Dr. Kristen DeV...:            Hello, and welcome back to Justice To Healing. I'm Dr. Kristen DeVall and in the studio with me today is Dr. Christina Lanier.

Dr. Christina L...:              Hello everyone.

Dr. Kristen DeV...:            Together we serve as co-directors of the National Drug Court Resource Center. So we're happy that you joined us. We're very excited to have Jim Eberspacher with us today. He is the division director of the National Center for DWI Courts. Welcome Jim.

Jim Eberspacher:              Thank you. Thanks for having me. I'm very excited about the opportunity to talk about DUI Courts.

Dr. Kristen DeV...:            Today's episode, State of the Field DWI DUI Courts is the newest in our seven part series highlighting specific types of treatment courts. To get us started, Jim, could you talk briefly about how you became interested in DWI and DUI courts?

Jim Eberspacher:              Absolutely. I think I have maybe a similar story to a lot of treatment court practitioners, but I think mine's maybe a little unique or hopefully people will find it interesting. So what seems like forever ago in the early '90s or I'm sorry, not '90s, early 2000s. I was a juvenile probation officer in Northern Minnesota, at a county on the Canadian border, International Falls, Minnesota. 

                                             We had one judge who oversaw and presided over every single case in that county and in neighboring county. Didn't matter if it was criminal, family, juvenile, civil, commitments, everything that came across the bench was his. His name was Chad LaDuke. He went to a training with our felony probation officer on drug court. I didn't know they went to this training, but he came back after this two day training and he said, "Jim, I've got this great idea."

                                             He's one of these real kind of outward thinkers, always coming up with ideas. A lot of them great. Some of them not so great. We're friends so I know he would appreciate that. I kind of looked at him and I said what is it? He said, "It's called drug court." And I said, no idea what you're talking about. I said tell me what it is. And he says, "You know how we have people come in through into the court all the time and they cycle in and out. And we see all the same people and a lot of it they're using drugs, they're using alcohol."

                                             And he said, "The concept of drug court is that if we treat the underlying symptoms, the substance use disorder, they'll get better and we won't see them over and over." And I looked at him skeptically and I said, "What's it got to do with me?" He said, "One of the things we learned at this two day training is that we really need somebody to coordinate this program to make sure that we do it correctly. And both Troy, the probation officer and I said Jim would be perfect for that. I'm like-

Dr. Kristen DeV...:            Great. 

Jim Eberspacher:              I said, okay. I said, I appreciate the thought. I said I don't think it's going to work. I said but you know kind of where I stand and then I'm burnt out on traditional probation. I said, I'm willing to try anything. He said, "Great." He said, "We go to training in a month." And this was back when NADCP had their training that was two days and then a week later on, and then another week later on and you'd fly out to different jurisdictions and have just this robust extensive training, which we now narrow down into three and a half or three, three and a half days. We went to training in Charlotte, North Carolina as a team. One of the first sessions was addiction in psychopharmacology. And back then, this was like a three hour session or somewhere, now we try to jam it into an hour.

                                             It was about halfway through that it clicked for me a little bit. And I thought, hmm, this could actually work if we do it correct and I probably grabbed the judge's arm at the time, or I'm like I kind of get it. We've essentially been failing people in the nutritional system. And I said, if we do this correctly, this could work. So we went back after all this training and started a hybrid court in Koochiching county, Minnesota. And we started a family dependency treatment court later on. And then we started a DWI court in the neighboring county which he was a presiding judge. 

                                             Through all of that, I really became just not involved, but also really bought into a system that took in my opinion, a brand new way of looking at individuals and the issues that they come in with. And then focusing on that type of treatment that's wraparound approach. I said when we were going through this training too. I said, "Someday, I am going to work for NADCP." 

Dr. Kristen DeV...:            Nice.

Dr. Christina L...:              Cool.

Dr. Kristen DeV...:            Nice.

Jim Eberspacher:              Here I am.

Dr. Christina L...:              Very good. 

Dr. Kristen DeV...:            That's awesome. It's neat to hear about how people came to be where they are now in the field and I think so many have sort of that light bulb moment.

Jim Eberspacher:              One of the interesting parts is as a coordinator, I was involved in, as I mentioned different models. When I came to work for NADCP, I started as a project director with the National Center for DWI courts, one of the divisions. It was really at that time ... I kind of happened into ... I know I wanted to work for NADCP, I kind of happened into the DUI court of the impaired driving part of it, but what I've come to appreciate and where now I've kind of found even a renewed passion is that for me DWI courts make an even greater impact on the system, just because of the various differences that I know we'll get into during our conversation here. But it has such a more profound impact not just on the people that it serves, but a greater whole.

Dr. Kristen DeV...:            So Jim at NADCP, your dream job. So what do you do as the director of the National Center for DWI courts? 

Jim Eberspacher:              That's a great question. So as a director, I guess I'm technically the supervisor of our NCDC team though. I really approach the work that we do as a team. I have two project directors who are wonderful and then we have a training coordinator who keeps us on track and together, and it's really as a team it's our goal, it's our mission, it's our job to train jurisdictions on how to implement DUI courts, how to implement best practices for existing jurisdiction that do have either a track or a standalone DUI court.

                                             Making sure or trying to provide the necessary education and knowledge that they're utilizing best practices, that they're doing what they should be to keep in fidelity with the models. Other than that, a lot of the boring stuff. Financial stuff, and-

Dr. Kristen DeV...:            Sure.

Jim Eberspacher:              The things that we all do behind the scenes that aren't as interesting, but of course they play a role.

Dr. Kristen DeV...:            That's great. I know that you guys offer a lot of resources, so we want to make sure that individuals know they can visit that website and get more information about all of these ideas and trainings and those types of things. So that's great. So let's get into a little bit more about DWI DUI court specifically. I would like for you to maybe if you could provide us a little bit, just a brief history of DUI DWI courts, and maybe talk a little bit around kind of how are they different from adult drug courts? We seem to ... We know a lot about adult drug courts through research, but perhaps distinguish between those two for us.

Jim Eberspacher:              Sure. So how or the first place where DUI DWI court started, it's a bone of contention with probably a few people. So officially kind of what we recognize as the first DUI court was in Los Cruces, New Mexico in 1995.

Dr. Kristen DeV...:            We deal with that in North Carolina with the first plane, the Wright brothers, where did it happen? So yeah, we get it.

Jim Eberspacher:              I didn't even know that was a sticking point. I just.

Dr. Christina L...:              Learn something new every day.

Jim Eberspacher:              It's a suggestion but it's good to know while down the side conversation. Love that. So Las Cruces, New Mexico, Doña Ana county and I'm probably butchering that because I don't speak a lick of Spanish or anything like that. But in 1995, I've talked with other judges and other jurisdictions in other parts of the country who say, no, we were doing that long before which is great. It's awesome. But so what they did and what we've seen in kind of the evolution of a DWI court is they evolved because the folks in Doña Ana county, the folks in other jurisdictions, and what we see now is they understand what they learned was the population's very different. 

                                             The population of impaired drivers, those who use an impairing substance and continually get behind the wheel of a car were ... Looked different demographically, had very different attitudes, had very kind of different needs in terms of case planning and whatnot. And so they just took like treatment courts do, they evolve and we steal everything and we just adapt pieces of it to fit who we needed to fit. So they took the 10 key components and change some things around and which evolved into the 10 guiding principles of DWI courts to really fit the unique needs of this population.

                                             What we've seen over the years is that we continue to adapt according to the research. I think one of the key things too that folks can take away is that though DWI courts are different in the model, we're not so different that the research from other models don't apply.

Dr. Kristen DeV...:            That's a good point.

Jim Eberspacher:              I think you also asked about, well, what are some of those differences? What we generally see from a repeat impaired driving population is that they tend to be male. They tend to be a little older, and this is in comparison with the populations in adult drug court. So male, slightly older, slightly higher rates of education, slightly higher rates in socioeconomic status, very different attitudes in terms of antisocial thinking and those behaviors that go along with it of a huge disconnect from impaired drivers as they're not criminals, they don't have problems with substances. A lot of them had these attitudes of we went out, I partied, I got in trouble and I got caught. 

                                             There's what we generally see is a big disconnect and they don't think of themselves as ... And I'm going to just kind of spoil ... I'm going to use stigmatizing language for effect, knowing that they don't associate themselves as junkies, as heroin addicts in the streets. So they use that to try to minimize their own behavior which then leads into that anti-social thinking and attitudes.

Dr. Kristen DeV...:            I think that's an important distinction in terms of, again, the target population being served by these programs.

Jim Eberspacher:              Absolutely. I mean, we hear stories all time about the minimizing of their behaviors. The minimizing of the number of rests that they have. And the interesting part of that, that some folks might not know is that what research shows is that minimally people drive 80 to 100 times impaired before they're ever caught. Then in rural areas, it's two or three times that. So when you think about those who have been caught 5, 6, 7, 8, 9, 10 times, and you think about all the times they're not caught, it's a very dangerous population on everybody's streets. 

                                             There's not a jurisdiction, there's not a city, there's not a town, there's not a village that doesn't have someone in the community driving impaired. So to that extent, we can certainly do more to make sure as a system that we have the things in place to respond to the needs of the folks that DWI courts generally deal with.

Dr. Christina L...:              Is there a different approach when it comes to treatment within these courts, perhaps as compared to say adult drug courts?

Jim Eberspacher:              I mean, that's a great question. We hear that a lot. Luckily for me, one of the project directors that we have, Julie Sites has a clinical background of 20 some odd years. So any treatment kind of questions or things they could ask, I've learned a ton from her with the three years that she's been with us already. Her general response to that question would be for treatment? No, not really. 

                                             Do we care what behaviors lead up to them needing treatment? Absolutely. Do we care what substances they are using so we can respond to that and understand as a treatment approach the impact on what we're working with? Absolutely. But in terms of generalized individualized treatment, now, it kind of they all fall in the same bucket. Where it might get slightly different is putting these individuals, impaired drivers with other types of populations. Because of those attitudes and because of the disconnect, it can definitely be a barrier for the people that we treat just because they don't associate that way. So sometimes breaking down those walls and breaking down kind of that guardedness and really getting to the point where they're not ambivalent about their disease can sometimes take a little longer, I think, in terms of treatment and getting buy in and engagement.

Dr. Christina L...:              I mean, they haven't been caught 80 to 100 times, they just think it was bad luck when they did get caught.

Jim Eberspacher:              They've got the worst bad luck on the planet. That's what I mean.

Dr. Christina L...:              Right. And I think one of the areas, and you just referenced it was around kind of drug of use and do these courts just ... I mean, would we say, okay, everybody in DWI court is only using alcohol, or do you think that's more of a myth of DWI courts?

Jim Eberspacher:              Definitely a myth. I mean, I think years ago, and there's still, we have conversations with folks all the times who attribute the work that we do, DWI courts, or even impaired driving in general as an alcohol problem. Alcohol is still absolutely a problem. I mean, the alcohol impaired driving kills over 10,000 people every single year in the US. But what we've seen, I don't know, over the last almost a decade is an understanding of where other drugs other than alcohol have played a role in kind of showing up in crashes and fatalities. 

                                             When I say showing up, I mean that in the sense that as we're seeing an increase and as we're seeing drugs in people systems after crashes and in fatalities when they're tested for drugs, the issue with it is that we don't know impairment which makes it a little more difficult. And so like with alcohol, we've got 0.08.

Dr. Christina L...:              Sure. 

Jim Eberspacher:              There's an established research base, there is established guidance, there's established thought about what point the level of 0.08 blood alcohol concentration does to individuals in terms of impairment for alcohol. We don't have that with drugs and it's kind of a moving target. It's very tough and we may never get there. So to understand whether or not people are actually impaired when they're driving if they're using marijuana or heroin or methamphetamine or whatever drug it might be, it's hard to do that without taking kind of a really extensive, comprehensive approach to understanding whether or not they show signs and symptoms of being impaired as opposed to just blowing 0.08 or higher.

                                             So kind of long winded answer to what I think your actual question was, we don't care what the drug is in terms of inclusion in a DWI court. We don't care if it's alcohol, we don't care if it's marijuana, we don't care if it's a combination because the likelihood is it is a combination and that's what we're seeing in the research. That's what we're seeing in the data year after year after year. Some jurisdictions have done a really looking back at old data and starting to test blood samples for drugs. 

                                             What they're finding in terms of not just having one drug present but multiple drugs present in the person's system is really mind blowing. When we talk about who's eligible and who needs the services at DUI court, obviously we're talking high risk and high need like we would for any other treatment court. Where we take a kind of a next approach is what we want to really do is impaired driving's a learned behavior. It takes kind of two different things. It takes using a substance that impairs and then getting behind the wheel of a car, or jumping on a motorcycle, whatever it may be, and that behavior is done over and over and over.

                                             So that's our goal is not only to give the treatment, but we also have to correct that behavior and to get them out of those habits. And so when we talk about, okay, if you've got somebody coming in who may be eligible that has an impaired driving arrest or DUI, but it's with drugs, they absolutely need to be part of that referral process because the likelihood is this time, it was a drug involved case.

Dr. Christina L...:              Sure. 

Jim Eberspacher:              Other times it's likely it was the previous were likely alcohol or at least contained alcohol. Again, to the point we don't care. Do they have the behaviors of using something and getting behind the wheel of a car? If that's the case, then they meet your eligibility criteria, DWI courts are the folks who should be the ones treating that individual. Hopefully they've gotten the training, they've got to know how ... They know to effectively deal and respond to those unique behaviors. So that's where they should be. That's opposed to another type of treatment court.

Dr. Christina L...:              Great. That makes sense. Sort of keeping with the idea of myths which I think that was a big one when it's more than just alcohol. Are there any other kind of myths that sort of function or operate around DUI courts that may kind of inhibit individual's ability to understand exactly what they do and how successful and useful they are?

Jim Eberspacher:              Definitely and let me kind of started off with a story. I have a colleague and an acquaintance, and I'll call him friend who is a prosecutor in a fairly large jurisdiction, was heavily bought into the concept of treatment court, adult drug court, veterans treatment court, to the extent that he himself served on the team for adult drug court in their community. He was part of the state's advisory board for treatment courts and just a real great guy who had all the best intentions when it comes to treatment court.

                                             You couldn't find a much bigger champion than him. For years I would talk to him about DWI court and he would not start in his jurisdiction. They had other ways he said of dealing with the issue and his greatest concern most often is that while what if I put him in a DWI court and they're out in the community and they go out and do the tragic thing that we're all kind of concerned about, and they go out and kill themselves or someone else in a crash.

                                             I totally understand that concern for a lot of different reasons, political reasons, a lot of the folks are elected officials. There's public safety concerns. It's like, well, what were they doing out in the community for people who really don't understand what a DUI court is and what it seeks to serve. I can understand why they might think a DUI court would create a greater public safety risk and or be considered soft on crime. When in fact, it's just the opposite. 

                                             When we look at sentencing, when we look at ways that the traditional system has dealt with especially repeat impaired drivers, it's been a lock up approach, generally speaking. And the issue with that is that it's very rare unless their behaviors or their actions has caused significant bodily injury to somebody else or death that somebody's going to be locked up forever, which means they're going to get out at some point.

                                             If we haven't treated the underlying issues, what's the likelihood that they're going to continue that behavior. I mean, I think everybody listening in and both you've well known the statistics on recidivism and everything else. If we're going to put them in a community at some point, a DUI court's best place for them, because it provides as that robust supervision, that constant contact. DUI courts are great at using technology to supervise and test and it's providing the treatment that folks need. While I understand the public safety concern or the soft on crime perception, I think that goes away when people really, truly understand when you kind of lay it out in the way that I just did.

Dr. Kristen DeV...:            Given sort of the history of DWI courts and where they came from back in 1995 to sort of where they are today, can you talk a little bit about who DWI courts are intended to serve a little bit about the target population?

Jim Eberspacher:              Yeah, absolutely. As I mentioned earlier, it's absolutely for a high risk kind need population. I think one of the challenges for jurisdiction is identifying what that is, and with impaired drivers, it can be even more challenging to really identify the high risk part. Some might think it would be as simple as well if you've got somebody who's doing this behavior and has multiple arrests, aren't they high risk?

                                             Likelihood is that, yeah, probably but criminal history is only one part of the equation. With kind of what I mentioned previously about they look different demographically, their attitudes are different. Sometimes we also see that they may not have other significant criminal histories other than maybe some driving things and DUIs on their record. When we look at traditional assessments that focus on high risk, sometimes those miss the mark because crash course in assessments and having been a probation officer, if you look at whatever system, whatever assessment you're using in your jurisdiction for anybody listening today, look at your assessment and pick apart whether or not it asks questions that fit this population.

                                             What I mean by that, does it ask specifically about DUIs? Does it ask specifically about are there kind of traffic driving behavior kind of questions, and does it ask kind of more extensive questions about antisocial attitudes and behaviors. Along with also kind of other circumstances that often also may potentially identify risk for future DUI in that were they driving with high blood alcohol concentrations? Were they driving with kids in the car? So some of those other behaviors lead potentially to identification of high risk. And if they don't, then these individuals are likely scoring lower, medium on traditional assessments.

                                             So a lot of what we talk about is when you're doing assessments, make sure you have an assessment norm for the population that you're working with. So when we look at impaired drivers, you need an assessment that can adequately identify what high risk and high need is. When we look at that, when identify some assessments. There's the impaired driving assessment, there's a computerized assessment referral system, cars and then there's a screening tool, DUI-RANT that have been known for the population. 

                                             We tend to advocate, like we understand you're likely using something different in your jurisdiction, supplement it with one of these other tools that's norm for the population or potentially change your tool or look at your tool and see if it can be normed for its impaired driving population. So you're adequately identifying those who are high risk to continue to re offend. If you're doing that and you're identifying risk in need in the criminogenic needs, the second step to that then is having a robust clinical assessment. Which I think we often lose sight in and I think we're guilty of that sometimes too as an agency or as advocates for assessment is that we also need to make sure people need long term individualized care. 

                                             So without doing a robust clinical assessment by qualified and trained clinicians, we're also doing it de service to really know if folks need the kind of treatment that we would come to expect in a treatment court, but also to make sure we're appropriately putting them in the level of care that they need. Because under treating, over treating are just as dangerous as mixing risk populations.

Dr. Christina L...:              For sure. I think and I've heard conversations around this exact issue or question, I guess it would be is DWI participants aren't high risk high need. You hear that and it's exactly for this reason because you're using a tool that doesn't apply to this population. I think that's a really important point to stress. I think those tools that you mentioned will definitely have those linked on our website under the DUI courts for our listeners so they can go and check those out for themselves. So I'm glad you gave us those examples.

Jim Eberspacher:              They're on our website too. They're on NDCI's website-

Dr. Christina L...:              Perfect.

Jim Eberspacher:              As well. We have a kind of a one page fact sheet on DWI risk assessments. The three that I had mentioned, the IDA, cars and the DUI-RANT screening tool are all on there along with kind of what they're intended for, who are some contacts to get more information about, but people can reach out to me as well if they want to have a discussion about that or how they may fit supplementing a new tool into everything that they're doing. Because I mean, I think sometimes jurisdictions have gone from under assessing to over assessing. Probably that's some of our fault. Well, no, you need to assess, you need to do this, you need to do this, but let's be realistic about the time that people have and also about who we're serving. I use this analogy quite a bit, think about when you go to a doctor. You have a doctor's appointment. 

                                             A lot of times you'll do some sort of like prescreening questionnaire, what's your medical history, what medications are you on? You turn that in when you go in and then what happens? You talk someone else and they ask you all the same questions. And then when you finally get to see the doctor, he asks you all the same questions. It's like, why didn't I just fill out 10 pages of information when you're going to ask me all the same questions and it's in my file from my pre ... And it's very frustrating. 

                                             Think about the people that we're working with and all the assessments that we're doing and both from a risk and from a criminogenic need and from a clinical perspective. And if we're adding mental health assessments and all this other stuff, think about the redundancy that might be involved in that and how that can be frustrating for individuals and may even be triggering for some folks.

                                             So we can do work, we advocate robust assessments on the front end. And then as people go through whatever programming they're involved in for reassessment, be aware and be thoughtful about what are the ways to minimize the redundancy part of that. I'll bang the assessment drum all long, just because it's one of the if not the most critical part of identifying folks for any intervention, whether it's DWI court or something different. But we also have to be thoughtful about intent versus impact when it comes to that too.

Dr. Christina L...:              Do you all have any idea? And then this, you may not, how many courts use these specific assessments? The ones you mentioned or just an idea, like more use it than don't or the other way around?

Jim Eberspacher:              Man, I wish I had the data on that ... I'm writing that down as actually a research point, but let me answer your question this way. So we go out and train ... Well, we don't go anywhere right now, but-

Dr. Christina L...:              We pull up our computers.

Jim Eberspacher:              We have contact with, how about that? We have contact with a number of jurisdictions, both training and just other technical assistance. We get questions from the field all the time over the phone or through email. I would say initial contact with jurisdictions, they tend to not have these assessments in place. So assessments for an impaired driving population. So when we talk about it, for some it's completely foreign that they should be doing some other type of assessment. Others they're aware of it, but kind of run into the barrier of, well, who's got the time and who has the energy to do more? And then others are really thoughtful about trying to get it in place. 

                                             So it runs a gamut, but hopefully our goal is that after we've talked with individuals or after we've provided training, that this is one of their number one priorities and I'll give you another example. We just recently did a training on it's implementing tracks within your DUI court. There was a jurisdiction I was working with who really came into the training with the intention of exploring whether or not they needed tracks, and we're talking tracks, we're talking about the quadrant model, different risk and need levels.

                                             As we were discussing some of the current issues and barriers and where they would like to go, it became clear that they may never develop tracks. It depends upon whether or not they have the numbers to do it. Whether they have the resources to support it and that's fine. But I thought one of the kind of coolest takeaways from this team that I was working with was even through this process, they were really thoughtful about having assessments for this population and making sure that they were doing it as close to arrest as possible. So they were identifying in a very kind of rapid way, like, "Hey, we may never get to the track or a quadrant model, but we could definitely tweak what we're doing." Which I thought was really neat and really kind of a considerate way to approach not just inclusion or expansion of numbers in your DUI court, but kind of changing the system entirely when it comes to impaired driving.

Dr. Kristen DeV...:            I was just thinking that's a great example of sort of system level change within that jurisdiction.

Jim Eberspacher:              Someday.

Dr. Kristen DeV...:            I mean, that's the hope for everybody. The DWI court being a part of that, but that's great.

Jim Eberspacher:              I'll be the first one ... Well, maybe not to first, but my job going back to some of the first words that we said in this podcast, my job is to really promote the expansion of DWI courts in jurisdictions. They're vastly underserved and underutilized in my opinion, both in jurisdictions that don't have one but also in jurisdictions that have a DWI court, but they could probably expand their capacity or their numbers because by using assessments or by bringing in additional resources if possible, to serve more.

                                             But DWI courts aren't for everybody. High risk kind need population, it's going to be not a small percentage, but it's not going to be likely the largest percentage of impaired drivers that come in or who are arrested. So you've got first timers who represent roughly two thirds of the arrestee population. Then you've got a third of the population who are repeaters. So the two thirds, if they're first timers never get another one.

                                             The stigma, the cost, the embarrassment, whatever it is, whatever the hopefully short intervention for a first timer was, is enough to correct that behavior right then and there. So the two thirds and if we narrow, instead of whittling down that population, in terms of risk and need, it's going to be a percentage likely of those folks who need DWI court, but what we're generally seeing in some of the research that's out there. Greater or the larger population is high risk and low need. So it's people who don't have a substance use disorder, moderate to severe who generally have risky drinking behaviors, but control their use.

                                             So if you tell them to quit it, they'll quit it. Or at least they have the ability to quit it without significant intervention, but to continue the behavior part and continue to really not care. So it's more about the criminal thinking piece of it and those anti-social attitudes that we want to focus on. That's likely going to be your larger percentage. And the reason why I bring this up is that we have to have interventions for first timers all the way through people who 10, 20 times. Because as I mentioned earlier, jail works in the immediate future in terms of stopping that behavior. They don't have access to a car. They're not on our streets. They're not going to repeat, but it's a short term intervention and they're going to be back in our communities. 

                                             But so when we look at the quadrant model or kind of on the continuum of impaired drivers, we need to make sure we're utilizing every possible resource and programming or intervention that we have available to us or that we're looking at adding pieces to that. I hope that kind of.

Dr. Christina L...:              Yeah, for sure and I just wanted to mention for maybe listeners who don't know what the quadrant model is. So we're talking about variations in level of risk and level of need, and the quadrant model gives us direction. So if somebody's low risk, low need, here's what they might need. High risk high need, here's what they might need, et cetera, et cetera. So just wanted to throw that out there in case somebody didn't know what the quadrant model was but we definitely need ... We can't have this cookie cutter approach as we like to call it when it comes to treatment and interventions.

Dr. Kristen DeV...:            And Jim, I liked your discussion about really thinking about the DWI issue within a community, and then having this continuum of services available to different segments of that DWI population all the way from the low risk low need to the high risk high need.

Jim Eberspacher:              I mean, because even with first timers. I mentioned that there's something that happens to them where they self-correct and they'll come back, but let's be thinking about, you have to be a first timer to become a second, third, fourth, fifth timer. 

Dr. Kristen DeV...:            Yes. 

Jim Eberspacher:              So even adopting some type of screening or assessment on the front end, for first timers to identify could they possibly to become a repeater. And there's been some jurisdictions who have done a tremendous job at kind of turning the system on its head when it comes to impaired driving, meaning they've implemented screening brief intervention referral to treatment, SBAR which I think is vastly underutilized in our system for impaired driving population. That's a whole separate topic we could go on, but what that does is that'll help identify for people who if they just have risky using behave, that's fine. 

                                             But if they show the signs and symptoms that maybe is something greater and they might have a moderate to severe substance use disorder, we just intervene very early on. Then let's give them the treatment that they need and if they don't have it, then we don't touch them or we just give them a little bit of education, and that's one example of front end kind of early stuff we can do. But when we're looking at other populations in that quadrant model and interventions, if we're truly responding, people have probably heard RNR, risk, need and responsivity. 

                                             If we're truly responding as a system to provide RNR for impaired drivers, we're looking at different tools and technology and programs that we could use based upon the population, whether 24/7 program is great, it's a different population than a high need population. DWI courts are great, it's a different population from people who don't need treatment and then there's ... They should interlock, there's other types of tools, there's alcohol monitoring cam devices and so on that we can utilize without having to go full blown DWI court if they don't need it.

Dr. Christina L...:              Jim, I think it's so important to understand the target population and these issues around risk and need. I don't think we can stress that enough for sure. One of the other things that we wanted to talk about was kind of what are the challenges that you all see or have seen related to getting these courts up and running? You mentioned your friend earlier, and you also referenced sort of the political aspect of these courts and the idea of do we just ... Are we letting them off easy kind of idea, that myth? So can you talk a little bit about some of the challenges that perhaps impede DWI courts from either starting or being successful in a jurisdiction? I suppose?

Jim Eberspacher:              Sure. I mean, I think there's a number of challenges. I think where I kind of might want to focus is if anybody's been involved in the justice system, whether you're an attorney, a judge, or a probation officer or whatever the case may be, DUIs or impaired driving statutes are some of the most complex convoluted just drawn out pages upon pages. You look at a murder statute and it's pretty cut and dry.

                                             You look at an impaired driving statue or DWIs statute, and it's crazy. I mean it, and the part of the other issue with that too, is that they're all different, right? You go to one state it's going to be different than another state, and the penalties are going to be different and what's allowed and how you can downward depart. It's all mess.

                                             Unfortunately we're not Canada who has the same thing across the entire country that would make things easier. So a lot of times the barrier that we face when we're having conversations with folks either thinking about starting a DWI court or a track, or trying to get them to consider it often runs into it might be a legislative issue or shortcoming. What I mean by that is that sometimes there's not enough enticement to do it. What I mean by that is DWI courts are a tough sell. They're a tough sell politically, they're a tough sell just because of the severe public safety issue and what a DUI could possibly do as an end result to individuals, death being the worst and most tragic end result.

                                             It being a tough sell sometimes you have to create some type of carrot to kind of coerce or entice entry. That said, there are other jurisdictions or statutes where some of the penalties are very lenient for a second or a third time. So if you don't have that carrot, you can't find that carrot because, hey, it's easier if I serve the 30 days and burn my number and I'm done or I'll take my chances on supervision because I know I'll likely fly under the radar. 

                                             That's a much easier course of action for people rather than having somebody in their face 24 hours a day over the course of 18 months or whatever the case it may be. Unless there's that sign carrot, and it could be harder to want to start a DWI court or convince defense counsel or even the individual to be involved or to want to participate in the program. Sometimes those legislative barriers make it difficult to get things started or kick things off.

                                             You look at other jurisdictions who may have very lenient front end stuff for a second or third time. And then suddenly you pick up your fourth, sorry, it's too bad you're going away for five years. No questions asked and you can't ... There's no mitigating circumstance where you can downward depart or put people on intensive supervision or in a DWI court program. And so it's like, those are unique challenges, not to mention how long it can take for a case from arrests to adjudication for DUI. 

                                             I mean, in some jurisdictions it could be a couple years. So if we can't do things close on the front end, if we don't have the ability to provide kind of carrots for entry, it can make it very difficult. Then sometimes there's just legislation that dare I say it just doesn't make any sense.

Dr. Christina L...:              Sure.

Jim Eberspacher:              It kind of goes to the RNR part of it. What the justice system has done very well is looking at things kind of in a back humor or microcosm and like, well, this is a great program. That means we can use it for everybody. That's not the case and so ... Or there are states or jurisdictions will say, awesome, we love 24/7 so that way we'll put our money and time and effort into 24/7 programming, and everybody can go through it because for whatever reason, and there are states who preferred DWI courts, there are states then prefer ... Who'll divert a number of cases before they're ever charged. It may be the person's third, but it looks like their first on paper. So some of that gets in the way with really kind of having the ability to just start at DWI court or get people interested in participating in that.

Dr. Kristen DeV...:            I think that sort of corresponds with what you said about the importance of an assessment, identifying a person's risk need level to see what is their risk of recidivism? What is their level of clinical need and need in terms of criminogenic risk and getting them and addressing their needs through appropriate clinical treatment and recovery support. I think that all ties back to exactly what you were saying at the beginning.

Jim Eberspacher:              I'm glad you brought up the clinical part because another thing that states have done really well, especially on the executive function and what I mean by that is Department of Vehicle Services or Department of Public Safety when it comes to licensing, there's often just arbitrary requirements connected to different levels of DUI statutes and arbitrary requirements in terms of to get my license back, I have to do 48 hours of education, or to get my driver's license back, I have to do 72 hours of treatment.

                                             It's not based upon any research, what people actually need. It's not based upon clinical assessments. So if I'm caught, I get arrested for DUI and I look, and I get a notice from my Department of Vehicle Services that says to get my license back, I have to go do 48 hours of treatment. Well, guess what, if I'm assessed by somebody that says, no, you need significant long-term individualized treatment. We're talking months, I'm going to say no way in hell am I going to do that? 

                                             No, they told me all I need is 48 hours. That's part of the other issue and then there's a whole secondary to that. Not secondary, a whole nother level to that is there are folks who think that driving education and especially when it comes to DUIs, that the education is a replacement for treatment. It absolutely is not replacement for treatment nor are support meetings or support groups or recovery, peer support kind of stuff. It's like that's an adjunct to support treatment.

                                             It's not treatment in and of itself. So we face a lot of those kinds of issues too, when we work with jurisdictions. And in trying to, yes, we know our departments from your DMV is however, you still need to clinically assess people and get them in the level care that they need, as opposed to offering some type of education support or something less. So it's very frustrating from a technical assistance piece. It's even more frustrating if you're in that jurisdiction trying to have to do with some of this.

Dr. Kristen DeV...:            Jim, obviously the researcher in me is really interested in sort of talking about some of the outcomes of interest. Obviously similarities between adult drug courts and some of the other treatment court types but specific outcomes of interest for DWI courts. Can you talk a little bit about what you see in the research and then also what you would recommend?

Jim Eberspacher:              Yeah, for sure. I think ... Not I think, if you've heard Doug Maelm talk and if you've heard him do that beyond a reasonable doubt preponderance of evidence stuff when it comes to research for different types of treatment courts, it's probably a few years ago where DWI courts actually kind of got to the level where they're effective. I think it was beyond a reasonable doubt. I'm probably butchering that somewhat and I'm sure Doug will let me know. But that was kind of a milestone in my opinion for DWI courts and their legitimacy and efficacy in a system where we knew treatment courts worked. 

                                             So the research that came before that to kind of get to that point, I thought obviously was really important and it showed ... There's and I'll point to kind of like one of the last larger scale studies was done in Minnesota, and we're going back seven years ago where they researched nine DWI courts and did a process, did an outcome and did a cost evaluation. So it was robust. The things that they found in terms of reduction of recidivism not just for future DUI, but also for general crimes was significant and was significantly lower than the comparison group. The cost was lower and the return on investment years out was significant.

                                             It was finally the research that we had to show folks who still were either on the fence or were opponents to say, "No, they're just like what we're seeing in adult drug court. They're effective. If you do it correctly, you stick to the model, you're going to find X, Y, and Z for results." So while that I think was critical in terms to legitimize DWI courts, the next step I think for anything is then, okay, let's drill down into what about them work. So we've got the adult drug court best practice standards and I think one of the key takeaways for folks listening to this that they should ... If they don't already understand this, is that all of those apply to DWI courts just as much as they do to adult treatment court.

                                             I understand that a lot of the research comes from adult drug court, but if you've fully read the standard deal and kind of look at some of the research that's included in that, there is DWI court research mixed in with that, but I think I might have said this earlier, we're not so different in how we function and operate that they don't apply. So everything that you read in those standards, you should strive for within the DWI court and then, but also thinking about, okay, so what are the differences, what else do we need to do in addition to the standards? Or how do we tweak some of what the standards ask for to kind of meet the needs of our population? Does that make sense?

Dr. Kristen DeV...:            Yeah, that's great.

Jim Eberspacher:              I think some of the key differences in addition to what I talked about earlier, transportation's a huge one for individuals in the DWI court. They're likely not coming in licensed. There's a stronger possibility that they will not get a license their entire time in DWI court and maybe even after, depending upon state guidelines and penalties. Looking at what can DWI courts do, what supports licensing, or what supports transportation and some of what we've seen in supporting not just outcomes in licensing, but the use of ignition interlock within a DWI court and its impact is pretty amazing. 

                                             If you've seen the research, Michigan has done significant research in this area where they looked at individuals within the calm sobriety courts, within their sobriety courts, whether or not they're on ignition interlock or they're not. They found that the group that also uses ignition interlock had better outcomes in attaining higher education levels, had better retention rates, better graduation rates, reduced recidivism one, two and three years afterward. 

                                             I mean, it was like wow, so if we just use a little bit of technology and we have the supervision, that's the other part that I think some people miss, we've got the supervision to respond to that technology when it's necessary, the impact that using something as simple as ignition interlock can have, not just in ensuring public safety because first and foremost, that's why we use it. People can't use alcohol and then drive, but the impact it has on that person and the long term outcomes that they have. I'd love to see other states could look at that and replicate some of that research to see was it a Michigan thing or truly is that kind of the standard in other jurisdictions? I think it'd be pretty interesting.

Dr. Kristen DeV...:            So for our research listeners, there's a study.

Jim Eberspacher:              I don't have the three letters after my name, but I fancy myself as a novice researcher. I kind of geek on over stuff like that because it should inform everything that we do. People say that's NADCP's messaging tagline. It's absolutely true. I mean, if we're not studying what we're doing, both from the very basic level to full blown, get people like you who are much smarter than me to do research.

Dr. Kristen DeV...:            I don't know about that.

Jim Eberspacher:              And do it correctly, let's put it that way. I can do it. It doesn't mean it's going to be scientifically valid. We absolutely have to do that. It should inform everything that we do. If we want to tweak something or if we have an idea, like my former judge would have many of them and call me all the time, it's like, we can try it, but let's be careful of how we implement it and let's make sure we study it to see if it's having the impact that we think it'll have. Everything that we do should not only be based in the research, we should be continually studying it to make sure that's truly it's having the impact that we think that it should have or that we expect.

Dr. Christina L...:              Thinking about the various areas of research, I know one thing that we hear a lot about, I mean, when it comes to other treatment courts, not just DWI courts, is you okay we know they work, we're starting to know for whom they work, but there's not a lot of research out there on treatment and sort of what impact does that have long term? Et cetera. What do you think about sort of the research with DWI courts and treatment? Is it there, do we need more of it? What do you think?

Jim Eberspacher:              I mean, it's a great question and I think a lot of people kind of feel the same, or let me put it this way. The folks that we work with I think often we so engage them and push and stress the importance and the outcomes that we see along recidivism and even a long kind of a quality of life outcomes. We stress that so much that I think we lose sight of what effective treatment is and having that based and rooted in the same research that we expect for everything else.

                                             I know I mentioned Julie or one of our project directors, she would kill me if I didn't say this, there's actually a lot of research that supports what engagement and what successful outcomes are in treatment from an objective perspective. Within treatment court, not so much. So actually she and I, mainly her had a session at RISE21 earlier this year where we talked about what treatment outcomes and how to base treatment in the research and in looking at it from an objective point of view, as opposed to having this notion that somebody's doing well so they successfully complete treatment.

                                             Which I think as practitioners who aren't treatment folks, that's kind of what we think happens. We send somebody to treatment or somebody goes to treatment. We know they go to group, maybe they have individualized counseling, they do this kind of stuff for however long. The treatment provider says they're good, everything ... They need some aftercare. They need some continued care. If we have recurrence, they need kind of some additional treatment, whatever it may be, but we kind of send people to treatment and expect magic to happen.

                                             When they come back out of treatment, we just kind of think, well, they told us it worked, or they told us they completed treatment so there we go. But if treatment is truly basing what they do on the data and understanding what objective measures are, that they have a process for that and they should be able to explain that to us as layman doctors that we think we are so that we truly understand what those expectations are. We know that treatment can be measured objectively.

                                             We know what successful outcomes can be based upon their baseline kind of data when they come in and then having the data tracked throughout their treatment. And Julie's going to kill me for butchering it in that way because she can talk about it much more eloquently than I can. But I think it's important for folks to understand that and let me kind of spin it this way too. If anybody's ever heard David Mee-Lee talk about treatment engagement and what successful treatment looks like, it's very different from a behavioral model that many of us outside of treatment expect from participants. 

                                             What I mean by that is that from a behavior modification perspective, we often think about the criminal thinking kind of approach, or habitual behaviors that we want to correct and change and utilizing what we know works for change in behavior. Everything and how we talk about and incentive sanctions and therapeutic adjustments. I think when you come at it from a disease perspective and kind of a treatment outcome model, it's very different than kind of behavior modification expectations in that we know that successful treatment often looks like there's an alliance with their treatment provider or their counselor, which leads to better engagement, leads to longer retention which leads to successful outcomes.

                                             It's slightly less about what the actual treatment was, if that makes sense. If you look at anything that David Mee-Lee has presented, and he presented this in a general session at RISE21, he had a chart or he had a graph or a pie chart or whatever it might have been on the screen. And it listed kind of the impact of successful treatment outcomes. And then lot to treatment alliance was one of the greatest predictors of outcomes using manuals and using specific types of treatment interventions and philosophies were certainly impactful and they have a role and there's a place and it definitely needs to be part of the package.

                                             But I think people lose sight of what alliance and client voice and the impact of that has. I think as not only as the DWI court model, as kind of treatment courts in general, we need to be cognizant of that and aware of that and how we have approach when people are engaged in treatment and when they come out of treatment, what that means in terms of if they're going to be successful or not. I maybe treading is a dangerous ground there, but I'm okay with it because I can support it.

Dr. Kristen DeV...:            It sounds like it's broadening the focal areas when you're thinking about long term change. It's having a voice in the process, it's feeling like you have an alliance with your treatment provider and then the behavior change. So thinking about all of that together is going to-

Jim Eberspacher:              Absolutely.

Dr. Kristen DeV...:            Improve outcomes.

Jim Eberspacher:              There's a balance between the two. I mean, we're absolutely court and a behavior modification type program. You've got the criminal thinking pieces and you've got the public safety aspects, especially for DUI courts when it comes to that. You absolutely have to have that in place, but it's a balance also then with treatment. It's like when we talk about our phase structure, one of the first things we mention is that your treatment phases and your treatment progress is a separate track from your court requirements. That's intentional, it's because while they may interplay with one another, one is not dictated, one doesn't dictate the other and so really understanding what treatment engagement is and how that impacts the other work that's going on, I think sometimes we lose focus of that and we absolutely should be paying attention to that. I know I kind of probably got off like the research part of it, but-

Dr. Christina L...:              No, not at all.

Jim Eberspacher:              People can dig in that.

Dr. Christina L...:              I mean, I think that's part of it. Definitely part of it.

Dr. Kristen DeV...:            I think across all treatment court types, sorry, we know the least about treatment and sort of what happens there.

Jim Eberspacher:              I think so. So the point, I think the big takeaway from that is that we shouldn't know the least about treatment. We're treatment courts.

Dr. Kristen DeV...:            Exactly.

Dr. Christina L...:              Then the name.

Jim Eberspacher:              As practitioners who aren't engaged in the treatment part, we have treatment representatives on the team for a reason. It's because they're the experts who can inform not only what the participants are doing and going through and expected, they can inform every one else on the team. I don't think we generally do enough to engage that and really understand why we should know more about treatment and what goes on in treatment because if we don't know that, it may impact the work that we ... Think about it from a trauma perspective alone, if we don't know what's going on in treatment and I don't mean the intricate details that-

Dr. Kristen DeV...:            Sure.

Jim Eberspacher:              Can't be or shouldn't be shared based upon confidentiality reasons. But if we don't know the entire story and picture of the person that we're treating or working with, how can we expect to really give them the tools that they need to be successful?

Dr. Kristen DeV...:            Yeah, exactly.

Dr. Christina L...:              I think kind of knowing about the research outcomes that we might know something about, although, as we just discussed treatment is one that we don't, but perhaps recidivism and driver's license restoration, those types of things that have been possibly looked at in the past, what other types of research questions if a funder came to you and said, word can fund some research, what do you want to know? What would you suggest that people been in their time on?

Jim Eberspacher:              I think there's a couple of areas where we don't have enough or it's more anecdotal. Let me start off with hybrid programs and what I mean by hybrid programs, it's treatment courts that take drug offending population, or crimes fueled by substance use disorder, but also take impaired driving cases. There's some research that points to that perhaps impaired drivers don't do as well in a traditional adult drug court.

                                             A lot of it I think anecdotally is based upon everything that we've discussed already. They're different people, different attitudes, they separate themselves from their crime and their substance use issue. If we pull them in together, whether it's in treatment programming or in court hearings, messaging can be lost in them very quickly.

                                             It may have kind of an impact on their buy-in and continued motivation to be in the program or to want to achieve success or recovery. So I'd love to see more research in whether or not that's actually true or support so then that way it would give us more to really advocate if you can't do a standalone DUI court, which we totally understand, sheer numbers or resources may be a prohibitive factor, but separating the populations into a DUI track or at least splitting the calendars in court so they're not all called together.

                                             That's minimally and something like that is very easy do. It's just separating again and I've seen plenty of jurisdictions do it. We do it often by gender. We could easily do it by DUI, by case. So more research kind of on that hybrid I think would be interesting to see, but the other part of it I think that leads potentially to sustainability and could lead to funding dependent upon how you use it, are impact on crashes. I see that variable or that outcome measure used very little, very infrequently with DUI courts. 

                                             It's a little confusing as to why, because if we're looking at really what's our overall goal? Aside from the participants we want to be in long term sustained recovery, that's the goal for participants. As a program, yeah we want to reduce recidivism, we want a return on our investment, blah, blah, blah, blah, blah. But ultimately don't we really want to reduce the fatalities and crashes that occur as a result of impaired driving? Absolutely. If we do, I mean, whether you're talking to law enforcement, prosecutors, MADD, the courts, whomever, absolutely, we want that to zero. 

                                             We don't want to see anybody die on our highways as a result of impaired driving. And so if we're not looking at the impact on crashes, I think we're kind of doing a disservice to are we really making our communities and our roads safer? And there's some good research out of San Joaquin county in California who looked at that and the work that they were doing had an impact in reducing crashes in half. If you have that data and you have that information, how can that be used? I mean, think about who has the greatest stake in wanting to see crashes reduced, can you guess?

Dr. Christina L...:              General public.

Jim Eberspacher:              Insurance companies, general public, insurance companies who pays out the most amount of money, who tries not to pay out any money when it comes to crashes or and so if you can show that your program hits their bottom line, their dollar, take that research and run with it. I mean, it's a tough industry to crack, don't get me wrong and insurance is very tough to even get a meeting sometimes. But years ago as an organization and we had some discussions on a national level with insurance agencies and that's essentially what they told us as a takeaway. It's like, look if you can show that DWI courts impact crashes and fatalities, that's good for us. Then that may be an end in terms of sustainability or even potential funding. That along with every other measure and outcome that we use for DUI courts, crashes should be along that continuum.

Dr. Christina L...:              Absolutely. Jim, this has been a really informative discussion around DUI courts. One of the things that we do at the end of all of our podcast is we like to give our listeners what we call a call to action. What can listeners take away from this episode if you had to pick a couple of things that could be done by our listeners to integrate some of this information.

Jim Eberspacher:              I'm guessing I'm not going to shock anybody by saying this because I've probably said it multiple times already, but early identification and intervention is kind of the critical piece. I mean, there's a reason why targeting is the first standard, and the best part standards. It's because if we get targeting wrong, it really doesn't matter what we do with folks because it's likely going to be either ineffective or we're going to harm people. So utilizing valid assessments as close as possible to arrest is kind of point number one.

                                             And then point number two from that I think is let's have everything that we can possibly have at our disposal to be their specific needs based upon risk and need. So whether that's if we introduce SBAT as an early kind of assessment process to full blown assessments for repeaters. And then having pretrial services to things after adjudication and conviction, whether that's interlock or treatment or 24/7, or DWI court, whatever it may be, let's make sure we're listening and following the assessments to get people into the services that will actually help them.

Dr. Christina L...:              We want to thank Jim for joining us on the Justice To Healing podcast today. Thanks a lot for being here, Jim.

Jim Eberspacher:              Thanks for having me. I had a lot of fun and I hope this kept people's interests even though I tend to maybe drawn on and on and repeat the same things, it's for a reason, but I had a lot of fun and I hope people take away the same things but also have a takeaway message too.

Dr. Christina L...:              I think it was really great to provide the listeners with information about these courts that perhaps aren't known exactly what they're there for. So I think that was really great. And we want to thank our listeners for joining us today. We welcome our listeners to continue the conversation on the Justice To Healing discussion forum on the NDCRC website. We hope you'll join us again next time and remember, we can all do better.

Speaker 4:                          To our listeners, we thank you for listening and we hope you enjoyed the show. Be sure to hit subscribe and stay updated on the podcast. Follow us on Facebook, Twitter, and LinkedIn, to stay engaged with us and check out our website ndcrc.org. Thanks again. Catch you next time on Justice To Healing. 

Speaker 5:                          The Justice To Healing podcast is presented by the National Court Resource Center and was supported by the grant number 2019DCBXK002 awarded by the Bureau of Justice Assistance, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the office of Juvenile Justice and Delinquency Prevention, the office of victims of crime and the smart office. Points of view or opinions in this podcast are those of the author and do not necessarily represent the official position or policies of the United States Department of Justice.