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Program Profile: San Juan County (N.M.) DWI First Offenders Program

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on June 06, 2011

Program Summary

A program for offenders arrested for the first time for driving while intoxicated (DWI) that aims to reduce DWI rearrest rates. The program is rated Promising. The treatment group improved more than the participants in the control group did for all three measures of alcohol use (total consumption, drinking days, and average blood–alcohol content). However, the findings were not statistically significant for a reduction in DWI recidivism.

This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Description

Program Goals

The San Juan County DWI First Offender Program is designed to work with court-defined first-time offenders convicted of driving while intoxicated (DWI). The goal of the program is reduce DWI rearrest rates.

 

Target Population

The program is run by San Juan County, which is in northwestern New Mexico, and targets court-defined first-time DWI offenders. The participants come from rural and tribal settings.

 

Program Components

The program was introduced to counter high rates of alcohol-related motor vehicle crashes. First-time offenders are incarcerated in a minimum-security facility for 28 days. While incarcerated, program recipients receive a multicomponent treatment that is culturally appropriate (for example, Native Americans have access to a sweat lodge and talking circles). There are nine specific treatment components:

 

·         Alcohol use, abuse, and dependence

·         Health and nutrition

·         Psychological effects of alcohol abuse

·         Drinking-and-driving awareness

·         Stress management

·         Goal-setting for the immediate future

·         Family issues and alcohol

·         Domestic violence

·         HIV/AIDS prevention

 

There is a work release program for clients who are employed. Participants receive individual counseling, group programs, and postdischarge monitoring for 3 to 12 months. The postdischarge monitoring program includes personal action plan implementation, weekly monitor meetings, alcohol breath tests, Alcoholics Anonymous meetings attendance, job referrals, and vocational education.

 

Throughout the program, motivational interviewing techniques are used in client–counselor interactions. Motivational interviewing is a nondirective, client-centered counseling style that emphasizes nonconfrontational communications. Counselors are trained in motivational interviewing. This technique rests on several assumptions, including the following:

                         

·         Confrontational/negative messages are counterproductive to bringing about change

·         Most people move through a series of steps before they are ready to change

·         Change is internally motivated rather than externally imposed

·         Education/knowledge alone will not effect change

·         A key to motivating change is to reduce ambivalence

·         The individual can, in fact, make a change [Fleming 2002]

Evaluation Outcomes

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Study 1

Alcohol Use

Wood and colleagues (2007) found that for all three measures of alcohol use (total standard ethyl-alcohol consumption [SEC], drinking days, and average blood–alcohol content [BAC]) the treatment group improved more than the participants in the control group did. The effect size ranged from small to medium. For SECs, the treatment group improved by 110.3 drinks over the 90 days, compared with the control participants, who improved by 26.9 drinks over the 90 days. Drinking days declined by 3.3 for control participants but by 11.6 for treatment individuals. Control participants had a decline of .005 for average BAC, while treatment individuals showed a decline of .018.

 

Contrary to expectations, antisocial personality disorder (ASPD) participants showed greater improvement over time than non–ASPD participants. However, these changes were not statistically significant.

 

DWI Recidivism

The probability of ASPD participants in the treatment group being rearrested was only .56 as large as that for ASPD participants in the control group. While this finding is suggestive, it is not statistically significant. This finding also contrasts with the hazard ratio for non–ASPD participants, where the ratio was 1.19 compared with the controls. This effect was also statistically nonsignificant.

 

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Evaluation Methodology

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Study 1

Woodall and colleagues (2007) conducted a randomized trial to assess the effectiveness of San Juan County’s DWI incarceration and treatment program. More specifically, this study examined the role antisocial personality disorder (ASPD) played in the treatment program for first offenders convicted of DWI in a region with a predominantly American Indian population. It tested the reduction of drinking levels and DWI recidivism and also examined how responsive the ASPD participants were compared with non–ASPD participants and controls.

 

The sample consisted of 305 first-time DWI offenders who volunteered to participate in the study. Recruitment into the study ran from January 2000 to February 2003. The study population was 76.0 percent American Indian and 86.9 percent male. Fifty-two of the participants were diagnosed with ASPD. Participants were randomized to the treatment group (n=177) or the control group (n=128). An analysis of the comparability of the two groups found that the treatment group had more individuals with ASPD and individuals with significantly more severe histories of drinking and driving. The ASPD group had heavier drinking at baseline. The control group participants were incarcerated for 28 days (as were the treatment group), but they received none of the program treatment components. The control group was afforded work release when employed.

 

Assessment included a baseline assessment and assessments at 6, 12, and 24 months postdischarge. Self-report data on drinking and driving was collected; DWI rearrest data was available for 274 participants. The Diagnostic Interview Schedule was used to assess presence of alcohol dependence and ASPD. Form 90 was used to assess the primary drinking measures (standard ethyl-alcohol consumption [SEC] units, number of drinking days, and average blood–alcohol content [BAC]). The Drinker Inventory of Consequences collected data on problems related to alcohol use over a past period of time. Analyses controlled for the impact of missing data. Rearrest data was available for up to 5 years postdischarge for some participants.

 

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Cost

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There is no cost information available for this program.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Woodall, W. Gill, Harold D. Delaney, Stephen J. Kunitz, Verner S. Westerberg, and Hongwei Zhao. 2007. “A Randomized Trial of a DWI Intervention Program for First Offenders: Intervention Outcomes and Interactions with Antisocial Personality Disorder Among a Primarily American Indian Sample.” Alcoholism: Clinical and Experimental Research 31(6):974–87.
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Additional References

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These sources were used in the development of the program profile:

Fleming, Michael F. 2002. Clinical Protocols to Reduce High-Risk Drinking in College Students: The College Drinking Prevention Curriculum for Health Care Providers. Bethesda, Md.: National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.
http://www.collegedrinkingprevention.gov/NIAAACollegeMaterials/trainingmanual/contents.aspx

Kunitz, Stephen J., W. Gill Woodall, Hongwei Zhao, Denise R. Wheeler, Robert Lillis, and Everett Rogers. 2002. “Rearrest Rates After Incarceration for DWI: A Comparative Study in a Southwestern U.S. County.” American Journal of Public Health 92(11):1826–31. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)
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Related Practices

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Following are CrimeSolutions.gov-rated practices that are related to this program:

Motivational Interviewing for Substance Abuse
A client-centered, semidirective psychological treatment approach that concentrates on improving and strengthening individuals’ motivations to change. The practice is rated Effective. Individuals in the treatment groups significantly reduced their use of substances compared to those in the no-treatment control groups.

Evidence Ratings for Outcomes:
Effective - One Meta-Analysis Drugs & Substance Abuse - Multiple substances
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Program Snapshot

Age: 18+

Gender: Both

Race/Ethnicity: American Indians/Alaska Native, Hispanic, White

Geography: Rural, Tribal

Setting (Delivery): Correctional, Other Community Setting

Program Type: Alcohol and Drug Therapy/Treatment, Motivational Interviewing

Targeted Population: First Time Offenders, Alcohol and Other Drug (AOD) Offenders

Current Program Status: Active

Listed by Other Directories: Campbell Collaboration

Program Director:
San Juan County DWI Treatment Center
1006 Municipal Drive
Farmington NM 87401
Website

Researcher:
W. Gill Woodall
Center on Alcoholism, Substance Abuse, and Addictions, The University of New Mexico
2650 Yale SE
Albuquerque NM 87106
Fax: 505.925.2313
Email