Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First‐Time DUI Offense

Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence‐based therapy in these programs may help prevent DUIrecidivism. We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUIprograms in California. Participants were 21 and older with a first‐time DUIoffense who screened positive for at‐risk drinking in the past year. Participants were randomly assigned to a 12‐session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent‐to‐treat analyses to test the hypothesis that participants receiving CBTwould report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol‐related negative consequences. We also explored whether race/ethnicity and gender moderated CBTfindings. Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBThad lower odds of driving after drinking at the 4‐ and 10‐month follow‐ups compared to participants receiving UC(odds ratio [OR] = 0.37, p = 0.032, and OR= 0.29, p= 0.065, respectively). This intervention effect was more pronounced for females at 10‐month follow‐up. The remaining 4 outcomes did not significantly differ between UCversus CBTat 4‐ and 10‐month follow‐ups. Participants in both UCand CBTreported significant within‐group reductions in 2 of 5 outcomes, binge drinking and alcohol‐related consequences, at 10‐month follow‐up (p < 0.001). In the short‐term, individuals receiving CBTreported significantly lower rates of repeated DUIthan individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short‐term reductions in impaired driving. This study tested the effectiveness of cognitive behavioral therapy (CBT) in DUIprograms in a diverse sample of individuals with a first‐time DUI. Participants in both the CBTand usual care group reported significant reductions in binge drinking and alcohol‐related consequences after 10 months. However, those receiving CBTwere less likely than the usual care group to report driving after drinking at follow‐up. DUIprograms may consider delivering CBTin programs to specifically intervene with this high‐risk population.