- 學位論文
酒駕累犯參與強制酒癮治療之經驗與啟示
The Experiences and Lessons of Repeat Drunk Driving Offenders Participating in Mandatory Alcohol Addiction Treatment
摘要
在臺灣寬鬆的酒精限制下，目前尚無酒害防制專法，酒駕事件對社會產生了深遠影響，酒駕者重複酒駕機率高，飲酒問題是酒駕再犯的主要危險因子，接受酒癮治療有其必要性。因此在司法與醫療合作的酒駕酒癮治療趨勢下，強制酒癮治療成為降低酒駕再犯的解決策略之一。本研究採質性研究，訪談緩起訴附命戒癮治療者、易科社會勞動者、酒駕吊銷駕駛執照重新申請考照者共5位，探討參與依法律規定之酒精戒癮治療的經驗，以及其停酒的動機改變情形，以了解強制酒癮治療對於酒駕累犯的價值與意義。研究透過自我決定論（Self-determination theory, SDT）及跨理論模式（Transtheoretical Model, TTM）來說明行為改變的動機以及了解行為的改變。本研究結論如下，探討受訪者戒酒動機的改變為：(1)主要源於法律規定與強制性的壓力。(2)家庭生活、工作責任是戒酒動機的考量。(3)年齡增長及健康示警的動機。(4)獲得成就感及蛻變重生是延續行為改變的動機。受訪者參與強制酒癮治療的經驗為：(1)強制酒癮治療有嚇阻、約束、警示及監督作用。(2)提供解決酒癮問題的機會。(3)支持與指引的醫病關係。(4)強調個人意志及責任的重要性。(5)展現較多的正向情緒和較少的負向情緒。針對研究的結果及發現，呈現以下建議。在政策制度方面：提升醫療及司法相關專業人員的培訓，以及增加司法醫療之間的合作及溝通。提供適當資源，作為激勵受治療者接受治療或是維持戒酒行為的酬賞機制。根據個體的差異性給予適切的治療策略。在實務工作面：(1)實務工作者自身的調整。(2)運用自我決定論(SDT)的基本需求滿足概念，協助內化受治療者的改變動機。(3)運用跨理論模式(TTM)的改變階段策略，進行行為的改變。(4)建立一個信任的醫病關係,有助於執行強制酒癮治療工作。本研究作為醫療端，探討接受酒癮治療之酒駕累犯的看法及經驗，以及建議實務工作者如何與接受強制治療的酒駕累犯一起工作，並提供有關「強制酒癮治療」相關政策的改善建議。
並列摘要
Under Taiwan's loose alcohol restrictions, there is currently no special law to prevent alcohol abuse. Drunk driving incidents have a profound impact on society. Drunk drivers are more likely to repeat drunk driving. Drinking is the main risk factor for drunk driving recidivism. Receiving alcohol addiction treatment has its own advantages. necessity. Therefore, under the trend of cooperation between the judiciary and medical care in the treatment of alcohol addiction, compulsory alcohol addiction treatment has become one of the solutions to reduce the recidivism of drunk driving. This study was a qualitative research, and interviewed 5 people, including those who received deferred prosecution and sentenced to life imprisonment, those who changed to social work, and those who reapplied for a driver's license after their license was revoked for drunk driving, to explore their experience of participating in alcohol addiction treatment in accordance with legal provisions, and The changes in their motivations for stopping drinking are analyzed to understand the value and significance of compulsory alcohol addiction treatment for recidivist drunk driving offenders. The study used Self-determination theory (SDT) and Transtheoretical Model (TTM) to explain the motivation for behavior change and understand behavior change. The conclusions of this study are as follows: (1) It mainly comes from legal regulations and mandatory pressure. (2) Family life and work responsibilities are considerations in motivation for quitting drinking. (3) Motivations for aging and health warnings. (4) Gaining a sense of accomplishment and transformation is the motivation for continuing behavioral change. The respondents’ experiences of participating in compulsory alcohol addiction treatment are as follows: (1) Compulsory alcohol addiction treatment has deterrent, restraining, warning and supervisory effects. (2) Provide opportunities to address alcohol addiction. (3) Support and guidance of the doctor-patient relationship. (4) Emphasize the importance of personal will and responsibility. (5) Show more positive emotions and fewer negative emotions. Based on the results and findings of the study, the following recommendations are presented. In terms of policies and systems: improve the training of medical and judicial professionals, and increase cooperation and communication between the judicial and medical sectors. Provide appropriate resources as a reward mechanism to motivate patients to accept treatment or maintain abstinence. Provide appropriate treatment strategies based on individual differences. In practical work: (1) Adjustment by practitioners themselves. (2) Use the concept of basic needs satisfaction from self-determination theory (SDT) to help patients internalize their motivation to change. (3) Use the Transtheoretical Model (TTM) change phase strategy to change behavior. (4) Establishing a trusting doctor-patient relationship helps to implement compulsory alcohol addiction treatment. As a medical end, this study explores the views and experiences of recidivist DUI offenders who receive alcohol addiction treatment, suggests how practitioners can work with recidivist DUI offenders who receive compulsory treatment, and provides suggestions for improving policies related to "compulsory alcohol addiction treatment."