A HARM REDUCTION APPROACH FOR REDUCING DWI RECIDIVISM

对酗酒者和药物滥用者的研究表明，干预措施侧重于减少未来酒精/药物消费的有害后果和增加客户改变的动机，对治疗参与和治疗结果产生积极影响。在本研究中，我们提出了一种针对酒后驾车违法者的干预措施，包括在综合减少伤害方法的背景下使用动机性访谈策略，重点是减少与酒精和药物使用相关的未来伤害，包括酒后驾车累犯。样本将包括1200名参加纽约州酒驾计划（DDP）的酒驾罪犯。所有受试者将参加初步的综合评估。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（MI）、动机访谈反馈（MI+）以及六个以减少酒精使用有害后果为重点的治疗阶段。评估后一周，IO组的人将返回参加酒精信息会议，该会议将包括观看关于酒精广告对行为影响的录像带。患有精神分裂症的个体将返回进行反馈会议，该会议将纳入动机性访谈的原则，旨在增加个体改变其饮酒习惯的动机。最后，MI+状态的个体将返回进行反馈会议和六次减少伤害干预。MI和MI +干预措施的设计便于移植到其他治疗方案中。提案的目的如下：通过短期和长期的跟踪调查，评估实验条件对酒后驾车罪犯改变饮酒和吸毒行为的承诺和参与的相对影响。2. 系统地评估实验条件对酒后驾车罪犯的酒精和药物使用以及物质相关问题的相对影响。3. 评估实验条件是否与酒后驾车累犯有关。总之，该研究将为酒后驾车罪犯提供重要的临床相关数据，说明旨在提高客户改变饮酒行为的动机、减少客户退出治疗和减少酒后驾车再犯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.