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Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
Dui evaluator training 2004
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Dui evaluator training 2004

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DUI Evaluator training conducted by Tom Wilson, MA, LCPC at 2004 Idaho Conference on Alchol and drug Dependence

DUI Evaluator training conducted by Tom Wilson, MA, LCPC at 2004 Idaho Conference on Alchol and drug Dependence

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  • Welcome, introduce self, private practice, years in practice, ideas presented are derived from personal experience and new research on evidence- based practices.
  • Absorption, Metabolism, and Elimination; Alcohol Presence Driving-Related Performance; Acute and Chronic Effects
  • The level or hours of recommended treatment is often viewed as an additional fine by the defendant, his lawyer and some members of the judiciary.
  • Transcript

    • 1. DUI Evaluator Training- ICADD 2004 Tom Wilson, LCPC 06/22/11 <ul><ul><li></li></ul></ul>[email_address]
    • 2. Session One Overview- Application and Preparation for Licensing <ul><li>Role of a DUI Evaluator </li></ul><ul><li>Application Requirements </li></ul><ul><ul><li>Evaluation or treatment experience </li></ul></ul><ul><ul><li>Minimum educational requirements </li></ul></ul><ul><ul><li>Competency – based examination. </li></ul></ul><ul><li>Study areas for exam </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 3. Who is the Client? <ul><li>Defendant has a court order for a DUI evaluation. </li></ul><ul><li>Defendant is referred by his attorney for a DUI evaluation before pretrial. </li></ul><ul><li>Defendant is self referred three days after DUI arrest and knows he will have to get an evaluation, no attorney. </li></ul><ul><li>Defendant had a recent “voluntary” evaluation he didn’t like, wants second opinion. </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 4. DUI Evaluator License Application <ul><li>Certified copy of college transcripts-Baccalaureate degree or higher in allied health field or </li></ul><ul><li>Current copy of CADC Certificate issued through IBAADC </li></ul><ul><li>Copy of LCP, LCPC or MSW Certificate </li></ul><ul><li>Detailed employment history showing minimum of 720 cumulative hours in a drug or alcohol education or treatment program for the three years prior application (Program Name. Dates, Hours, Supervisors). </li></ul><ul><li>Statement of fee you will charge </li></ul><ul><li>$25.00 application fee </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 5. DUI Evaluator License Renewal <ul><li>Application form with updated info </li></ul><ul><li>Statement of fees </li></ul><ul><li>Verification of 12 hours of CEUs by </li></ul><ul><ul><li>Workshop Certificates </li></ul></ul><ul><ul><li>College Transcripts </li></ul></ul><ul><li>$25.00 renewal fee </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 6. Licensure Examination Topics <ul><li>Statutes and rules governing evaluators and their evaluations </li></ul><ul><li>Physiological effects of alcohol/drugs </li></ul><ul><li>Withdrawal symptoms </li></ul><ul><li>Referral processes </li></ul><ul><li>12-step programs </li></ul><ul><li>Interview techniques </li></ul><ul><li>Screening tools </li></ul><ul><li>Professional conduct and ethics </li></ul><ul><li>Gender and cultural issues </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 7. Statutes and Rules <ul><li>Idaho Code 18-8005(9) established the requirement for DUI Evaluations </li></ul><ul><li>Idaho Code 10-8005 (5) established the requirements for DUI Evaluators </li></ul><ul><li>IAC 16.06.08 gave DHW the authority to establish rules and minimum standards for DUI evaluators </li></ul><ul><li>Supreme Court Misdemeanor Criminal Rule 9.4 prescribed the format and content of the DUI report </li></ul><ul><li>Federal Regulations </li></ul><ul><li>42 CFR Part 2 </li></ul><ul><li>Confidentiality of Alcohol and Drug Abuse Patient Records </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 8. Physiological Effects of Alcohol 06/22/11 <ul><ul><li></li></ul></ul>BAC .02 BAC .40 <ul><li>Reduces tension </li></ul><ul><li>lowers inhibitions </li></ul><ul><li>impairs concentration </li></ul><ul><li>slows reflexes </li></ul><ul><li>impairs reaction time </li></ul><ul><li>reduces coordination </li></ul><ul><li>slur speech </li></ul><ul><li>cause drowsiness </li></ul><ul><li>alter emotions </li></ul><ul><li>vomiting </li></ul><ul><li>breathing difficulties </li></ul><ul><li>unconsciousness </li></ul><ul><li>coma </li></ul><ul><li>Death </li></ul>
    • 9. Chronic Effects of Alcohol <ul><li>Nervous System: loss of sensation hands/feet </li></ul><ul><li>Muscles: Weakness and loss of muscle tissue </li></ul><ul><li>Lungs: Infections </li></ul><ul><li>Liver: Liver damage including cirrhosis, hepatitis, </li></ul><ul><li>Pancreas: Pancreatitis </li></ul><ul><li>Sexual Organs - impotence and decreased sperm count , irregular periods, reproductive problems, pregnancy and birth problems </li></ul><ul><li>Brain: Cell damage, memory </li></ul><ul><li>Breasts: Risk of breast cancer </li></ul><ul><li>Heart: High blood pressure </li></ul><ul><li>Skin: Red nose and cheeks </li></ul><ul><li>Stomach: Inflammation, bleeding, and ulcers </li></ul><ul><li>Intestines: Inflamed lining and ulcers </li></ul><ul><li>Esophagus- bleeding </li></ul><ul><li>Blood: Changes in red blood cells </li></ul><ul><li>Hands and Feet: &amp;quot;Pins and Needles&amp;quot; and loss of sensation </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 10. Acute Effects of Methamphetamine <ul><li>Increased alertness </li></ul><ul><li>Paranoia </li></ul><ul><li>Hallucinations </li></ul><ul><li>Aggressive behavior </li></ul><ul><li>Increased heart rate </li></ul><ul><li>Insomnia </li></ul><ul><li>Loss of appetite </li></ul><ul><li>Excessive talking </li></ul><ul><li>Panic </li></ul><ul><li>Delusions </li></ul><ul><li>False sense of power and confidence </li></ul><ul><li>Loss of interest in friends, sex or food </li></ul><ul><li>Emotional numbing </li></ul><ul><li>Acne, sores </li></ul><ul><li>Tactile delusions </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 11. Chronic Effects of Methamphetamine <ul><li>Fatal kidney and lung disorders </li></ul><ul><li>Brain damage </li></ul><ul><li>Depression </li></ul><ul><li>Hallucinations </li></ul><ul><li>Permanent memory, attention, concentration problems </li></ul><ul><li>Violence </li></ul><ul><li>Paranoid delusions </li></ul><ul><li>Malnutrition </li></ul><ul><li>Loss of hair </li></ul><ul><li>Loss of teeth </li></ul><ul><li>Stroke </li></ul><ul><li>Liver damage </li></ul><ul><li>Severe impairment in </li></ul><ul><li>legal, financial social, and family role functioning </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 12. Alcohol Withdrawal Symptoms <ul><li>Sweating or Rapid Pulse </li></ul><ul><li>Increased Hand Tremor </li></ul><ul><li>Insomnia </li></ul><ul><li>Nausea or Vomiting </li></ul><ul><li>Physical Agitation </li></ul><ul><li>Anxiety </li></ul><ul><li>Transient Visual, Tactile or Auditory Hallucinations or </li></ul><ul><li>Illusions </li></ul><ul><li>Grand Mal Seizures </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 13. Methamphetamine Hydrocodone <ul><li>fatigue </li></ul><ul><li>long, disturbed periods of sleep </li></ul><ul><li>irritability </li></ul><ul><li>intense hunger </li></ul><ul><li>moderate to severe depression </li></ul><ul><li>psychotic reactions </li></ul><ul><li>anxiety </li></ul><ul><li>intense cravings for the drug </li></ul><ul><li>irritability </li></ul><ul><li>nausea or vomiting </li></ul><ul><li>muscle aches </li></ul><ul><li>runny nose or eyes </li></ul><ul><li>dilated pupils </li></ul><ul><li>sweating </li></ul><ul><li>diarrhea </li></ul><ul><li>yawning </li></ul><ul><li>fevers </li></ul><ul><li>chills </li></ul><ul><li>inability to sleep </li></ul><ul><li>depression </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 14. Referral Processes <ul><li>Education or Treatment? </li></ul><ul><li>Match severity of client’s problem to level of education or treatment </li></ul><ul><li>Special needs of clients? </li></ul><ul><li>Three referrals </li></ul><ul><li>Private Providers and State approved Substance Abuse Treatment Programs </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 15. 12 Step Programs <ul><li>The “tools of recovery,” common to all of the 12-Step Programs, include:Meetings (usually 60 - 90 minutes) </li></ul><ul><li>Sponsorship </li></ul><ul><li>Twelve steps </li></ul><ul><li>Twelve traditions </li></ul><ul><li>Service work </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 16. Interviewing Techniques <ul><li>Physical environment </li></ul><ul><li>Reading level </li></ul><ul><li>Client’s language </li></ul><ul><li>Distractions </li></ul><ul><li>Confidentiality </li></ul><ul><li>Informed consent </li></ul><ul><li>Acceptance and respect vs. agreement </li></ul><ul><li>Empathy vs. Sympathy </li></ul><ul><li>Verbal vs. Nonverbal communication </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 17. Approved Screening Tools <ul><li>Addiction Severity Index (ASI) </li></ul><ul><li>Michigan Alcohol (ASI) Screening Test (MAST) </li></ul><ul><li>Substance Abuse Subtle Screening Inventory (SASSI) </li></ul><ul><li>DSM-4 Criteria for Substance Abuse Disorders </li></ul><ul><li>Mortimer-Filkens Questionnaire with Interview </li></ul><ul><li>Compu-13 </li></ul><ul><li>Compu-15 </li></ul><ul><li>Substance Abuse Disorders Diagnosis Schedule(SUDDS) </li></ul><ul><li>Driver Risk Inventory II </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 18. Professional Conduct and Ethics <ul><li>Non-discrimination </li></ul><ul><li>Competence </li></ul><ul><li>Client welfare </li></ul><ul><li>Confidentiality </li></ul><ul><li>Dual relationships </li></ul><ul><li>Receiving remuneration for referral of clients for professional services </li></ul><ul><li>Using one&apos;s relationship with clients to promote personal gain or the profit of an agency </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 19. Gender and Culture Issues <ul><li>Gender Issues </li></ul><ul><li>Women have higher BACs </li></ul><ul><li>Higher risk for Cirrhosis </li></ul><ul><li>Higher risk for co-morbid disorders </li></ul><ul><li>Higher risk for O.B. complications </li></ul><ul><li>Higher risk for FAS </li></ul><ul><li>Risk for Domestic Violence </li></ul><ul><li>Cultural Issues </li></ul><ul><li>Cultural drinking norms </li></ul><ul><li>Attitude towards treatment </li></ul><ul><li>Cultural sensitivity </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 20. Session Two Overview <ul><li>“ Treatment = Punishment” </li></ul><ul><li>Approved Screening Tools </li></ul><ul><li>Transtheoretical Model of Change and Stages of Change </li></ul><ul><li>Level of Care: Treatment or Education </li></ul><ul><li>Motivational interviewing </li></ul><ul><li>Making recommendations </li></ul><ul><li>Confidentiality, ethics </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 21. Approved Screening Tools <ul><li>Addiction Severity Index (ASI) </li></ul><ul><li>Michigan Alcohol Screening Test (MAST) </li></ul><ul><li>Substance Abuse Subtle Screening Inventory (SASSI) </li></ul><ul><li>DSM-4 Criteria for Substance Abuse Disorders </li></ul><ul><li>Mortimer-Filkens Questionnaire with Interview </li></ul><ul><li>Compu-13 </li></ul><ul><li>Compu-15 </li></ul><ul><li>Substance Abuse Disorders Diagnosis Schedule(SUDDS) </li></ul><ul><li>Driver Risk Inventory II </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 22. Transtheoretical Model of Change: Five Distinct Stages of Change <ul><li>Precontemplation: not seeing a problem </li></ul><ul><li>Contemplation: seeing a problem and considering whether to act </li></ul><ul><li>Preparation: making concrete plans to act soon </li></ul><ul><li>Action: doing something to change </li></ul><ul><li>Maintenance: working to maintain change </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 23. Moving through the Stages <ul><li>Stages of Change </li></ul><ul><li>Precontemplation </li></ul><ul><li>Contemplation </li></ul><ul><li>Preparation </li></ul><ul><li>Action </li></ul><ul><li>Maintenance </li></ul><ul><li>Relapse </li></ul><ul><li>Processes of Change </li></ul><ul><li>1. Consciousness Raising </li></ul><ul><li>2. Environmental Re-evaluation </li></ul><ul><li>3. Dramatic relief </li></ul><ul><li>4. Self Re-Evaluation </li></ul><ul><li>5. Self-efficacy </li></ul><ul><li>6. Helping relationships </li></ul><ul><li>7. Contingency management </li></ul><ul><li>8. Counter conditioning </li></ul><ul><li>9. Stimulus control </li></ul><ul><li>10. Social liberation </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 24. Assessing Stage of Change <ul><li>Readiness Ruler </li></ul><ul><li>Clinical Interview </li></ul><ul><li>TCU DRUG Screen </li></ul><ul><li>SOCRATES- Stage of Change Readiness for Treatment Scale </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 25. Treatment vs. Education <ul><li>ASAM Treatment </li></ul><ul><li>DX: Substance Abuse or Dependence </li></ul><ul><li>Level 1-OP </li></ul><ul><li>Level 2-IOP </li></ul><ul><li>Level 3 IP </li></ul><ul><li>Level 4 IP </li></ul><ul><li>PPCR-2 used to classify intensity of tx required </li></ul><ul><li>Precontemplation to Maintenance </li></ul><ul><li>ASAM Early Intervention </li></ul><ul><li>May not meet DX for Abuse </li></ul><ul><li>At risk </li></ul><ul><li>ASAM .5 level </li></ul><ul><li>No individual tx plan defined </li></ul><ul><li>Precontemplation to Contemplation / Preparation </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 26. Motivational Interviewing (MI) <ul><li>Miller and Rollnick (1991) - Counseling style used to enhance client’s use of the processes of change . </li></ul><ul><li>Principles of Motivational Interviewing </li></ul><ul><li>Express Empathy-seek to gain understanding </li></ul><ul><li>Develop Discrepancy-pros and cons of change </li></ul><ul><li>Avoid Argumentation-avoid labeling </li></ul><ul><li>Roll with Resistance-reflecting skills </li></ul><ul><li>Support self-efficacy-confidence and importance </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 27. Examples of MI Counselor Behaviors <ul><li>“ That must have been difficult.” (sympathetic not appreciative) </li></ul><ul><li>“ You’ve accomplished a difficult task.” </li></ul><ul><li>“ It was your decision to come here today.” </li></ul><ul><li>“ Thank you for coming today.” </li></ul><ul><li>“ Would it be all right if I suggested something?” </li></ul><ul><li>Support </li></ul><ul><li>Affirm effort </li></ul><ul><li>Emphasize Control </li></ul><ul><li>Affirm appreciation </li></ul><ul><li>Advise with Permission </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 28. Examples of MI Counselor Behaviors <ul><li>Client: “I don’t really have a problem with alcohol.” </li></ul><ul><li>Counselor: Drinking really hasn’t caused problems for you . </li></ul><ul><li>Your 18 drinks a week places you in the 96th percentile for men. </li></ul><ul><li>Tell me about your DUI. </li></ul><ul><li>Did you take the field tests? </li></ul><ul><li>Reflection </li></ul><ul><li>Giving Information </li></ul><ul><li>Open question </li></ul><ul><li>Closed question </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 29. Case Studies <ul><li>Review Case study and reach consensus on : </li></ul><ul><li>Severity of problem </li></ul><ul><li>DSM Diagnosis </li></ul><ul><li>Stages of Change </li></ul><ul><li>Motivation for change </li></ul><ul><li>Recommendations for education or treatment </li></ul><ul><li>Reasons for recommendations </li></ul><ul><li>Recommended programs </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 30. Session Three Overview <ul><li>Goals of Early Intervention </li></ul><ul><li>Picking Topics </li></ul><ul><li>Designing Learning Activities </li></ul>06/22/11 <ul><ul><li></li></ul></ul>Interventions for First Time Offenders
    • 31. Goals of Early Intervention <ul><li>Consciousness Raising </li></ul><ul><li>Dramatic Relief </li></ul><ul><li>Environmental Reevaluation </li></ul><ul><li>Self reevaluation </li></ul><ul><li>Scope of DUI problem </li></ul><ul><li>Client’s quantity, frequency and pattern of use </li></ul><ul><li>DUI laws, Fines, penalties, jail </li></ul><ul><li>Effects of alcohol.drugs on driving </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 32. Goals of Early Intervention <ul><li>Consciousness Raising </li></ul><ul><li>Dramatic Relief </li></ul><ul><li>(Emotional arousal) </li></ul><ul><li>Environmental Reevaluation </li></ul><ul><li>Self reevaluation </li></ul><ul><li>Emotional responses to Victim’s Panel or other testimonials </li></ul><ul><li>Feelings at time of arrest </li></ul><ul><li>Feelings since arrest about drinking behavior </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 33. Goals of Early Intervention <ul><li>Consciousness Raising </li></ul><ul><li>Dramatic Relief </li></ul><ul><li>(Emotional arousal) </li></ul><ul><li>Environmental Reevaluation </li></ul><ul><li>Self reevaluation </li></ul><ul><li>Costs of DUI to community /society </li></ul><ul><li>Effects on friends and family </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 34. Goals of Early Intervention <ul><li>Consciousness Raising </li></ul><ul><li>Dramatic Relief </li></ul><ul><li>(Emotional arousal) </li></ul><ul><li>Environmental Reevaluation </li></ul><ul><li>Self reevaluation </li></ul><ul><li>DUI vs. Personal Values </li></ul><ul><li>Financial costs of DUI </li></ul><ul><li>Personal costs of DUI </li></ul><ul><li>Future life goals and drinking /driving behavior </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 35. Adult Learners… <ul><li>expect a learning climate that is interactive and mutually respectful. </li></ul><ul><li>diagnose their own needs and progress using interactive exercises, not lecture. </li></ul><ul><li>have a broad base of knowledge and experience they contribute to the learning situation. </li></ul><ul><li>learn by interacting and doing. </li></ul><ul><li>“ do not argue with their own data”-Bob Pike, author of Creative Training Techniques . </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 36. Training Methods for Small Groups (up to 15) <ul><li>Traditional lectures </li></ul><ul><li>Participatory lectures/structured discussions </li></ul><ul><li>Open discussions </li></ul><ul><li>Brainstorming </li></ul><ul><li>T-group exercises </li></ul><ul><li>Self-tests </li></ul><ul><li>Case studies </li></ul><ul><li>Incident process </li></ul><ul><li>Warm-ups/Icebreakers </li></ul><ul><li>Energizers </li></ul><ul><li>Role plays </li></ul>06/22/11 <ul><ul><li></li></ul></ul>
    • 37. Where to Get More Information <ul><li>Tom Wilson Counseling Center </li></ul><ul><li>514 So. Orchard, Suite 101 </li></ul><ul><li>Boise, ID 83705 </li></ul><ul><li>Ph 208-368-9909 Fax 208-388-1687 </li></ul><ul><li>Website: www.tomwilsoncounseling.com (/signup) </li></ul><ul><li>Email: [email_address] </li></ul><ul><li>Books: “Motivational Interviewing”, William Miller and Steve Rollnick </li></ul><ul><li>“ Changing for Good” Prochaska and Diclemente </li></ul>06/22/11 <ul><ul><li></li></ul></ul>

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