A HARM REDUCTION APPROACH FOR REDUCING DWI RECIDIVISM

对酗酒者和吸毒者的研究表明，侧重于减少未来酒精/毒品消费的有害后果和增加客户改变动机的干预措施对治疗参与度和治疗结果具有积极影响。在本研究中，我们建议对酒后驾车犯罪者进行干预，包括在综合减少伤害方法的背景下使用激励性访谈策略，重点是减少未来与酒精和毒品使用相关的伤害，包括酒后驾车再犯。样本将包括1200名参与纽约州酒后驾车计划(DDP)的酒后驾车罪犯。所有受试者都将参加初步的全面评估。评估结束后，受试者将被随机分配到三种实验条件中的一种：仅提供信息(IO)、动机访谈反馈环节(MI)、动机访谈反馈环节以及专注于减少饮酒有害后果(MI)的六个治疗环节。评估一周后，IO组的个人将返回参加酒精信息会议，内容包括观看有关酒精广告对行为影响的录像带。患有心肌梗塞的患者将返回接受反馈会议，该会议将纳入旨在增加个人改变酒精使用的动机的激励性访谈原则。最后，处于心肌梗死状态的个人将返回接受反馈会议和为期六次的减少伤害干预。MI和MI干预设计成便于移植到其他治疗方案。这项建议的目的如下：1.评估实验条件对承诺和参与改变饮酒和吸毒行为的相对影响，对被判酒后驾车的违法者进行短期和长期随访。2.系统地评估实验条件对酒后驾车违法者酒精和毒品使用以及与物质相关问题的相对影响。3.评估实验条件是否与DWI累犯有关。综上所述，拟议的研究将为酒后驾车违法者提供重要的临床相关数据，以了解旨在增加客户改变饮酒行为的动机、减少客户退出治疗以及减少酒后驾车复发的简短减少伤害方法的有效性。

Research with alcoholics and drug abusers has demonstrated that interventions focused on reducing the harmful consequences of future alcohol/drug consumption and increasing client motivation for change have a positive impact on treatment engagement and treatment outcome. In the present study, we propose an intervention for DWI offenders that includes the use of motivational interviewing strategies within the context of a comprehensive harm reduction approach focusing on decreasing future harm related to alcohol and drug use, including DWI recidivism. The sample will consist of 1,200 convicted DWI offenders participating in the New York State Drinking Driver Program (DDP). All subjects will participate in an initial comprehensive assessment session. Following the assessment session, subjects will be randomly assigned to one of three experimental conditions: information only (IO), motivational interview feedback session (MI), motivational interview feedback session plus six-treatment sessions focused on reducing the harmful consequences of alcohol use (MI+). One-week after the assessment session, individuals in the IO group will return for an alcohol information session that will consist of viewing a videotape concerning the effects of alcohol advertising on behavior. Individuals in the MI condition will return for a feedback session that will incorporate principles of motivational interviewing designed to increase the individuals motivation to make a change in their use of alcohol. Finally, individuals in the MI+ condition will return for a feedback session and the six-session harm reduction intervention. The MI and MI + interventions are designed to be easily portable to other treatment protocols. Aims of the proposal are as follows: 1. To assess the relative effects of experimental conditions on commitment to and involvement in changing drinking and drug use behavior over short-term and long-term follow-ups for a sample of convicted DWI offenders. 2. To assess systematically the relative effects of experimental conditions on the alcohol and drug use, and substance-related problems of convicted DWI offenders. 3. To assess whether the experimental conditions are related to DWI recidivism. In summary, the proposed research will provide important clinically-relevant data for DWI offenders on the effectiveness of brief harm reduction approaches designed to increase client motivation for changing drinking behavior, reduce client dropout from treatment, and reduce DWI recidivism.