legal issue, it is a healthcare issue. As such, efforts to interceded in the use of such substances should seek to minimize the likelihood of harm for those who use and advocate for the treatment of those whose use has resulting in a SUD. Unfortunately, the use of illicit substances in general and “addiction” specifically carry the stigma of problems realized by those morally weak and/or criminally disposed members of society.

 

Addiction is, in many ways a social construction - A social construct is something that exists not in objective reality, but as a result of human interaction. It exists because humans agree that it exists[2]. In other words, addiction is a collection of behaviors that society has deemed outside the bounds of its vie of normal and therefore aberrant. Because those with addictions do not behave in accordance with what society deems acceptable and appropriate behavior, these individuals must, therefore, suffer from some degree of moral turpitude or be criminally inclined. This “moral model” view of addiction explains our societal reaction to those who use illicit substances or display the symptoms of what we call a substance use disorder. It also justifies our proclivity as a society to arrest and punish rather than diagnose and treat those who use illicit substances.

 

To pursue the specifics of the moral model and its impact on the history of the treatment of SUDs is

beyond the scope of this essay. It is the prevention of harm to those who use substances, licit or illicit, irrespective of their reasons for use…physical dependence or hedonistic reward…that is the reason for this piece.

 

The pursuit of harm reduction can lead a healthcare professional in one or two general directions. The first, regarding treatment, results in the practitioner’s efforts to engage individuals in a way that increases the likelihood of motivating users to reconsider their use, thereby increasing the likelihood of reducing the frequency and/or quantity of that use. The second regards simply reducing the risk of untoward consequences resulting from use. Treatment is not the primary objective, just the reduction of harm associated with the use, both to the user and to the society in which that user resides.

Interestingly, HR. efforts in pursuit of the second objective can and often do result in the opportunity to pursue the first, treatment. An example of this is the evidence that comes from harm reduction efforts like “user room.” In the Netherlands, Amsterdam specifically, user rooms are places where individuals can go to consume their substances…drugs…safely. Trained staff supervise these locations, often with EMT experience and access to Naloxone. At such facilities, users can shower, wash their clothes, get something to eat, and have their basic human needs addressed. While visiting a “user room,” individuals would often establish a rapport with staff and over a period of visits, begin to talk about their use with staff. The staff, often trained in Motivational Interviewing techniques, then engage users in a discussion about the benefits and costs of their use, helping users to take a critical look at the “return on investment” related to their substance use, a more than occasional result being the user’s entering treatment.

 

Harm reduction efforts related to substance use are more concerned with the user and those with whom the user has contact than with the legality of use or the socially constructed barriers that distinguish between the “appropriate use of licit substance,” like alcohol, or its “inappropriate use” or the use of any illicit substance. It is an approach rooted in the belief that the prevention of harm is rooted in the promotion of health and therefore a quintessential exemplar of health care.

 

And before rejecting this argument by citing concerns about needle exchange programs, the encouragement of use  by user rooms, or state-supported addiction in methadone maintenance programs, notice how dependent we all are on harm reduction in our lives already: seat belts, airbags, antilock brakes, fire retardant clothing, smoke detectors, CO2 detectors, hand railings, antiskid strips on steps, sunscreen, etcetera, etcetera, etcetera.

What do you think?

Dr. Robert

 

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[1] See Principles of Harm Reduction at https://harmreduction.org/about-us/principles-of-harm-reduction/ for a summary of these principles.

[2] Bainbridge, Carol (2020). CF - https://www.verywellmind.com/definition-of-social-construct-1448922

What We Need to Understand About Willpower

Willpower is arguably a social construction that we humans have conjured up to explain why some are successful in controlling their behavior while others are not -- For those who do, we say they “have willpower” while those who do not, don’t. 

What is willpower but a means by which we choose to measure our ability to control ourselves and/or our

environment. This preoccupation with control, especially when measured regarding our ability to regulate our personal behavior, lends itself to a binomial consideration of success…we either succeed or fail in exercising that control. However, it is just this point…viewing willpower as an ability one either possesses or not…that results in self-defeating beliefs when struggling with efforts to self-direct behavior change. But what if willpower is not so much an ability one either has or does not have, like a biological trait genetically passed along by birth parents, but a skill capable of development like any other?

The first step in developing this skill of self-regulation is identifying the specific details associated with the behavior I am trying to regulate. If, for example, I “drink too much” and have come to the realization that I have a “drinking problem,” then the behavior I am trying to regulate is my drinking and my objective is to drink less if not quit altogether. Although “not drinking” may seem the obvious objective, until and unless I understand the details associated with my issue, I am likely to think that the only option available to meet my quit-objective is to “will myself” to “not do it,” the white-knuckle approach to change if you will. With willpower as my perceived only approach to change, I assign the responsibility for my success to a supposed character trait, one that I may or may not have. In short, viewing willpower as a trait relegates my ability to change to the genes I inherited from my biological parents, which makes the likelihood of my success little more than a crapshoot. But is this an accurate assessment of how people change? Are only “some of us” destined to change our behavior should we wish to do so?

And what if “willpower” is a skill rather than a trait? A skill, like any other, capable of development over time through practice. By attending to the details of my behavior, for example, my drinking, I can identify important clues that affect my ability to change it…or change my gambling habit, or failure to take my medication, or “whatever” it is I seek to change. If what-causes-a-problem-is-a-problem-when-it-causes-a-problem, then the more I know about “it,” the better prepared I am to make appropriate behavioral changes that support my ultimate change objective. When I do “it,” where I do “it,” with whom I do “it,” etc. This is consistent with viewing willpower as a skill that I develop. Like the old joke about the visitor to N. Y. City when asking the maestro, “How do I get to Carnegie Hall” gets the reply, “Practice, practice, practice,” the will to change is as much a skill that one develops as it is a personal desire to alter one’s behavior.

The more I know about “my habit” or the pattern of behavior I wish to change, the better prepared I am to address it. And when I do decide to address it, I am choosing to act on that behavior rather than react to it. This means my success in changing my behavior has more to do with the steps I take that support that change than the amount of willpower I may or may not have been born with. In short, as a skill, willpower is something developed, strengthened, controlled, and then, directed.