Models of Treatment with DUI Offenders

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Transcript Models of Treatment with DUI Offenders

Models of Treatment and
Education with DUI Offenders
Tom Wilson Counseling Center
Boise, Idaho
Education Model
• 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 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
Motivation Techniques
• Facilitator uses nonconfrontational, Socratic
questioning methods to
“develop discrepancy” between
client’s and society/groups’
view of problem
• Motivational interviewing
techniques used to facilitate
change
Lesson Topics
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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
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
Lesson Topics
•
LESSON 9: PROCESS AND STEPS TO
PREVENTING RELAPSE AND
RECIDIVISM
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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
Sample Worksheet, Page 1
Your DWI Event: Describe and evaluate the specific circumstances surrounding
your DWI arrest? Type of event?
1.
2.
3.
4.
5.
6.
7.
8.
9.
Date of arrest
Time of arrest
Location of arrest
Persons you were with
Time took first drink
Total drinks or drug doses from first to arrest
Kind of alcohol
Where did most drinking take place
Blood alcohol level
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?
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?
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
Therapy Group Expectations
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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
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
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
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
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
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
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
Client Feedback
•
General client satisfaction rated as high
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Clients liked structured format and task
orientation
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Clients liked facilitator’s non-confrontational
style
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Clients appreciated facilitator’s skill in managing
disruptive group members
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Clients identified with some of the group members
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Client retention rate 90% (successfully completed
program)
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Did not like being forced into treatment
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Did not like having to pay for treatment