Best Practices - Treatment and Rehabilitation for Driving While Impaired Offenders

3. Current Treatment Practice Issues (continued)

3.5 Interventions that target impaired drivers who are apprehended but not processed through the courts

Key Points

• Individuals who are given roadside suspensions are similar to those who are convicted of an impaired driving offence in terms of drinking and driving patterns.
• It is likely that both those who receive a roadside suspension and society will experience the same types of benefits that remedial programs confer.

3.5.1 Indications from the literature

There is some evidence that individuals who receive a roadside suspension are similar to those who receive a Criminal Code impaired driving conviction. For example, Quaye and Boase (2002) reported that as the number of roadside suspensions increased in a jurisdiction, so did the number of Criminal Code convictions on driving records. In an unpublished study, Vingilis (1983) examined the characteristics of a sample of 3,337 drivers who received a roadside suspension in Ontario in 1982. This sample excluded drivers who were involved in a collision or were charged with a Criminal Code impaired driving offence. They found that over one third of the sample already had a licence suspension--most often for a DWI conviction--on their driver's record. Over a 2.5-year follow-up period, about 19% of the total sample were convicted of an impaired driving offence--a figure that is similar to recidivism rates observed in drivers convicted of a Criminal Code impaired driving offence (Mann et al., 1991).

3.5.2 Key informant interviews

Some, but not all, key informants felt that those who have received an administrative roadside licence suspension (particularly those with multiple administrative offences) should be screened or assessed for substance use problems as well.

3.5.3 Best practices

The evidence suggested that individuals who are given pre-conviction roadside suspensions resulting from an impaired driving occasion are similar to those who are convicted of an impaired driving offence. Thus, it is likely that both they and society will experience the same types of benefits that remedial programs confer.

Best Practice 9
Individuals who receive pre-conviction roadside suspensions for impaired driving should be considered for referral to assessment and participation in remedial programs.

3.6 Governance and training issues

Key Points

• Effective remedial programs for convicted DWI offenders require a behavioural health perspective and an orientation consistent with addictions treatment.
• Programs that address DWI substance use problems should be placed in the hands of trained addictions professionals operating from a behavioural health perspective, who are given ongoing training to maintain their skills and acquire effective new techniques.

3.6.1 Indications from the literature

DWI offenders share many characteristics with persons with substance use problems (Macdonald and Mann, 1996; Miller and Windle, 1990) which suggests that programs that aim to address their substance use problems should be placed in the hands of trained addictions professionals operating from a behavioural health perspective. This means an emphasis on individual responsibility and the use of science-based knowledge and techniques to bring about behavioural change through self-initiated individual activities that result in abstinence or less harmful substance use behaviours. A variety of alternative governance models have, however, been developed (Mann et al., 1997). Thus, in Canada, responsibility for various portions of programs rests with provincial addictions agencies, health ministries, transportation ministries or private sector service providers. In the United States, programs are often regulated and managed by an agency with a state mandate to provide impaired driver programs and to ensure that programs meet state-determined standards (e.g. Mississippi, New Jersey). These agencies often contract with other agencies to provide programs in specific areas. In some US jurisdictions, where only education programs are provided to some DWI offenders, there is little regulation of programs and the situation approximates that of a free market, with providers competing on the basis of such factors as price and length of program.

3.6.2 Key informant interviews

Generally, key informants recommended that the level of programmer training differ between those delivering education programs and those delivering treatment/rehabilitation programs. It was felt that those delivering education programs should have adult education and group facilitation skills, while those involved in treatment and rehabilitation should be trained addictions counsellors/clinicians with particular training in DWI-related issues. Personal credibility, being a resource to the community and having role models from the recovering community were also mentioned.

Several key informants identified the need for ongoing, annual training to address issues such as updated information on program applications and quality assurance. Several key informants indicated that Motor Vehicle Registration staff could benefit from training on remedial programs so they would understand that perspective.

3.6.3 Best practices

The evidence suggests that effective remedial programs for convicted impaired drivers require a behavioural health perspective and an orientation consistent with addictions treatment. This means an emphasis on individual responsibility and the use of science-based knowledge and techniques to bring about behavioural change through self-initiated individual activities that result in abstinence or less harmful substance use behaviours.

Best Practice 10
Remedial programs should be located in an environment in which a behavioural health perspective and treatment orientation are well established and can be maintained.

Key informants indicated that individuals who provide remedial services to convicted impaired drivers need to have skills in adult education, group facilitation and addictions counselling. These skills are typically found in individuals who have been trained in, or have acquired skills in, the addictions field.

Best Practice 11
Those providing remedial services to DWI offenders should be trained in substance use issues, and in adult education (particularly those delivering educational interventions) and group facilitation (particularly those delivering more therapeutic interventions).

There are many remedial programs for convicted impaired drivers in Canada and the number of these programs is likely to increase over time.

Best Practice 12
Those providing remedial measures programs to convicted impaired drivers should be supported in accessing provincial or national training opportunities on an annual or biennial basis.

The key informants indicated that ongoing training is required for professionals to maintain their skills and acquire effective new techniques.

3.7 Relationships between DWI programs and licensing authorities

Key Points

• The administrative model, in which a licensing agency requires an offender to complete an education or treatment program prior to reinstatement of the driver's licence, is used in most jurisdictions in Canada.
• The administrative model is generally considered to be superior and more efficient than the judicial model as it ensures that all offenders complete an education or treatment program prior to licence reinstatement.

3.7.1 Indications from the literature

There are two general models in which treatment and rehabilitation programs for convicted drinking drivers have been implemented. The first model can be termed the judicial model, in which attendance at a treatment or rehabilitation program is required by the courts. Under this model, judges assign convicted offenders to programs at the time of sentencing and the courts assume responsibility for ensuring that programs are completed. Often, program attendance is a condition of probation, and those who do not attend or do not successfully complete the program may be considered in breach of probation. Under this model, vehicle registration departments have very little contact with treatment and rehabilitation services. This model was previously common in Canada, and is still very common in the United States (Century Council, 1997; Stoduto et al., 1998).

Secondly, there is an administrative model, in which a licensing agency requires an offender to complete an education or treatment program prior to reinstatement of the driver's licence. This model is used in most jurisdictions in Canada. It is generally considered to be superior and more efficient than the judicial model because it ensures that all offenders complete an education or treatment program prior to licence reinstatement. It also reduces the likelihood that courts will use a reduced licence suspension as an incentive to encourage offenders to attend programs. This model requires treatment and rehabilitation services to communicate with driver licensing authorities, particularly when offenders begin and complete programs. In some provinces, programs are actually managed by driver licensing agencies (Stoduto et al., 1998).

3.7.2 Key informant interviews

In most jurisdictions, but not all, the administrative model is in place; this means that the decision regarding licence reinstatement is made by the driver licensing authority and it is the responsibility of the offender to meet any requirements for licence reinstatement. One key informant noted that prior to implementation of the administrative model, when legal and other sanctions were court-ordered, the onus was often on the probation officer rather than the offender to find the appropriate education or treatment service or other services.

All respondents recommended clarity regarding roles and responsibilities, and good communication between the treatment/rehabilitation sector and driver licensing offices and/or the justice system (e.g. regular meetings, provincial coordinating body). Several raised concerns about offenders being "caught in the middle" when communication is unclear. Key informants also indicated that offenders need to be clear about their responsibilities and reporting requirements. Manitoba was identified as a jurisdiction that had clear protocols (e.g. the Addictions Foundation of Manitoba [AFM] working for the client and the motor vehicle registration office dealing with the enforcement aspect). The Manitoba respondent emphasized that the provincial justice department always involves AFM and the motor vehicle licensing authority in any discussion of proposed changes to DWI legislation and that AFM works very closely with the motor vehicle registration office.

Several key informants raised the issue of offenders "shopping around" for a jurisdiction with less onerous requirements in terms of education/treatment and that it would be helpful to have mechanisms for information exchange between jurisdictions on driver history and remedial requirements. Many key informants mentioned the need for national standards or standardization between jurisdictions.

Most, but not all key informants indicated that they were not concerned with confidentiality about the nature of the information being transmitted to licensing authorities. Most intervention programs provide standardized and basic information to the motor vehicle registration office regarding whether the client has met requirements. They will also identify any concerns regarding future substance use issues. Some jurisdictions use risk levels and some concerns were raised regarding their interpretation by motor vehicle registration offices and issues of confidentiality and liability in their interpretation. One key informant raised the issue of risk levels for drugs other than alcohol needing to be developed.

The issue of DWI programs being able to proactively contact those convicted of DWI offences was not supported by most key informants. However, the issue was raised in the context of offenders being unaware of the requirements for assessment and intervention or leaving it until the last moment in terms of the licence suspension period. One key informant recommended that programs have access to conviction information and driver history in order to follow up with clients who are not complying with program attendance requirements, while another suggested that all those arrested for DWI should be required to go through a program whether or not they decide to get their licence back.

In this context, some key informants mentioned the issue of enforcement and that there was little likelihood that offenders driving while under suspension would be caught, particularly in rural areas. One key informant in particular felt that much greater levels of enforcement in terms of detecting impaired drivers were required to reduce DWI offences. Several key informants also mentioned the need for increased public awareness about the consequences of DWI in terms of legal and other sanctions.

3.7.3 Best practices

Preceding sections have made it clear that, to achieve the maximum impact on traffic safety, all impaired driving offenders should complete a remedial measures program (instead of relying on the discretion of the courts to refer to programs those who they think would benefit). The research indicates that maximum safety benefits, in terms of reduced collisions, are achieved when all offenders are required to complete a remedial requirement as a condition of relicensing, as opposed to the situation where the court determines who is and who is not suitable for a remedial program.

Best Practice 13
Remedial programs should be operated using an administrative model, where program completion is a requirement for relicensing.

One possible model is for the licensing authority to supervise or run remedial programs themselves. However, the conflicts between the "administrative culture" of a licensing authority and the "therapeutic culture" required in a remedial program are likely to be substantial. The balance of expert opinion is that there needs to be a separation between the administration of licence suspensions by the licensing authority and the provision of remedial programming.

Best Practice 14
Remedial programs should be operated by an agency other than the licensing authorities.

One issue that arose is that of communications between licensing authorities and remedial program providers. The key informants indicated that remedial programs require information from licensing authorities to make important decisions about clients, and licensing authorities require information from remedial authorities to make decisions about licence status. In addition, clients need to be able to obtain clear information about program requirements and regulations.

Best Practice 15
There is a need for formal and clear mechanisms for coordination and collaboration between licensing authorities and remedial programs, to ensure reciprocal exchange of information to serve the best interests of clients and the public.