manage all of their priorities and responsibilities (e.g., childcare and employment) which could affect their success in treatment.
> Provide more training for clinicians and strengthen state certification protocols as appropriate. In some jurisdictions, little training is required to deliver therapy or treatment interventions and this is not an ideal scenario. It is often assumed that if a clinician is licensed that they are qualified, but that is not always the case. Subsequently, practitioners note the importance of the creation of standards in education and standardized testing for clinicians in order to be licensed. The implementation of audit protocols of treatment providers to verify that appropriate services are being provided is one potential option. Clinicians would also benefit from backgrounds or education in the areas of trauma and relationships, particularly when working with female clientele.
> Use alcohol-intake instruments that acknowledge and identify a history of trauma as this can have implications for treatment (e.g., it could assist practitioners in making better referrals to more appropriate services). There is also a need for more trauma services, trauma-informed clinicians, and one-on-one counseling services for trauma.
> Increase screening for co-occurring disorders. There is a need for medical services that are acceptable and affordable that includes psychiatric, medical, and physical health services. In order for treatment of substance use to be successful, any co-occurring mental disorders must also be identified and treated.
> Provide more outpatient services outside of regular business hours (e.g., in the evening and on weekends). This would make it easier for women who work during the day or care for children to attend treatment.
> Increase skills among alcohol education counselors in relation to the moderation of group sessions. It is important that counselors are able to ‘shut down’ difficult clients and ensure that the group is functional and constructive and that all participants are able to share their experiences.
> Increase the availability of aftercare which is important to success following the completion of treatment and the maintenance of long- term sobriety. It is essential to offer these services which enable women to return for follow-up if they successfully completed treatment. The
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provision of follow-up services can also help women maintain abstinence and prevent relapse.
Melissa came from an affluent family and was never in trouble as a teenager. By the time she was in her mid-20s, she had completed her undergraduate degree and was employed full-time as a high school teacher and looking to complete a Masters of Education. Then she was arrested for two DWIs within a six-month period. On both occasions, she had been celebrating accomplishments and had not considered herself to be impaired or unable to drive because she had been drinking.
Her convictions meant she was forced to resign from her job and she entered an inpatient program for substance abuse. She found that the intense media coverage of her offenses made it more difficult for her to cope with her already challenging situation. There was tremendous stigmatization because she lived in a small community and was a well-known teacher. She says she found it difficult to manage after her convictions and could not have done it without the support of family and friends. Now re-located, she cautions that the significant costs and demands resulting from a DWI can make it difficult to succeed, even though she had means and was very motivated. “I had to work multiple jobs to cover all of the costs and fees associated with my DWIs and to be compliant. Getting a job once you have a criminal record is really challenging. If I had known the consequences, I would never have driven.”
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6. CONCLUSIONS
As evidenced by TIRF’s 2011 review of the literature, much of the available research about female drunk drivers is outdated and several gaps in knowledge exist. What is known is that there are important differences between female drunk drivers and their male counterparts. In particular, they are often older at arrest, are more likely to be single, separated or divorced, have more education, and are often the primary caregivers of children. Mental health issues and prescription drug use is typically more pronounced, and histories of abuse, trauma, and health problems are common. In contrast, what is not well understood are the pathways to this behavior among women, the factors that contribute to it or that compound it, their experiences post- conviction, or what strategies can best serve this population.
This study adds to this body of knowledge and demonstrates that, in addition to issues identified above, offending behavior among a large majority of female drunk drivers appears to often be associated with a significant emotional event or trigger (e.g., intense pressure to succeed, financial problems, the end of a relationship, the illness of a child, death of a parent). A majority of women struggle with low self-esteem or depression and turn to alcohol use as a coping mechanism without understanding its effects. They further report that the stigma associated with a drinking problem not only compounds these problems but frequently discourages them from admitting it or seeking treatment. This is equally true in relation to other issues such as trauma and abuse. And, they are immensely attuned to how the acknowledgement of such problems will negatively influence the perceptions of family, the custody of children, and their professional status.
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This study also identified three distinct and unique profiles of female drunk drivers that begin to shed light on the confluence of factors that play a role in their offending. Of importance, such profiles illustrate that women may be subject to different risks and needs, and that drinking and driving behavior may not emerge until later in life. This knowledge has important implications for prevention initiatives as well an interventions targeted towards this population.
Once convicted of drunk driving, it appears that female offenders experience greater financial pressures as the sole breadwinner and caregiver of children, and they are often forced to choose between an unhealthy relationship and sobriety. They are frequently overwhelmed and unequipped to manage the demands of supervision in combination with ongoing parental, employment, and community responsibilities. They are more often reliant on emotional support from family members and friends, and require assistance with childcare, housing, and transportation. Moreover, women with fewer financial resources express significant safety concerns in relation to their limited transportation options. Perhaps most notably, these women frequently define their experiences in the criminal justice and treatment systems in terms of emotional consequences; shame, anxiety, frustration, anger, fear, and uncertainty.
This study also revealed that there are important gaps in existing criminal justice and treatment systems that can make it more challenging for female drunk drivers to successfully complete their sentence and comply with the conditions imposed upon them. Practitioners report that they often lack knowledge about the risk/need dynamic of this specific population, and have limited understanding of addiction issues. They also note that the tools they frequently utilize are not designed to identify mental health issues or histories of trauma, and it can be challenging to gather sufficient information about the personal history of the women they supervise in order to best serve them. Existing supervision and scheduling protocols are generally less appropriate for females because of the competing responsibilities that they face.
It is also apparent from this study that women often receive conflicting or confusing information from the different systems they are involved with (i.e., criminal justice, treatment, and licensing) regarding expectations, requirements, and consequences. This is perhaps most poignantly illustrated by the fact that many women resign themselves to not reinstating their
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