Models of Treatment and Education with DUI Offenders

1. Models of Treatment and Education with DUI Offenders Tom Wilson Counseling Center Boise, Idaho

2. 12 to 24 hours presented over several weeks Identifies goals as reducing risk for relapse and reducing risk for recidivism Intended for lower risk offenders Based on the following manualized curriculum: “Driving With Care: Alcohol, other Drugs, and Driving Safety Education, Level II Education” Kenneth W. Wanberg, Harvey B. Milkman and David S. Timken. Education Model

3. Education Approach • The education model uses a cognitive-behavioral model of behavior change to reduce the risk for relapse and recidivism • Assumes that most clients are in pre-contemplation stage, i.e., don’t really think they have a problem other than DUI

4. Motivation Techniques • Facilitator uses non-confrontational, Socratic questioning methods to “develop discrepancy” between client’s and society/groups’ view of problem • Motivational interviewing techniques used to facilitate change

5. Lesson Topics • LESSON 1: PROGRAM ORIENTATION: DEVELOPING A WORKING RELATIONSHIP • LESSON 2: ALCOHOL AND OTHER DRUG IMPAIRED DRIVING: THE LAWS AND BEYOND THE LAWS • LESSON 3: HOW OUR THINKING, ATTITUDES AND BELIEFS CONTROL OUR ACTIONS • LESSON 4: HOW BEHAVIOR IS LEARNED AND CHANGED: LEARNING SELF-CONTROL AND DRIVING WITH CARE

6. Lesson Topics • LESSON 5: ALCOHOL AND OTHER DRUGS: HOW DO THE FACTS AND IDEAS ABOUT ALCOHOL AND OTHER DRUG USE FIT YOU? • LESSON 6: ALCOHOL AND OTHER DRUG USE PATTERNS: HOW DO THEY FIT YOU? • LESSON 7: PROBLEM OUTCOMES OF ALCOHOL AND OTHER DRUG USE: PATTERNS OF MISUSE AND ABUSE: HOW DO THEY FIT YOU? • LESSON 8: PATHWAYS TO RELAPSE AND RECIDIVISM

7. Lesson Topics • LESSON 9: PROCESS AND STEPS TO PREVENTING RELAPSE AND RECIDIVISM • LESSON 10: PREVENTING RELAPSE AND RECIDIVISM: BUILDING PERSONAL VALUES AND PROSOCIAL ATTITUDES AND BEHAVIORS AND DRIVING WITH CARE • LESSON 11:PREVENTING RELAPSE AND RECIDIVISM: MANAGING STRESS AND EMOTIONS • LESSON 12: PREVENTING RELAPSE AND RECIDIVISM: BUILDING HEALTHY FAMILY AND SOCIAL RELATIONSHIPS

8. Sample Worksheet, Page 1 Your DWI Event: Describe and evaluate the specific circumstances surrounding your DWI arrest? Type of event? 1. Date of arrest 2. Time of arrest 3. Location of arrest 4. Persons you were with 5. Time took first drink 6. Total drinks or drug doses from first to arrest 7. Kind of alcohol 8. Where did most drinking take place 9. Blood alcohol level

9. Sample Worksheet, Cont’d 10. Events before started to drink: who with, where, what was happening, conflicts with people 11. Thoughts you remember before you started drinking 12. Events during drinking: who with, where, what was happening, conflicts with people 13. Feelings and emotions you remember before and after started drinking 14. How did you act when you were arrested?

10. Sample Worksheet, Cont’d 15. Where were you taken after your arrest? 16. How long did you stay where you were taken? 17. Who were among the first persons in your family that you spoke to after you were arrested? 18. What did they say and do? Write down their reaction. 19. What were your thoughts after you returned home? 20. What were your feelings after you returned home?

11. Therapy Program • Consists of 21, two-hour manual guided sessions and homework • Designed for clients who meet diagnostic criteria for alcohol abuse or dependence or who have a high BAC of .15 or greater • 2 or more DUIs • Has completed Level 2 Education • Requires active participation in a group process and increased accountability

12. Therapy Group Expectations • Complete all exercises and worksheets • Attend all sessions and pay all fees • Actively participate in group • Complete homework, thinking reports • Alcohol and Drug Free • Follow group rules and program policies

13. Therapy Session Topics SESSION 1: UNDERSTANDING AND ENGAGING THE CHANGE PROCESS SESSION 2: PROGRAM ORIENTATION II: TARGETS AND TOOLS FOR CHANGE SESSION 3: PATHWAYS TO AOD OUTCOMES AND ADDICTION SESSION 4: AOD PROBLEM OUTCOMES AND PATTERNS

14. Therapy Session Topics SESSION 5: MANAGING AOD CRAVINGS AND URGES SESSION 6: SKILLS IN COGNITIVE SELF-CONTROL: RECOGNIZING AND CHANGING NEGATIVE THOUGHTS SESSION 7: SKILLS IN COGNITIVE SELF-CONTROL: RECOGNIZING AND CHANGING ERRORS IN THINKING

15. Therapy Session Topics SESSION 8: SKILLS IN COGNITIVE SELF-CONTROL: MANAGING STRESS AND DEPRESSION SESSION 9: SKILLS IN COGNITIVE SELF-CONTROL: RECOGNIZING AND MANAGING ANGER SESSION 10: SOCIAL AND RELATIONSHIP SKILLS BUILDING: COMMUNICATION TOOLS AND SKILLS

16. Therapy Session Topics SESSION 11: SOCIAL AND RELATIONSHIP SKILLS BUILDING: STARTING A CONVERSATION SESSION 12: SOCIAL AND RELATIONSHIP SKILLS BUILDING: GIVING/RECEIVING POSITIVE REINFORCEMENT SESSION 13: SOCIAL AND RELATIONSHIP SKILLS BUILDING: LEARNING PROBLEM SOLVING SESSION 14: SOCIAL AND RELATIONSHIP SKILLS BUILDING: ASSERTIVENESS SKILLS

17. Therapy Session Topics SESSION 15: SOCIAL AND RELATIONSHIP SKILLS BUILDING: LEARNING AND PRACTICING REFUSAL SKILLS SESSION 16: SOCIAL AND RELATIONSHIP SKILLS BUILDING: DEVELOPING AND KEEPING INTIMATE AND CLOSE RELATIONSHIPS SESSION 17: STRENGTHENING RECIDIVISM AND RELAPSE PREVENTION SKILLS SESSION 18: RELAPSE AND RECIDIVISM PREVENTION: YOUR RELAPSE AND RECIDIVISM PREVENTION PLAN AND LIFESTYLE BALANCE

18. Therapy Session Topics SESSION 19: COMMUNITY RESPONSIBILITY SKILLS: STRENGTHENING CHARACTER AND PROSOCIAL VALUES AND BEHAVIOR SESSION 20: COMMUNITY RESPONSIBILITY SKILLS: UNDERSTANDING AND PRACTICING EMPATHY SESSION 21: COMMUNITY RESPONSIBILITY AND RELATIONSHIP SKILLS: RESOLVING CONFLICTS AND NEGOTIATION

19. Client Feedback • General client satisfaction rated as high • Clients liked structured format and task orientation • Clients liked facilitator’s non-confrontational style • Clients appreciated facilitator’s skill in managing disruptive group members • Clients identified with some of the group members • Client retention rate 90% (successfully completed program) • Did not like being forced into treatment • Did not like having to pay for treatment