ProvidingAOD Services to Students in College

Acolleague posed the following questions on an online discussion group to whichI subscribe:

I am seeking feedback about how private,Christian colleges provide substance abuse treatment for students. Specifically, how are referrals from administrative sources such as judicialaffairs handled?  Are there separate mandated and voluntarytreatments?  How is student confidentiality maintained or addressed inlight of community abstinence policies? 

Hereis the reply I posted to the list:

Theseare wonderful questions and ones that get asked all to infrequently,especially by administrators in higher ed. The good news, as the saying goes,is that there are literally thousands of pages written on this general topicand these specific questions…the bad news is, there are literally thousandsof pages written on this general topic and these questions J So, where to start…

  

Howare referrals from administrative sources such as judicial affairs handled? When student affairsand judicial affairs are walking in sync, this is a relatively easy question toaddress. When at a small, urban, Catholic university, we negotiated what wecalled an “alternate sanctions program” for those first-offenders or subsequentoffenders where the infractions were minor, e.g., no hospitalization; noinjuries. In this program, there were set consequences that would followspecific violations—deferred suspension of housing, probation, etc.—butstudents were offered the choice between a hefty monetary fine or toparticipate in an alcohol awareness program modeled on harm reduction andMotivational Interviewing as the last consequence of the violation. Thisincreased the likelihood that students would participate in the educationalalternative and do so “voluntarily,” which allowed the practitioner presentingthe program to be the “good guy” who allowed the student to save $X, not tomention used choice to more directly involve the student in the process.

Howis student confidentiality maintained or addressed in light of communityabstinence policies? Regarding the issue ofconfidentiality, students would be told at the first session that everythingthat went on in the sessions was confidential and nothing, including attendanceinfo, would be released w/o a written consent to do so. That said, studentswere reminded that it would be in their best interest to allow judicial affairsto at least know about their attendance. NOTE: A written report would beprepared for Judicial Affairs, but again would not be released until (1) thestudent reviewed the report with the practitioner and (2) provided the writtenconsent. A similar process was used with MANDATED students. NOTE: As acounselor I addressed the “seeing mandated clients” dilemma by ensuringstudents that I “work for you and not judicial affairs” and for this reasonwould not release info unless such was indicative of likely harm to oneself orothers. For details/copies of forms/etc. please contact me back channel: Chapman.phd@gmail.com

Atthe end of every semester I would routinely hear from judicial affairs abouthow students actually found the alcohol sessions interesting if not enjoyable.I would be asked, “What are you doing over there? When we sent him/her yourway, he/she went kicking and screaming.” It was this student compliance withthe program that allowed judicial affairs to recognize that approachinghigh-risk student behavior as something done “with a student” rather than “to astudent” was actually more productive…a collaborative rather than adversarialapproach.

Wherethe issues you raise become challenging is when senior administration and/orjudicial affairs folks see violation of institutional policy as being a hangingoffense AND assert their need to know everything that goes on as the result ofthat violations. In this day and age we tend to see institutions open to mysuggestions above regarding alcohol, but closed to them when the violation isfor “drugs other than alcohol.”

Isuggest that you look at the literature related to (1) environmental managementand (2) Brief Alcohol Screening and Intervention with College Students, BASICS.Basic info on both can be found on my web site. I also suggest that looking atmy 3-monograph series entitled, When They Drink, especially the first one,which includes invited essays on all aspects of addressing high-risk anddangerous collegiate drinking. Links can be found at http://robertchapman.net/essays.htm

What do you think?

Dr. Robert

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Considering Collegiate Drinking; The Rest of the Story

When considering collegiate drinking, it is important to step back from issues such as student AOD use and consider a larger picture.  As a profession, substance use disorder prevention specialists have a tendency to be myopic in our consideration of "the problem."  As accurate as accounts of this problem may be, they are, nonetheless, incomplete.

Lists of strategies to address collegiate drinking generally include several important and proactive suggestions.  Approaches such as social norms marketing, environmental management along with clinical intervention strategies like Brief Alcohol Screening and Intervention for College Students (BASICS) are on the short list and are important steps that need to be considered when addressing the issue of alcohol and other drug use by students.  As important as these approaches are in addressing high-risk and dangerous collegiate drinking, they do not provide access to the "big picture."  If anything, these are “problem-oriented” strategies, but are the metaphorical equivalent of effective strategies for bailing the water from a sinking ship, but do little to solve the problem of taking on the water being removed from the bilge. 

What we need to ask is, when framing the issue of collegiate drinking, "what is just outside the framed shot.”  What would we capture in our picture of collegiate drinking if we used a wide-angle lens?  I suspect that there are several influential factors that heretofore have been overlooked at best or more likely, simply not considered...at all.  As Paul Harvey used to say in his syndicated radio program, what is, “the rest of the story”?

Just like Pluto--before it was demoted to a dwarf planet--was predicted to exist before it was actually discovered by Tombaugh in 1930, its existence was postulated via mathematical calculations.  So do "other forces" exist that affect the use of alcohol and other drugs by students?  Although I focus on this in great detail in the latter 2 monographs in my 3-monograph series on collegiate drinking, When They Drink (links included at the end of this post), here are three invisible, that is to say, "unstudied," forces I suggest affect collegiate substance use:

•                What do "alcohol" as a substance and "drinking" as a behavior mean to students?  This social constructionist view of collegiate drinking has never been seriously investigated.  "How" does alcohol reach its iconic status for students?  "What" affects the meaning ascribed to alcohol and drinking?  "Why" and more importantly, "how" does this meaning change with time...often in 2 to 3 semesters via the "maturing out" phenomenon?  If we better understood the social construction of use, we would be likely to incorporate this into prevention strategies...again, read my monographs.

•                Explore the "positive consequences" of abstinence and/or moderate use rather than the "negative consequences" of abuse.  We already know that students respond better to "positive" messages than to negative...and we know that "scare tactics" do not work.  How about investigating what students view as being the "pluses" of abstaining and moderating use rather than always hawking the negatives. 

•                "Bystander Behavior" - This comes in at least 2 forms: (1) "the silent majority," to quote Spiro Agnew, who say nothing when John Jones or Mary Brown act like a jerks at a drinking gathering, and (2) "most of us" when we fail to hold drinkers accountable for their irreverent, inappropriate, or otherwise untoward behavior because we "don't want to hurt his feelings" or "she'll get all Jersey Shore on me" if I say/do something.

We have learned much in the last 15 years regarding how to affect the campus drinking culture; this is very good news.  That said, we have a long way to go and, unfortunately, much of the interest and money that drove discoveries of the past 15 – 20 years has gone other places.  But just as we knew Pluto was there before we were able to "see it," so is it likely that "something else" is there as regards changing the campus drinking and drugging culture.

Solution-Focused counselors suggest asking individuals to consider a time "before" the problem existed or imagine "when" the problem no longer exists.  By doing this, they invite us to explore how we acted before the problem existed or consider what happened or was done to solve the problem in the future.  This becomes the focus of the practitioner's intervention...get us thinking about possible solutions rather than being preoccupied with the consequences of problems.  

We all know the old adage about the glass being half empty or half full.  There is another option, however, when looking at that glass, namely, that it is always "fully full."  Think about it…the glass is half full of water and half full of air!  We need to look at the "air in the glass" in order to appreciate that the glass is, indeed, always full.  So, when considering collegiate drinking, with what is the rest of that glass filled?

What do you think?

         When They Drink:Is Collegiate Drinking the Problem We Think It Is? (PDF)

         When They Drink:Deconstructing Collegiate Alcohol Use (PDF)

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