College Binge Drinking (Chickering and Fowler)

Sean is a student with a clear alcohol problem. He is a white, protestant, and 19 years old male sophomore. He was recently found unconscious in a parking lot; although found lying on the floor, he refused to go to the hospital. Since this is the second time he has required medical attention for alcohol use this semester, it is necessary to have a conversation with him as his Residence Hall Director.

College binge drinking has been an immense concern on campuses around the country. In their initial review of the literature, Skidmore and Murphy (2010) found that 84% of college students have reported at least one heavy drinking episode in the last year. The risks and consequences of binge drinking are enormous, ranging from blackouts, fights and assaults, to deaths, raps and injuries. Sean has been lucky so far, but he is approaching a dangerous limit.  He is very concerned about his parents knowing what is going on in his college life. He comes from a conservative and strict Christian family, so he may be struggling with his identity as a college student, as a Christian, and as a white male.

In order to clarify what is happening to him as a college student, we need to remember Chickering’s student development theory. According to Chickering’s theory (1999), there are seven vectors than can illustrate the way college affects students’ development in terms of identity. For Sean’s case, the most relevant vector is moving from autonomy to interdependence. An important part of this vector is the experience of separation from a support group, such as parents, church, peers, and teachers. Students have to accept voluntarily to displace the support group to attempt for his or her goals in life and express their own opinions. A student achieves independence once he or she is able to organize activities and learn how to solve problems on their own. Individuals also see growth in problem solving abilities, initiative, and self-direction.

From Checkering’s perspective, it is clear that to become autonomous is necessary to realize the interdependence of others, but both of them are crucial to promote student development. Sean may need to improve his autonomy in decision-making and initiative. He is growing as an independent adult, so he needs to face the consequences of his decisions. Religion identity may be the core concern for him, because college academics normally confront students with his previous beliefs and certitudes. In his way to developing growth, Sean may be trying to escape the anxiety of being independent by avoiding his responsibilities, and above all, avoiding a confrontation with his parents. Alcohol may be the best excuse to avoid commitment.

Sean is also struggling with his identity as a Christian. James Fowler is a psychologist from Emory University famous for his theory about the different faith phases humans transit in life. His theory is not related to age but to the different periods people transit in life. He describes five stages in his book Stages of faith: The psychology of human development and the quest for meaning (1995); in Sean’s case, he may be moving from phase two to phase three. Phase two is called mythical-literal faith. In this phase, Fowler, using Piaget ideas about acquired concrete operational thought, describes how students begin to distinguish between what real things are real and what is imaginary. During this phase, students incorporate into their lives the stories, beliefs and observances of the group to which they belong. This helps to raise linear, narrative construction of meaning and coherence. In order to find meaning, students in this stage are attached to stories, and they cannot disengage themselves from those stories to reflect and analyze. Stories heard in the immediate environment are so powerful that students in this phase base on them their understanding of self and universe. Another characteristic of this phase is a type of morality based on the perspective of others, and morality develops based upon reciprocal fairness and justice.

Following Piaget’s stages, Fowler describes the third stage as synthetic conventional. This stage follows Piaget’s formal operations thought. In this stage, students start examining their belief system and comparing contradictory stories. They discover themselves involved in different social circles and they feel the need to get a synthesis. From this moment on, students show the first evidence of spiritual identity and outlook. In general, students compare contradictory theories, but they don’t take an individual perspective; instead, they seek to conform to the group they belong to by placing authority in individuals or groups that represent the student’s beliefs. Sean seems to be between phases two and three.

Sean may need to move to phase four, but it is always a difficult passage. In the fourth stage, people start thinking outside their own religious system and discover that there are many religious systems. Critical thinking about their beliefs takes the place of conformity, and they normally feel ashamed of their previous beliefs.

Another factor that may be playing a major role in Sean’s case is the male culture related to alcohol drinking. According to Morgan (2002), a national study discovered that “students are most likely to drink if they are first-year students, males, whites, members of Greek societies, athletes, attending a college in the Northeast, or attending a college with prominent athletic teams.” The peer pressure is part of a culture that pervades college life. So Sean may be vulnerable to his peers’ influences. 

Binge drinking has been defined as the consumption of at least 5 drinks in a row for men or 4 drinks in a row for women. According to Wechler and Kuo (2002) two of five college students are binge drinkers. Researchers recommend college authorities to consider the student-body composition, as well as the value of diversity at the college, organizational, and dormitory levels to reduce their binge drinking problems. “Encouraging more older students to live on campus and in fraternity houses may be one practical application of these findings; another may be decreasing the heavy concentration of young, male, and White students in residential arrangements.” (Wechler and Kuo, 2002).

In the meeting with Sean, the previously mentioned three factors should be explored: his college student life, his Christian faith, and the male drinking culture related to peer pressure. These factors may be considered in the first place.

In order to explore the first factor, Sean’s college life, some of the open-ended questions I may use are: can you tell me about your life on campus? What extracurricular activities are you involved in? Do you feel integrated to campus life? What kind of activities do you do on your free time? What kind of friendships are you interested in?  I would try to be mindful of his answers to reflect and deepen in whatever topic Sean may raise.

The second factor, his Christian faith, may be a little difficult to face, especially if my relationship with his is superficial. However, a good set of questions would be:  What is the role of your faith/religion in your daily life? How do you feel about your parents knowing about what happened today? What are the contradictions you face between college life and your faith? When do you think you will be prepared to talk about what happened today with your parents? Are you struggling with any challenges related to your faith?

The third factor, the male drinking culture and the peer pressure, may be the most significant topic to talk about because it is directly related to the unconsciousness event. The next group of questions could be useful to engage Sean in the conversation: can you talk about what happened that day? Is there a pattern in the way you drink? Are there any other areas of your life affected by the way you drink, like academics, health, relationships, etc? Can you talk about times when you have had fun without alcohol? Tell me about the people you drink with, how are your relationships with them?

According to Clara Hill (2010), to make decisions about how to intervene in the insight stage it is necessary to have an idea about what is going on in a deeper level in the student life. This translates into the ability of the helper to interpret of the student’s reaction, and what is behind the exterior appearances. To do this, helpers make use of their perceptions and intuitions, using themselves as barometers of what is going on. The goal of this is to foster awareness and facilitate insight in the student. Conceptualizing about the student situation is a helpful tool for further probing in the insight stage. Thus, by hypothesizing about the student’s problems, the helper is able to decide what deserves deeper exploration; it is a way to keep a clear focus and intention during the session. The different theories explained before are the background that can serve as support for the hypothesis.

Sean is having a crisis due to the way he is drinking. The most important question now is if he is willing to change that behavior, but what causes people to change behaviors? One of the clearest learning outcomes from this class has been the power of the three stages model as a tool to facilitate personal awareness and help students take decisions. Prochaska, Norcross and DiClemenete (1992), developed a construct of stages of change called Stages of Readiness for Change. They characterize this model more as a spiral model as opposed to linear. Readiness refers to the inclination or willingness to change some unhealthy or addictive conduct. Their theory describes the different stages of change starting with precontemplation, a stage where the individual is not aware of anything wrong with his or her behavior. However, people around him notice the problem and make pressure on them to get help. The second stage is contemplation; in this stage, individuals recognize their behavior as a problem and may start thinking about how to change in the future. The problem with contemplator is that they can remain as contemplators for long periods of time without taking any significant action to change. Preparation is the third stage; in this stage, individuals combine intentions with behavioral conditions. Small changes take part of their daily routines, but they refuse to stop their addictive behavior effectively. The next stage is action; in this stage, individuals take concrete steps to change by modifying their behavior, experiences or environment. A person can be considered in the action stage if he or she has successfully altered the addictive behavior for more than one day up to six months. Maintenance is the last stage. In this stage, individuals work to prevent reversion and strengthen the gains reached during the action stage. It extends from six months to an indeterminate period of time.

In Sean’s case, the most likely stage he may be in is precontemplation. Sean may be in denial of a drinking addiction, and he is obviously not aware of the risks related to his condition. As a good precontemplator, Sean is oblivious of the consequences that this problem can cause him. He thinks he can handle the situation, and most likely he may be reacting as a rebellious precontemplator, a type of individual who is prideful of taking his or her own decisions, and they are reluctant of being told what to do.

            As Sean’s helper, the best outcome to pursue during the sessions would be to make him aware of his alcohol addiction problem, and work on helping him raise self-motivation to recognize the need for change, seek treatment, and achieve successful change. After the some general exploration, the aim should focus on Sean’s considerations, commitments, reasons and intentions that lie behind his drinking behavior. To achieve this, the cognitive therapy may be very effective. We can use either Ellis’ or Beck’s approach (Hill, 2010). For Ellis, the best way to do this is by using persuasion and challenges.  Some of the questions the helper may use are: what are you telling yourself when you are drinking? What are you telling yourself that is keeping you from facing your parents? The goal should be to recognize any faulty or irrational thinking related to the behavior we are targeting. On the other hand, Beck approach uses collaboration with the helpee by pointing out cognitive themes and underlying assumptions that work against students.

            Another factor to be considered in Sean’s case is the ethical dimension of the helper-helpee interaction. Two main concerns may rise in this particular situation. The first one is recognizing limits. Almost all the ethical codes of many organizations use beneficence as a general principle in the helping process. This principle states that helpers should be committed to the growth and development of their clients. In Sean’s case, if, in the process of helping him, I discover a deeper issue like depression or an out-of-control addiction; my ethical response should be to recognize I have no training for those types of problems. The appropriate, ethical response in this case would be to refer Sean to the competent office or counselor.

            The second concern has to do with confidentiality, which means to respect a student trust by not divulging information shared in the helping session, although there are some circumstances when this is allowed. In college environments, this can be a difficult job, especially when helpers and helpees interact outside the sessions on a daily basis, but we have to remember that the success of the helping relationship is based on the confidentiality. However, if the student reveals that he or she intends to do harm to self or other, I have the ethical and legal obligation to report this threat to the appropriate authorities. If Sean expresses intentions of harming his own life, it would be necessary to report this to the authorities on campus.

            Boston College offers many resources for student life. In case that Sean is having a real addiction or depression problem, it would be necessary to send him to the office of Counseling Services. This office “addresses the mental health needs of the Boston College community by working with students in counseling or psychotherapy and by working with faculty and administrators on problem solving and policy decision making” (BC Webpage, 2011). A second option would be to send Sean to the office of Health Promotion. This office deals with “the health needs of students by offering programs and services that foster the health and well-being of students and campus community” (BC Webpage, 2011).  This office holds the Office for Alcohol and Drug Education, an invaluable resource for Sean. The last possible referral would be the Student Programs office. This referral depends on Sean’s adaptation to college life. In case Sean is disconnected to student activities it would be a good idea to send him with the objective of finding a right and interesting activity as an alternative for drinking. This office “is committed to providing opportunities for students to integrate the intellectual, social, and spiritual aspects of their collegiate experience, and to develop men and women for others. They provide programming advisement and facilitate the planning of educational, cultural, and social programs by approximately 125 registered student organizations on campus” (BC Webpage, 2011).

Boston College Webpage, Division of Student Affairs Resources - ODSD - Boston College. (n.d.). Retrieved on Nov. 3, 2011 from http://www.bc.edu/offices/odsd/studentaffairs.html

Fowler, J. W. (1995). Stages of faith: The psychology of human development and the quest for meaning. San Francisco: HarperSanFrancisco.

Hill, C. E. (2010). Helping skills: Facilitating exploration, insight, and action. Washington: American Psychological Association.

Morgan, R. (2002) Report on Alcohol Use Criticizes 'Culture of Drinking' on Campuses. The Chronicle of Higher Ed. Retrieved on Nov. 5 2011 from: http://chronicle.com/article/Report-on-Alcohol-Use-Criti/115716/

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102-1114. doi:10.1037/0003-066X.47.9.1102

Perry, W. G. J. (1999). Forms of Intellectual and Ethical Development in the College Years: A Scheme. Jossey-Bass Higher and Adult Education Series: San Francisco.

Skidmore, J. R. and Murphy, J G. (2011) The effect of drink price and next-day responsibilities on college student drinking: A behavioral economic analysis. Psychology of Addictive Behaviors, Vol 25(1), 57-68. doi: 10.1037/a0021118

Wechsler, H, and Kuo M Watering Down the Drinks: The Moderating Effect of College Demographics on Alcohol Use of High-Risk Groups. American Journal of Public Health, Vol 93, No. 11. Retrieved on Nov. 3, 2011 from:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448078/pdf/0931929.pdf