The last time you dialed a friend while driving you probably didn't think you were endangering those around you. However, several scientific studies and the state of New York beg to differ. The state recently made it illegal to use hand held cell phones while driving.

Oddly, drivers who use cell phones behave almost exactly as if they were impaired by alcohol or drugs. In fact, it's much more common these days to suffer the erratic driving of someone driving while yakking then driving while impaired. Cell phone users often speed through traffic weaving from one lane to the next, or drive too slowly in the fast lane. One study found that drivers using cell phones were four times as likely to get into an accident. I call these people "cell heads" or some other words that aren't appropriate for publication.

One of the causes of driver impairment from cell phones is the simple act of dialing the telephone. Our eyes are focused on what is happening inside the car and not on the traffic around them, and the surrounding traffic becomes peripheral. Initial attempts to solve this problem resulted in the proliferation of hands free devices. Unfortunately, this doesn't make things any safer, since it turns out that it's not only attentiveness but also focus that suffers from cell phone use while driving. Although a driver's eyes may be focused on the road their brain is elsewhere.

The same problem exists for counselors, especially those in a role where they must simultaneously collect information and assess a client's suitability for treatment, all while making sure to attend to their verbal and non-verbal cues. It isn't difficult to imagine the following scenario taking place:

Client: "... and then I lost my father in a horrible crash ..."

Counselor:  "... what's that you said? I was trying to spell your last name here on my computer screen."

The crux of the problem is this: How can a counselor collect all of the necessary information in an accurate and timely way while at the same time, providing the client with the attention and focus required to provide quality care? A counselor whose head is "in the screen" can't possibly provide the same quality of care as one who has the luxury of being an active listener. 

When the U.S. Air Force encountered a similar problem - one in which pilots were faced with the daunting challenge of operating a complicated machine while maintaining situational awareness of their surroundings - the agency began using a heads up display that projected instrument readings on a glass panel or canopy right in front of the pilot. This kept the pilot's head focused outside the cockpit, thereby resolving the problem of inattentiveness. 

Unfortunately, this type of heads up approach doesn't work as well in the counseling setting. Projecting information onto a sheet of glass suspended between the counselor and the client might be a little distracting. But the idea of getting the counselor's head up away from the computer screen seems worth exploring further. 

Technology has dramatically changed the practice of counseling but the biggest benefits remain to be seen. Collecting reams of information about a client might be helpful if that information can be collected in a way that doesn't hinder clinical practice and is used to bring the most effective care possible. 

As an employee of a software company this is one of my biggest concerns. One of the questions I frequently ask myself is, "How can we put the focus back on the client and away from the tool being used?"

Technology is nothing more than a tool. Ask a carpenter how much time he or she spends thinking about his or her tools and I suspect you would find that it's very little. They don't think about them they just use them. 

In order to become a tool that has the magnitude of usefulness as a hammer, computer software needs to conquer a couple of problems:

1. ‑Complexity - Present only the minimum amount of information needed to do the job.

2. ‑Data Entry - Make entering the data seem more like a natural part of human interaction and make it so easy to use that it doesn't take a great deal of time to learn.

3. ‑Focus - Make sure the information presented and the actions required by the user are highly intuitive.

4. ‑Reliability - Make the system so reliable and easy to use that it fades into the background.

For example, an application that assists a nurse in dispensing medication has to be drop-dead easy to use. There can't be too many things going on in that application because the nurse must be focused on the task at hand and not the software. There is no room for error in dispensing medication, so only the most basic information should be displayed and a minimum of user interaction should be required. 

A great deal of progress has been made in the structure of applications, reducing their complexity to make tasks more manageable, but no one has yet conquered the demands of data entry. The solution might involve some type of alternate device - maybe a keyboard that resembles what a stenographer would use, or something else yet to be developed. One approach involves the use of a stylus to write on a screen. A similar approach would be to use a special pen to write on an actual sheet of paper. It would be pretty ironic if the best method for data entry turned out to be the one which has existed for thousands of years. 

What are your ideas? Are their better ways to collect data and help the counselor to provide better care?

This article is published in Counselor,The Magazine for Addiction Professionals, December 2006, v.7, n.6, pp.56-57.

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