The health educator often walks a tightrope trying to balance her role as educator, nurturer, and professional. When I started working with adults, I began to examine the role of the adult basic education teacher in helping students handle addictions that might affect them or family members.

Thelma Barer-Stein and Carmen Connolly have developed a five-step learning process for adults (Barer-Stein and Connolly, in Barer-Stein and Draper, 1993). I have found the process useful as a structure in developing a curriculum about alcoholism. I have gained my insight about teaching students with addictions through direct experience. I worked as a coordinator of a young parents program for over 10 years and often had to help the teen moms deal with addictions -- their own or those of their partners or parents. The teens were usually reluctant to handle the problem or they were in denial about it. When I started working in ABE with adults who were so motivated about the academic side of their lives, I began to do more research on alcoholism and to think about a process for helping someone handle alcohol-related problems.

Step 1: Being Aware
In our health conscious society, we are bombarded with messages to "Just say no." Kids bring home information from school from anti-drug programs like DARE. These messages may help us develop awareness of health problems, but it is only when these messages jog something in our comfort zone that the information becomes relevant and motivates us to learn more. At this stage of teaching, health educators might begin by presenting physical evidence of substance abuse through a biology lesson. Examining the function of the liver, for example, could lead to a discussion of cirrhosis and suppression of the immune system. Students are safely distanced emotionally by a biology lesson.

Step 2: Observing
The health educator at this stage wants to keep the learner comfortable enough to progress further. This might be the time for the teacher to present more statistics that lead to further discussions. In an advanced ESOL class, for example, a lively discussion about alcohol in foreign countries ensued after an explanation about Mothers against Drunk Driving (MADD) and Students Against Destructive Decisions (SADD). GED students can research and write an essay on the effects of alcohol and drug consumption on the unborn child. Teachers can seek out informative videos on the dangers of drinking and driving if they want to discuss these topics.

Step 3: Shall I Try It Out?
At this stage, the learner either claims ownership of the subject or declines that ownership. This is where the health educator's role becomes less teaching-oriented and more "responsive, supportive, and interacting" (Barer-Stein and Draper, p. 94). This is where a learner who has a problem with alcohol himself or experiences it in his family must make a decision to deal with this new knowledge in a personal, positive way. He may also remain in denial but still see the problem in the abstract. The student who doesn't have a problem with alcohol can move forward by using the stimulating data, discussions, and videos from previous classes to research information on the Internet. The person with problems relating to alcohol who does not disclose problems may either cover up the problems and join the group or may be unable to continue.

Step 4: Confronting
At this stage students can perceive the risks and be ready to face the challenges of dealing with such addictions. Those with problems might take a much longer time to internalize the issues or might never leave stage three. At stage four, students are ready for discussions on heavier topics that lead to complex discussions. For example, how do you handle a coworker who creates more work for you while trying to hide his alcohol problem? How does alcohol consumption by parents affect the lives of children? Should package stores and pubs be less visible in a community? What do you think about parents who let their teens have drinking parties at home?

Step Five: Reflective Internalizing
Reflective internalizing involves deliberate effort and commitment to change. This stage can occur after a person confronts a problem, contradiction, or decision suddenly, but sees the problem as a challenge rather than an obstacle. Not all students reach this step when the topic under discussion is alcohol education. That's okay. The role of the health educator is to impart information in a comfortable, nurturing environment and make the students realize that they are ultimately responsible for the care of their own bodies and commitment to their own health and that of their families.

Student Disclosure
What does a health educator do when a student discloses that he, or a family member, has problems with alcohol, and as a result of what he's learned in ABE class about the topic, is now ready to deal with those problems? The student has obviously made a decision of great personal importance, but most ABE health educators aren't equipped to handle something like this alone. When a health educator introduces potentially difficult subjects in the classroom, she needs strategies for dealing with student responses.

• Be prepared for disclosure. When you present information on sensitive subjects, it may initiate soul searching and start to make students see themselves or family members in more realistic ways. They feel comfortable with you. Be prepared to have long honest conversations about the possibility of alcohol-related physical and emotional abuse in the home, work-related problems, relationship problems with other family members. If you don't know the answer to questions they ask, try to find out by checking with health professionals or by doing research.

• Know the names of appropriate counselors in the community you can refer students to. If necessary, try to find a counselor that speaks the same native language as your student.

• Tell students about Alcoholics Anonymous (AA) and any other support groups in your area. Often students from other countries are unaware of what's available locally and they don't realize that it's often free.

Notes:
Barer-Stein, T. and Draper, J. (1993). The Craft of Teaching Adults. Malabar, FL: Krieger.

Videos on alcohol abuse:
Drunk and Deadly: A Day on America's Highways (1987). Produced by Niemack Hassett Productions, Pyramid Media www.pyramidmedia.com

For other videos on drunk driving, like Fatal Vision and Under the Influence: Kids, Ads and Alcohol, check with your local police station for lending copies.

Beverly Hobbs works as assistant to the ABE director at Mount Wachusett Community College in Gardner, Massachusetts. She can be reached by e-mail at b_hobbs@mwcc.edu