Working with college students can be a daunting task. They are considered adults legally, but exhibit mostly adolescent behaviors and emotions. They act as if they have all the answers, yet tend to make very poor decisions and have an almost fantasy-like view of the world. They turn red in the face, stomp their feet, and clench their fists while demanding to be treated like adults. And then there are the ones who abuse substances!
According to research conducted by Henry Wechsler, PhD, of the Harvard School of Public Health, an estimated 31% of college students meet DSM-IV criteria for an alcohol abuse diagnosis and 6% for alcohol dependence. These data have huge implications for those in the substance abuse treatment field, as the sheer number of students who need services is staggering.
College counseling centers are overworked and understaffed. The decision makers on college campuses usually have no idea how expansive the substance use problem is in the student body, and have a difficult time directing funds to meet the needs of today's student in crisis. This is why partnerships between addiction treatment professionals and college personnel are so important. But there's a catch.
Treatment and higher education professionals seem to speak different languages, which is why treatment professionals find it so difficult to get in the door of the local college or university. Treatment professionals see themselves as a potential ally, but the university sees them as a threat. One of the reasons is that universities today are very concerned with retention. Look at the agenda for any higher education conference and you will find the word “retention” in the titles or abstracts of many sessions and workshops. Colleges are afraid to let a student go to treatment or see an “outside” therapist for fear that they will never see that student again—and this very well may be true.
Learn the culture
So how can the wall between treatment and higher education get taken down? One way is for the treatment professional to speak the language of academia. Talk about research and statistics. Know about the Harvard studies and CORE Institute (Southern Illinois University) data. Find out what the specific needs are on campus and how extensive the college's alcohol and other drug (AOD) and health promotion efforts are.
Here are some questions to investigate. Does the college have a “social norms” campaign or does it use a “harm reduction” model? Is it employing an “environmental change” approach or using Motivational Interviewing? Has the college been listed as a “top 10 party school” (an embarrassment for administrators)? Search the institution's Web site to get an idea of the campus “personality.”
Many colleges and universities are reactive rather than proactive in their approach to AOD-related issues. When a student death occurs and receives national attention, the school responds—and usually not very well. Colleges tend to be punitive in their response rather than supportive, with sanctions tending toward the severe rather than the educational.
Universities are tricky places to navigate. Allies can come from many different offices. The main offices to look into are counseling, health promotion, health education, the health center, AOD services, or even student development. The larger the university, the more options the professional will have here. Some smaller colleges might have only a nurse who handles substance abuse issues, or possibly only one counselor on a campus of 2,500 students. The smaller schools probably will be more open to the outside treatment professional than the larger ones will be.
The HERO House Here's an example of a possible scenario that could work in a larger institution. You find out that the major state university in your area has an office for substance abuse counseling, with three full-time counselors and two interns. You write and call numerous times and receive no response. Then you find out that the school has a health promotion office. You write to the coordinator of health promotion and she writes back within 10 minutes and says she would like to meet with you. At the meeting, you find out what the school's needs are, and you tell them about yourself and what you can offer. She tells you that a friend of hers works in substance abuse services, and she introduces you to the assistant director of substance abuse services. You put your card in the assistant director's hand, offering to take the person to lunch and possibly do a free in-service training for staff. You are now in the door.
More and more campuses are seeing the need for outside help in addressing students who have substance abuse problems. This is good news for all of us, but there is still one piece missing: where students should go when they finish treatment or get sober through counseling.