Key Findings and Recommendations

In addition to providing a contemporary source of information on procedures and programs for dealing with DWI offenders in Canada, it was also the purpose of this report to suggest ways to enhance the efficacy of efforts targeted at the DWI offender by identifying: (1) gaps in existing procedures and programs as well as key issues that need to be explored in greater detail: (2) critical research needs that, if addressed, would enhance our understanding of the DWI offender; and, (3) promising programs that could be evaluated for the purposes of determining their effectiveness and appropriateness to serve as models for others to use.

This section discusses these issues in three subsections -- the first examines gaps and key issues in procedures and programs; the second identifies research needs; and the third examines issues related to evaluation.

6.1 Gaps and Key Issues in Procedures and Programs

In the course of compiling information for this project, several information gaps concerning current systems and programs became apparent which, if filled, could improve the overall efficiency and effectiveness of procedures and programs for DWI offenders. Several key issues also arose that present problems for the efficient operation of procedures and delivery of programs. This section discusses these gaps and key issues and recommends a course of action that can be taken.

Cooperation among agencies. In most jurisdictions, numerous different government departments or agencies are responsible for, or come into contact with, DWI offenders. For example, the police, justice, transportation, licensing, health and corrections typically have some responsibility for impaired drivers. In many respects, the involvement of so many departments reflects the multidimensional nature of the problem. Unfortunately, there is often either a lack of, or an inefficient system for, communication and coordination among the various departments. This results in some agencies being unaware of what others are doing and how the various programs and procedures fit together. Where there are gaps in the coordination of programs and activities of different agencies, there is the potential for offenders to slip through the cracks and effectively by-pass various aspects of intended procedures and programs. It is, therefore, recommended that:

• jurisdictions with an existing interagency committee on impaired driving coordinate the activities of the various departments and serve as a liaison between them; and
• jurisdictions without an active interagency committee pursue the formation of one

Access to programs. In some jurisdictions, there are either no rehabilitation programs presently available or there is limited access to those that are offered. For example, neither Newfoundland nor British Columbia presently have rehabilitation programs for DWI offenders. Both jurisdictions, however, are considering the implementation of programs. In Ontario, there exists a scattered array of educational programs available only in selected communities. These programs vary in style, format, and approach with little consistency among them. Access is most generally through judicial order and the number of offenders attending such programs represents a small proportion of the overall number of offenders in the province each year. A more efficient approach involves requiring attendance as a condition of licence reinstatement.

It is, therefore, recommended that:

• jurisdictions that do not presently have DWI offender rehabilitation programs widely available undertake the development of a standard program with a detailed curriculum so that the same program can be delivered consistently in all regions of the jurisdiction; and,
• to ensure that all offenders have equal access to the program, attendance be made an administrative requirement of licence reinstatement.

Matching offenders with programs. One of the problems of rehabilitation programs for DWI offenders that has been repeatedly identified is the heterogeneity of offenders who attend. Some offenders are simply not suited to attend certain programs and are unlikely to derive significant benefit from it. For example, offenders who are dependent on alcohol are unlikely to benefit from an educational program and would more appropriately be directed to a treatment program. The efficiency and effectiveness of programs would be greatly enhanced by ensuring that programs were attended only by those offenders who were most likely to benefit from them -- i.e., matching offenders to programs.

The key element in matching offenders to programs is the systematic assessment or screening of all DWI offenders. At the very least, this assessment would determine the level or extent of alcohol abuse. The results of the assessment would be used to determine the most appropriate remedial/rehabilitation program for the individual.

It is strongly recommended that:

• jurisdictions implement a system of assessment/screening for all convicted DWI offenders and that the results of the assessment be used as a basis for directing offenders to the appropriate rehabilitation programs.

Monitoring and follow-up. From the review of offender programs, it is apparent that routine monitoring and follow-up of offenders is rare. Once offenders have completed a program or are given treatment recommendations they are typically on their own. Only a portion of all offenders will act on the recommendations and actually enter the recommended treatment program. Others may initiate treatment but fail to complete it.

Once offenders have completed a given program, periodic follow-up can be used to facilitate compliance with treatment recommendations. Indeed, a recent study has demonstrated that routine monitoring and follow-up of DWI offenders is an effective approach to prevent recidivism among both first and repeat offenders (e.g., Voas and Tippetts, 1990).

It is, therefore, recommended that:

• jurisdictions implement a system of routine monitoring and follow-up of DWI offenders to enhance compliance with treatment recommendations and the overall effectiveness of programs.

Roadside Suspensions. Most provinces and territories have legislation that allows a police officer to suspend at roadside the licence of any driver found to have a BAC above some minimal value (usually 50 mg%) but below the level specified in the Criminal Code (i.e., 80 mg%). This legislation provides for swift and certain action to be taken against the marginally impaired driver to remove them from the road before they become involved in an alcohol-related crash. Such suspensions result in no further sanctions and no action is taken for repeated suspensions.

The efficiency of issuing roadside suspensions has undoubtedly contributed to the widespread use of the procedure across Canada. There is, however, little information available concerning the effectiveness of roadside suspensions in preventing subsequent incidents of impaired driving or alcohol-related crashes. To a large extent, the lack of information about roadside suspensions stems from the fact that few jurisdictions make note of such suspensions on the driver’s record. Keeping a record of such suspensions would allow for the possibility of addressing many as yet unanswered questions about the use and effectiveness of roadside suspensions.

It has also been reported that in some cases police officers are issuing roadside suspensions to drivers in lieu of laying charges for impaired driving under the Criminal Code (Moyer, 1991). Taking this action has the effect of immediately removing the drinking driver from the road but also saves the police officer several hours processing an impaired driving charge. The apparent efficiency of this approach, however, has unknown longer term consequences in preventing subsequent instances of impaired driving.

It is, therefore, recommended that:

• a record of all roadside suspensions issued to a driver be made on the driver licence file; and,
• the practice of issuing roadside suspensions to drivers who could possibly be charged with impaired driving under the Criminal Code should be thoroughly investigated to determine the circumstances under which it occurs, the reasons for the practice, and the implications of doing so.

6.2 Information and Research Needs

It is essential that the development and implementation of effective programs for offenders be based on the best available information. Although , the amount of information on offenders has proliferated rapidly over the past several years, there remain many unanswered questions that, if addressed, would be of great utility in developing and refining programs and procedures for dealing with DWI offenders. Some of the areas in need of further study are outlined below.

Prediction of potential repeat offenders. The incidence of recidivism has been increasing and, in some jurisdictions, as many as 60% of offenders have been previously convicted of impaired driving. For the majority of offenders, the sanctions imposed and programs completed for the previous offence were ineffective in preventing subsequent convictions. The efficiency and effectiveness of rehabilitation programs could be significantly enhanced if it were possible, at the time of the first conviction, to identify offenders most likely to repeat the offence. Rehabilitation programs could then be tailored specifically to, and utilized exclusively by, this high risk group of offenders.

It is recommended that:

• a longitudinal prospective study of first-time DWI offenders be undertaken to identify the characteristics of those most likely to repeat the offence.

Who benefits from which programs? Where more than one rehabilitation option exists, program assignments are often based on either: (1) the number of convictions without consideration of the characteristics or needs of the offender -- i.e., first offenders are required to attend one program and second offenders are required to attend another; or (2) the results of an assessment process. While this latter approach appears to provide a more rational basis for assignment to programs, decisions are often based largely on intuition and clinical judgment and not on empirical evidence of which types of individuals are most likely to benefit from which programs.

The efficacy and efficiency of rehabilitation programs could be greatly enhanced if it were known which types of individuals were most likely to derive the greatest benefit from which types of programs. It is, therefore, recommended that:

a longitudinal, prospective study of offenders attending different types of rehabilitation programs be conducted to determine the offender characteristics most predictive of success in each type of program.

Which program elements are most effective? Most rehabilitation programs consist of a collection of several different elements, each presumed to contribute to the overall success of the program. For example, an educational program may cover five or six topic areas and use a number of pedagogical techniques such as videos, small group interactions, and paper and pencil exercises. It is not known whether all of these elements are necessary or whether two or three could be eliminated without altering the overall effectiveness of the program.

It is recommended that:

• a study be conducted of each of the major components of a program to determine which elements are most effective.

Why are programs not more effective? Rehabilitation programs are typically developed by experts and administrators on the basis of what they perceive to be the needs of offenders. Most evaluations of DWI programs confine their data sources to responses to structured questionnaires and official records and assess the success of the program in terms of changes in questionnaire responses, the incidence of subsequent DWI charges, other violations, and/or alcohol-related crashes. Although this approach indicates the "bottom line" effectiveness of a particular countermeasure, it fails to provide insight into why the program achieves results, the conditions under which it does and does not work, the type of offenders for whom it is and is not effective, or the reasons for apparent failure.

To understand the reasons for either success or failure of a given program, it is important to obtain direct, frank and honest feedback from individuals who have experienced a particular program. In order to maximize the effectiveness of the various measures, it is imperative to understand how offenders perceive and respond to these measures. This requires in-depth interviews with individual offenders who have completed various programs. These interviews must be conducted several months after completion of the program and by an agency that has no connection with the program or its administration. Occasionally, offenders are provided an opportunity at the end of a program to indicate what they did and did not like about the program. The feedback provided in this situation is biased by the recency of the program and the fact that such interviews are often conducted by program staff. The validity and utility of the information provided could be greatly enhanced by separating the collection of this type of information from the program and its administration.

Therefore, it is recommended that:

• a series of in-depth discussions be held with a large group of DWI offenders who have experienced various rehabilitation programs as a means to determine their thoughts about the effectiveness of programs, the reasons why sanctions were or were not effective, and how programs could be changed to better meet their needs

6.3 Evaluation Options

Evaluation is a critical component of any program. The purpose of evaluation is not only to determine how effective a program is but also to identify ways for enhancing its effectiveness. In this latter sense, evaluation is viewed as a constructive process.

Some of the programs described in this report have been the subject of evaluation studies. Typically, these studies involve an assessment of the delivery and administration of the program (i.e., process evaluation) as well as a short-term follow-up of a group of participants to determine changes in attitudes, knowledge and/or behaviour (i.e., outcome evaluation). While the process evaluations have undoubtedly been invaluable to program administrators, the outcome evaluations are generally weak and inconclusive, providing no definitive evidence about the effectiveness of the program.

More methodologically rigorous studies are urgently needed to determine the extent of benefits that can be expected from DWI programs. The results of such studies could be used to help refine programs to enhance their efficiency and effectiveness and to help administrators in other jurisdictions determine which types of programs should be implemented.

On the basis of the review of DWI offender programs in Canada, several existing and proposed programs have been identified as potential candidates for evaluation research.

These programs were selected on the basis of an assessment of their unique approach, their consistency in content and delivery, their accessibility and applicability to a broad population of offenders, and their potential to show positive effects.

It is recommended that:

• methodologically rigorous evaluation studies be conducted on the following programs:

Manitoba’s comprehensive system of assessment and rehabilitation. The impaired driver program in Manitoba comes as close as possible to the model system described in Section 4.0. It is an integrated system of assessment and rehabilitation that uses the results of the assessment to guide decisions concerning rehabilitation options. The program is required of all offenders which provides a sufficiently large population for the study. In addition, the several rehabilitation programs available within the system provide the opportunity to examine the effectiveness of these programs and the matching of offenders to programs.

A series of studies on this program was conducted several years ago and a report published in 1990. One of these studies was an outcome evaluation. The design of this study, however, was insufficient to permit any definitive conclusions about the effectiveness of the program. Because this program contains so many of the elements deemed essential to an effective system of dealing with offenders, a more thorough, comprehensive, and controlled evaluation study should be designed and conducted by a respected and reputable agency that is not directly associated with the program or its administration. Such a study could also address some of the research questions posed in the previous section.

Alberta’s IMPACT program. The IMPACT program is an intensive residential weekend assessment intervention program required of all repeat offenders in Alberta. This type of program is becoming increasingly popular in North America. In fact, the Auto Control Plus program in New Brunswick follows a similar model. The IMPACT program is widely available and is delivered consistently, making it a most suitable candidate for evaluation.

A recent evaluation of the IMPACT program provides evidence suggestive of positive effects. The design of the study, however, renders the results largely inconclusive. A more thorough and rigorous evaluation would provide a better indication of the extent of IMPACT’s effectiveness.

Alberta’s alcohol ignition interlock program. The alcohol ignition interlock program in Alberta is unique in Canada. Evaluation studies of interlock programs in the United States have demonstrated beneficial effects. The Alberta program differs from the U.S. programs in that access to the program is handled administratively (not judicially) and the program is now available to first-time offenders. As more jurisdictions begin to consider implementing an interlock program, it is important for them to be able to determine the extent of the benefits that may be expected from this type of program.

Newfoundland’s proposed 24-hour roadside suspension program. Newfoundland has proposed a 24-hour roadside suspension for drivers found to have a BAC in excess of 50 mg%. The proposed system has several features that make it unique from other roadside suspension laws in Canada. First, offenders will be required to pay a $100 licence reinstatement fee. Second, a record will be made of all such suspensions. Third, repeat suspensions will result in a longer-term suspension and, finally, repeat offenders will be required to attend a brief educational program. These aspects of the roadside suspension program provide enhanced deterrent and rehabilitative components not available elsewhere in Canada.