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Section 1

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In this section, we will discuss self monitoring.  The three steps to self monitoring are to focus on ounces and percentage of alcohol, when and where alcohol is consumed, and self monitoring around others.

As you listen to how Greg used the techniques in this section for his self monitoring, consider how your client can implement similar strategies.  Could playing this section for your client at your next session help initiate a productive use of tools for moderation

Greg, age 32, had recently gotten married.  He and his wife planned to start a family.  Greg felt that the frequency with which he consumed alcohol would not be appropriate for his role as a father.  Greg stated, "Now that I’m married, I guess I need to settle down some.  I’ll have to do things differently, but I don’t want to give up the good times." 

The first tool for moderation that Greg used was self monitoring.  There were three general steps that Greg used to implement a self monitoring technique.  The three steps to Greg’s successful self monitoring were to focus on ounces and percentage of alcohol, when and where alcohol is consumed, and self monitoring around others. 

♦ #1  Ounces and Percentage of Alcohol
First, let’s discuss focusing on ounces and percentage of alcohol.  I explained to Greg that to use self monitoring effectively, he could begin to keep good records of his alcohol use.  Greg monitored two aspects of his drinks to begin this self monitoring technique.  The first aspect was the ounces of alcohol in each of his drinks. 

I stated, "When you are drinking from a commercial can or bottle, the number of ounces is usually indicated on the label.  However, it becomes a little trickier when alcohol is poured into a glass."  Greg replied, "I like mixers and cocktails, so how do I keep track of the ounces in those drinks?"  I explained that Greg could fill his usual drinking glasses, minus the ice, and pour the contents into a measuring cup.  Greg mentioned that he sometimes enjoys drinking at a bar.  I stated, "Your bartender will know how much alcohol your drink contains." 

Greg then expressed concern that he might feel self-conscious asking the bartender to measure each of his drinks.  Greg asked, "What’s everyone else going to think if I’m sitting there asking, ‘How much alcohol is in this or that?’" 

I explained to Greg some low key ways he could ask the bartender about the measurement of his drinks.  For example, Greg could say, "I’m driving- could you tell me how much alcohol is in this margarita?"  As you probably know, most bartenders are concerned with the safety of their customers and will be glad to provide accurate information.

The second aspect of Greg’s self monitoring technique was to become aware and keep track of the percentage of alcohol each drink contained.  Greg used the same techniques for gathering information regarding alcohol percentage as he did for tracking the ounces of his beverages.  Greg stated, "Tracking alcohol percentage is pretty easy.  It’s usually on the label.  If it’s not, wine is about 9 to 14%.  Beer is between 4 and 6%.  The hard stuff is usually 40 to 50%." 

After Greg and I reviewed the self monitoring technique of tracking ounces and percentage of alcohol, Greg implemented the technique.  At our next session, I found that Greg’s records indicated that he had consumed a six-pack of beer, a pint of vodka, five whiskey sours, and a liter of wine in one evening.  I as Greg if he felt he was drinking too much

Greg stated, "I know.  I probably am and I’m writing it all down the next morning. So I probably did not remember everything."  Since Greg was confident this method would work.  I stated, "Consider breaking it up into one drink units, and remember to write it down just before you start each drink.  Also, remember to be specific about each drink in ounces and alcohol percentage."

♦ #2  When and Where Alcohol is Consumed
The second step Greg used to implement the self monitoring technique was to track when and where he consumed alcohol.  Clearly, tracking when and where alcohol is consumed included the date, time and location. 

However Greg found it challenging to keep track of this information while drinking.  I explained to Greg that each step in the self monitoring technique was important to getting a handle on his drinking.  I shared with Greg the following motivating reminders that other clients had found useful.  As you listen to these reminders that other clients found useful to maintain good self monitoring habits, consider your client. 

Could one of these work for your Greg?

1. Make it a rule never to take a drink before recording it, and think of your first sip as a reward for writing it down.
2. Figure out a good reminder for yourself, something you will see just before you drink that will remind you to keep records.  Greg kept a small stone in his pocket because, he said, it reminded him that he needed to be as solid as a rock for his new family.
3. Each time you write down a drink, before starting it, congratulate yourself for keeping track.  Greg thought to himself, ‘Way to go!  I’m really sticking to the program.’
4. Involve other people in your record keeping.  Greg usually drank in the company of his wife.  She helped him remember to write down his drinks and encouraged him along the way.

♦ #3  Self Monitoring Around Others
In addition to ounces and percentage of alcohol and when and where alcohol is consumed, the third step Greg used to self monitor was self monitoring around others.  Greg expressed concern regarding how those around him might react to his record keeping. 

I explained to Greg, clients generally find self monitoring is even less noticeable if records are kept in a small notebook, a check book or a personal digital assistant like a Palm Pilot.  After hearing this, Greg still had his doubts.  Greg stated, "Ok, whatever.  But what do I say if somebody does notice and asks me what I’m doing?" 

Clearly, there are no answers that work for all clients, but I shared with Greg some replies that he might find useful, such as:

  • "I’m trying to cut down, so I’m keeping track of my drinks."
  • "I’m on a diet, so I’m keeping track of calories."
  • "I’m keeping track of expenses."
  • "It’s something I’m doing for myself."
  • "It’s for a class I’m taking."
  • "I’m taking notes for the FBI."

Consider your client.  Would he or she feel more comfortable fielding questions regarding self monitoring if he or she had some creative responses?

Another alternative I explained to Greg was to be subtle.  I stated, "Excuse yourself to the rest room, or make a call to keep your records in private.  Leave the table and go to the bar to make notes.  Or make notes on your bill, bar tab, or charge slip."

Which method for effectively self monitoring around others might benefit your client?  Would playing this section be a helpful therapeutic introduction to self monitoring?

In this section, we have discussed self monitoring.  The three steps to self monitoring are to focus on ounces and percentage of alcohol, when and where alcohol is consumed, and self monitoring around others. 

In the next section, we will discuss the moderation tool of slowing down.  Three aspects of slowing down are types of drinks, making it last, and spacing drinks.

Peer-Reviewed Journal Article References:
Simpson, T. L., Stappenbeck, C. A., Varra, A. A., Moore, S. A., & Kaysen, D. (2012). Symptoms of posttraumatic stress predict craving among alcohol treatment seekers: Results of a daily monitoring study. Psychology of Addictive Behaviors, 26(4), 724–733.

Tucker, J. A., Foushee, H. R., & Black, B. C. (2008). Behavioral economic analysis of natural resolution of drinking problems using IVR self-monitoring. Experimental and Clinical Psychopharmacology, 16(4), 332–340.

Wolfe, R., Lennox, R., & Hudiburg, R. (1983). Self-monitoring and sex as moderator variables in the statistical explanation of self-reported marijuana and alcohol use. Journal of Personality and Social Psychology, 44(5), 1069–1074. 

What are three steps to the self monitoring technique?
To select and enter your answer go to Test.

Section 2
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