Research Korner: Domestic Violence

VIOLENCE AGAINST WOMEN AND CHILDREN

RESEARCH PROPOSAL     RESEARCH TITLE:               A retrospective study on the presence of mental disorders diagnosed on the sexually abused clients referred to the Women and Child Protection Unit at the National Center for Mental Health (NCMH).     RESEARCH OBJECTIVES:   1.      To determine the incidence and comorbidity of mental illness found in the sexually abused clients referred at the NCMH from January – December 2001.     METHODOLOGY               A statistical study from representative data gathered from 100 clients with complete court reports referred to the NCMH from January to December 31, 2001.      PROPOSED BY:      M.D. Medical Office III     DISCUSSION            A total of 100 documented cases of family violence, obtained from the files of the NCMH covering the period from 2001-2002, were analyzed statistically, based on the list of factors that could provide a comprehensive profile of these clients.  The following general findings of the study show the extent and the kind of abusive and violent environment the clients were in and the circumstances which have triggered such events to happen.   1.  Violence in the family consists of several forms of abuses - physical, verbal, economic, emotional and sexual. Due to their vulnerability in the family structure, it is often the women and the children who are the recipients of such acts of violence. Figure 1 shows a graph of the different forms of abuse. For this study, the most common form of abuse is sexual assault (66%), followed by physical abuse (18%) and then by verbal abuse (10%).  There was also an incidence of economic abuse (1%), plus an incidence wherein verbal, physical and economic abuse occurred simultaneously (1%).  Other forms of abuse (3%) consisted mostly of varying degrees of emotional abuse with combinations of any of the aforementioned types.                    Some of these abuses occur in different combinations.  Sexual abuse is often accompanied by physical and verbal abuse .A typical example would be a case of a male neighbor molesting a young girl after which he menaces the girl with pernicious words and promises of retaliation if the victim seeks help. Another would be a case of a young girl being raped by a distant family relative and then being taunted by a series of physical and verbal threats.   Figure 1.  Forms of Abuse   2.         Victims experience violence repeatedly at varying periods of time (worst case was one victim who was raped every Sundays), in the hands of the same or different household members from brother to father or uncle to a male neighbor (the most frequent abuser) to the stepfather, in-laws, foster parents, siblings and employers (in the case of domestic helpers).  The cycle of violence usually starts with one form of violence that leads to another.  There have been cases wherein such abuses led to sexual molestation and rape.           Figure 2.  Progression of Violence     Figure 2 shows the graph of the progression of violence.  Typical progressions are: a) physical abuse to sexual abuse to rape (71%); and b) sexual molestation to rape and economic abuse to physical abuse (15%).  There were also cases of verbal abuse that led to physical assault (7%) and verbal abuse that led to physical abuse, sexual molestation and finally, to rape (5%). In some cases, rape was also preceded by verbal abuse and physical assault (2%).   Rarely is one abuse exclusive of another.   3.  Figure 3 shows the age range of the clients.  The average age of the victims is 15.27 years old.   The most dominant group, comprising sixty-two percent (62%) of the clients, were between the ages eleven to seventeen.  Twenty- two percent (22%) were young adult females, with ages between 18-24 years old.  Twelve percent (12%) were of children’s age, between 4-10 years old.   The youngest victims were a 5-year old boy and girl, while the oldest was a 48-year old widow.    Figure 4 shows the civil status of the clients, with ninety-nine percent (99%) of the respondents being single.  Only one was a widow.    On the other hand, figure 5 shows the gender of the clients.  Almost all victims were female (95%) and only 5% were male.    Figure 7 shows the educational attainment if the clients.  Almost all of the victims have been educated, half of which reached elementary education (58%), 1/3 reaching high school (31%), and 2% of them reaching college.  Nine percent (9%) were still of pre-school age and even then, did not still go to school.    Figure 9 shows the employment background of the victims. About 82 % of the victims (8 out of 10) are not gainfully employed, since most of them are minors.  The rest, who are of working age, toil in menial types of jobs.               Minors (aged 0-17) comprise an overwhelming 84% of the total victims of abuse. More than half of the cases of domestic violence against children and minors involve some form of sexual abuse. Figure 10 shows the most common abuses against minors.  Rape is the most common form of assault against minors (46%).  This is followed by sexual molestation (17%), physical abuse (12%), incestual rape (9%) and pregnancy out of wedlock (8%).    Figure 3. Age of Victim (in Years Old)                   Figure 4.   Civil Status           Figure 5.  Gender                     Figure 6.  Address / Area     Figure 7.  Educational Attainment               4.  Figure 6 shows that most of the clients came from Quezon City (20%), with Pasig City and Nueva Ecija next (11%) followed by Mandaluyong City (7%).  The clients came from as far as San Jose, Occidental Mindoro, Batangas and most of the cities and municipalities in Metro Manila   Figure 8.  Person Who Brought Patient to Hospital             5.  Figure 8 shows the graph of the persons who brought the patient to the hospital.  The mother of the patient was the most common helper (42%), followed by the grandmother (26%), the auntie (13%).  Nonrelatives accounted for 19% of the people who helped the patient.   Figure 9.  Employment of Victim   Figure 10. Forms of Violence Against Minors               4.  Forty-one cases of mental illness were found.  Figure 11 shows a graph of the figures.  The most common mental illnesses were major depression and mild mental retardation (32%).  Both accounted for more than half of the cases.  Another common form of mental illness was moderate mental retardation (20%).  There were also cases of bipolar affective disorder (10%), severe mental retardation (5%) and schizophrenia (2%).   Figure 11.  Presence of Mental Illness                       Figure 12.  Number of Episodes of Sexual Abuse   5.  Figure 12 shows the number of episodes of sexual abuse.  The frequency of sexual abuse ranged from once to more than five times.  The most common number of episodes of sexual abuse ranged from once (32%) and more than five times (36%).  A repeat of the first sexual abuse was also fairly common (27%).  More than half of the number of episodes (68%) occurred more than once, showing that the perpetrator has easy access and has more power economically, physically and emotionally than the victim, that’s why the perpetrator can repeatedly abuse the victim.   6.  Figure 13 shows the profile of the perpetrator.  The most common perpetrator of assaults on women (young and adult) is their male neighbors, who account for 30% of the abuses. The average age of the perpetrator is 32 yrs. old, more than double that of their victims (15 yrs. old).    Figure 14 shows the educational attainment of the perpetrator.  Generally, he is more educated than his victim. Only 31% of the victims reached high school as compared to the 45% of the perpetrators.  Only two percent (2%) of the victims were able to reach tertiary education compared to the 11% of the perpetrators.  One-fourth of the perpetrators finished elementary.               The child molester or abuser is significantly older than his victim.  Two out of five men who victimized children and minors are in their 30’s or 40’s.  The abuser’s average age is 32 yrs. old, more than twice that of their victims, whose average age is 15 yrs. old.   Figure 15 shows a graph of the abusers of minors.  The most frequent abuser of minors is their male neighbors (30%), followed by their uncles (12 %), and their fathers (8%).   Figure 13.   The Perpetrator   Figure 14. Educational Attainment of Abuser       Figure 15. Abusers of Minors                    7.  Figure 16 shows the aggravating circumstances of the abuse.  Most child abuses took place at home while the victim is alone (42%).  Victims are often easy prey even at their own homes since this is where they usually feel safe.  And often, their mothers also have the same mindset.  As this study shows, they are often wrong.  One-fourth of the victims are usually young, trusting and vulnerable.   One half of the cases involve absentee parents, meaning some belong to broken families and the other cases happened while the parents are away or working. This underscores the need for supervised childcare (as most of the perpetrators are male neighbors). Also, the majority of the sexual abuses occurred at night. There were even cases wherein the perpetrator shared rooms with the victim.  This shows that the separation of sleeping quarters or rooms and the presence of household members seemed to be no assurance against sexual abuse.               The influence of alcohol or drugs on the abusers is a major exacerbating factor in domestic violence (14%). Aside from that, influences like the presence of pornographic materials, magazines, videotapes, and VCD are potential aggravating factors in child molestation, accounts for a smaller number of cases (1%).  Poor quality of family life and relationships is also an aggravating circumstance.  There have been cases wherein the spouses fight (3%) and when the husband is unfaithful (1%).     Figure 16 . Aggravating Circumstances   Figure 17 shows the family background of the perpetrator.  The graph shows that harsh economic conditions and poor family relationships that prevail in the perpetrator’s family are the major reasons that could have led to the behavior of abuse.  The foremost background of the perpetrator is strained family relations (19%), usually that involving the spouse.  This is followed by extreme poverty (10%), and a history of abuse (23%) in the perpetrator’s family.  This history of abuse can also stem from the fact that twenty-three (23%) percent of the cases involve an abuser who has a history of intoxication before abuse.   Figure 17. Family Background   8.  Figure 18 shows the major reasons why the patients don’t report to the authorities.  Majority of the victims were minors and often were trusting of their much older perpetrators.  Some clients showed resistance, while the much younger ones may not have known that the actions done on them were already a form of abuse.  Fear of their own personal safety is the major reason for the victim not reporting their abuse to authorities (37%).  Often, they are too young to know that they are already being abused and this ignorance and naivete is a major drawback in resolving these cases, unless an adult intervenes (22%).  Another common reason for not reporting is ambivalence or the indecision of the client to report the abuse (20%).  Since majority of the clients are minors, they would often not take the initiative to report the abuse without any willing help from their older relatives.  Alarmingly, eighteen percent (18%) of the clients feared reporting their ordeal since it would cause embarrassment to their families.               Figure 18. Reasons for not Reporting the Abuse   9.  Figure 19 shows the effects of the abuse on the clients.  It is interesting to note that the effect of the abuse on the children is met by a palliative, instead of something more concrete.  This palliative was done by sixty four (64%) of the clients, who decided to move residences, to stay as far away from the perpetrator.  Twenty percent (20%) of the clients  had to face an even stiffer penalty for reporting their case, and that is ostracism from their own family.  These clients are usually the ones who were raped by a family member.  Due to the emotional strain caused by the abuse, thirteen percent (13%) of the clients decided to stop schooling for lack of concentration.    This study did not dwell extensively on the true extent of the psychological damage inflicted on the victims and can be the subject of a future follow-up to the study.    Figure 19. Effects of Abuse                                               Conclusion   Family violence can appear in different forms; physical, verbal, economic, emotional and sexual. However, such incidences are precursors to even more disturbing abuse, which is usually sexual in nature.  In this study, such abuse starts with sexual molestation and finally, rape.  The majority of the clients in this study are minors, making them easy prey to their much older perpetrators.  Their ages ranged from 5–17 years old.  These clients often experience violence at varying periods of time, with the perpetrator, being a close relative like their own brother, father, uncle or, their male neighbors.  The victims’ average age for this study is only 15 years old, while that for the perpetrator is 32 years old.  Most of the patients are female and there were five male patients, all minors.  Most of the patients finished either high school or elementary.  There were even some who have only started school.    The abuse is often aggravated by the following circumstances: the most common is when the victim is alone.  Victims are often easy prey even at their own homes since this is where they usually feel safe.  One-fourth of the victims are very young (5-10 years old), trusting and vulnerable.   Also, one-half of the cases involve absentee parents, which either means, they belong to broken families or the parents are either away or working.  Also, the majority of the sexual abuses occurred at night. Only about a third of the victims experienced abuse only once.  The rest had to endure it twice, thrice and even more than five times before the victim had the courage to report to an adult who eventually accompanied the victim to the authorities.  There were even cases wherein the perpetrator shared rooms with the victim.  The intake of alcohol or the use of drugs is another major aggravating factor, aside from the presence of pornographic materials, magazines, videotapes, and VCD.  Other aggravating factors include poor quality of family life and relationships, spousal conflict and when the husband is unfaithful.               For this study, the minors (aged 5-17 years old) comprised an overwhelming majority of the total victims of abuse. More than half of the cases of domestic violence against children and minors involve some form of sexual abuse. The most common abuses against minors are rape, sexual molestation, physical abuse, and to a lesser degree, incestual rape and pregnancy out of wedlock.    Majority of the patients came from the Metro Manila area, but there were cases from as far as San Jose, Occidental Mindoro, Laguna, Batangas and Nueva Ecija.  Most of the patients are not of working age yet, but those who are, worked in menial jobs.  The victims were minors and often were trusting of their much older perpetrators.  Some clients showed resistance, while the much younger ones may not have known that the actions done on them were already a form of abuse.  The mother of the victim is the one who usually accompanies the victim to the authorities.  The grandmother, the auntie as well as friends and neighbors have also helped the victim.         The perpetrator is usually male, the most common, being the victims’ neighbors.   It may also include direct relatives like the father and the uncle.  The perpetrator, is generally, more educated than his victim. The child molester or abuser is significantly older than his victim.  Two out of five men who victimized children and minors are in their 30’s or 40’s.    Mental illness among the victims is not uncommon.  These are often direct results of the abuse.  The most common mental illnesses among the victims are major depression and mild mental retardation.  Another common form of mental illness was moderate mental retardation.  There were also cases of bipolar affective disorder, severe mental retardation and schizophrenia.   The following are the main reasons for not reporting to the authorities: fear of their own personal safety, ignorance and naivete, ambivalence or the indecision, and embarrassment to their respective families.  The effects of abuse ranged from ostracism from the immediate family, having to transfer residences to avoid retribution and shame from the neighbors, stopping school and some were even institutionalized.               This study shows a general picture of the profiles of the victims as well as that of the perpetrators.

VIOLENCE AGAINST WOMEN AND CHILDREN

RESEARCH PROPOSAL RESEARCH TITLE: A retrospective study on the presence of mental disorders diagnosed on the sex...

Counseling and Alcoholism

Counseling and Alcoholism Effective Ways of Motivating Treatment for Alcoholic Adolescents   Introduction             Alcoholism is one of the problems that the society faces today. It does not only affect certain individuals and families, but the whole community as well. It has been reported that approximately 14 million Americans or about 7.4% of the adult population meet the diagnostic criteria for alcohol abuse or alcoholism ( 2006). In addition, many diseases are being attributed to alcoholism, such as cancer, psychological disorders, ulcers, brain damage, glandular problems, birth defects and other bodily malfunctions. These diseases cause the lives of many Americans annually. Moreover, adults are not the only ones suffering from alcoholism, but teenagers as well. The community and the society become affected with the issue of alcoholism, as many teenagers commit crimes as an effect of drinking alcohol. It has been reported that the total cost attributable to underage drinking, including costs of traffic crashes, violent crime, injuries, and treatment, is over $52 billion per year ( 2006). With these problems, it is necessary to propose treatment of alcoholism at an early age, preferably to teenagers or adolescents. With an early treatment, the incidence of alcoholism can be lessened in adult years. In this paper, the effective ways of motivating treatment for alcoholic teenagers or alcoholics will be presented. These ways will be evaluated and assessed to examine its effectiveness in convincing adolescents for early treatment of alcoholism. The hypothesis of this study is to prove whether adolescents with a family history of alcoholism is more likely to become alcoholics in the future. This will be proven and supported by the discussion of related studies already done.   Definition of Terms Alcoholism – Binge drinking -- Hallucinations – Homicide – Suicide –                           Review of Literature Facts on Alcoholism             Alcoholism is also known as alcohol dependence and is considered a disease with symptoms such as craving or feeling a strong urge to drink; loss of control or not being able to stop once drinking has begun; physical dependence such as nausea, sweating, shakiness, and anxiety; and tolerance or drinking greater amounts of alcohol to “get high” (2006). Many people believe that drinking alcohol will and may ease their problems regarding their family, work and the society, but in fact, it would not. Acquiring alcoholism may lead to more serious complications and fatal illnesses that would cause the person’s life.             Several think that alcoholism is a disease, and in fact, the  (2006) is supporting this statement. The Institute explains that the craving that an alcoholic feels for alcohol can be as strong as the need for food or water, and an alcoholic will continue to drink despite serious family, health, or legal problems. Moreover, like many other diseases, alcoholism is chronic, which means that it lasts a person’s lifetime, usually follows a predictable course, and has symptoms (2006). The risk for developing alcoholism is influenced by both the person’s genes and by his or her lifestyle (2006).              It has been reported that alcoholism was first recognized as a disease in the 1930s by a group called “Alcoholics Anonymous”, and since then, the American Medical Association has recognized alcoholism as a serious and chronic disease (2005). Alcoholism takes time to develop, but once it develops, it does not go away (2005). Cure is not available for alcoholism, but is treatable, and with proper treatment, an alcoholic will be able to reclaim his or her normal, satisfying lifestyle (2005).             It has been reported that the World Health Organization (WHO) estimates that there are about 2 billion people worldwide who consume alcoholic beverages and  76.3 million with diagnosable alcohol use disorders (2004). From a public health perspective, the global burden related to alcoholism and alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world (2004). Moreover, given alcohol’s significance in world health, the World Health Organization has been developing a database since 1996, named the Global Alcohol Database, in its aim in providing a standardized reference source of information for global epidemiological surveillance of alcohol use and its related problems (2004). This database will be helpful for the organization to record the incidence of alcoholism worldwide. This is essential so the government can take action and responsibility in proposing or implementing programs to help lessen the incidence of alcoholism.   Similarly, in the United States, alcohol is still the number one drug problem, and affects adolescents, middle-aged people and senior citizens, and people of all races, religions, intelligence levels and professions (2005). In fact, there are approximately 18 million alcoholics in America (2005), and this high incidence affects many aspects in the society. In 1995, the estimated annual cost of alcohol abuse in the United States was $166.5 billion, where alcohol use disorders cost $56.7 billion more than the estimated annual economic cost of illegal drug use and $36.5 billion more than the estimated annual economic cost of smoking ( 2006).      Effects of Alcoholism              Alcoholism presents a variety of effects, not only on the physical or biological aspect of an individual, but on the society as well. It has been reported that short-term physical effects of alcohol use include distorted vision, hearing and coordination, altered perceptions and emotions, impaired judgment and hangovers (1999). On the other hand, long-term physical effects of heavy alcohol use include loss of appetite, vitamin deficiencies, stomach ailments, skin problems, sexual impotence, liver damage, heart and central nervous system damage, and memory loss (1999). Long-term physical effects also include diseases and organ malfunctions. These diseases include brain damage, which varies from psychosis to permanent memory loss; cancer, such as in the mouth, esophagus, and stomach due to the irritating effects of alcohol; heart disease, such as an enlarged heart and congestive heart failure; liver damage leading to cirrhosis or scarring of the liver and liver cancer; ulcers that produces stomach and intestinal irritation; glandular problems in the adrenal and pituitary glands; and birth defects on women who drink alcohol during pregnancy (2005). This condition is known as Fetal Alcohol Syndrome or FAS (2005).             Aside from the diseases caused by alcoholism, it also presents psychological and psychiatric problems, which in turn determines social issues happening in the society, such as suicide, accidents, and crimes. Some of these problems include depression, which can be triggered by alcoholism and vice versa; anxiety, which occurs during attempted withdrawal; change in personality with loss of normal behavior and appearance; and hallucinations, which is an affect of alcohol withdrawal ( 1997). These psychiatric problems often lead to social issues such as suicide, which is result of depression; accidents, being a result of drunk-driving; and physical abuse, which are the cause of a large portion of homicides, child abuse cases and other domestic violence cases (2005).   Adolescent Alcoholism             Alcohol abuse and alcohol dependence are not only adult problems, but they also affect a significant number of adolescents and young adults between the ages of 12 and 20, even though drinking under the age of 21 is illegal (2000). According to a research done by the National Institute on Alcohol Abuse and Alcoholism, adolescents who begin drinking before age 15 are four times more likely to develop alcohol dependence than those who begin drinking at age 21(2000). In addition, drinking at an early age can also be associated with alcohol-related violence, not only among persons under the age of 21 but among adults as well (2000).             It has been estimated that over three million teenagers are alcoholics, and several million more have a serious drinking problem that they cannot manage on their own (2000). This is why early treatment of alcoholism in adolescents must be done to prevent further damage on their lives. It has been mentioned earlier that alcoholism presents grave threats on the lives of many individuals, especially on the lives of many teenagers. These threats include accidents associated with drunk driving, and crimes. It has been reported that the three leading causes of death for 15 to 24 year olds are automobile crashes, homicides and suicides, and alcohol is a leading factor in all three (2000). While drinking may be a singular problem behavior for some, research suggests that for others if may be an expression of general adolescent turmoil that includes other problem behaviors and that these behaviors are linked to unconventionality, impulsiveness, and sensation seeking (2000).             It has been reported that binge drinking, often begins around the age of 13, tends to increase during adolescence, peak in young adulthood in the ages between 18 to 22, then gradually decreases (2000). Individuals who increase their binge drinking from the age of 18 to 24 and those who consistently binge drink at lease once a week during this period may have problems attaining the goals typical of the transition from adolescence to young adulthood (2000). These goals include marriage, education, employment, and financial independence (2000).             Moreover, alcohol use among adolescents has also been associated with considering, planning, attempting, and completing suicide (2000). Research does not indicate whether drinking causes suicidal behavior, only that the two behaviors are correlated (2000). Suicide is also related to depression and anxiety, for these behaviors somehow trigger alcoholics to result to suicide. In addition, these behaviors can also become severe with the influence of alcohol. This is why during the event of suicide, the alcoholic has already experienced severe depression and anxiety prior to the activity, including the fact that with the influence of alcohol, a person cannot make sound judgments.             Furthermore, the influence of peers can also be attributed to adolescent drinking. More often than not, adolescents become exposed to alcohol drinking through their peers. With this, the role of the parents becomes crucial in the discipline of their children. Proper guidance must be given to adolescents regarding drinking alcohol. Education also is important, for information regarding alcoholism and drug abuse must be give to adolescents for early prevention.   Parental Guidance and Influence             (2000) reports that parents’ drinking behavior and favorable attitudes about drinking have been positively associated with adolescents’ initiating and continuing drinking. Children who were warned about alcohol by their parents and children who reported being closer to their parents were less likely to start drinking (2000). Lack of parental support, monitoring and communication has been significantly related to frequency of drinking, heavy drinking, and drunkenness among adolescents (2000). Harsh, inconsistent discipline and hostility or rejection toward children have also been found to significantly predict adolescent drinking and alcohol-related problems (2000).                 Methodology             Thirty participants (30) will be included in the study, and will be randomly selected from the population. The age will be considered, for only 13 to 20 years olds will be asked to participate in the study. This age bracket will be considered because at these ages, adolescents become exposed for the first time to alcoholic drinks or beverages. The socioeconomic status of the participants will also be considered, for it can be assumed that many adolescents belonging to the lower class of society are more exposed to alcoholic drinks compared to the adolescents belonging to the middle class or from the elite. Aside from these, the education of the participants will also be considered. Education is also a good basis for the knowledge of the participants regarding alcoholism.     These 30 participants will be asked to answer a questionnaire, for easy evaluation of their exposure and interest in alcoholic drinks. The questionnaire will have 20 questions that will be answered by each of the participants.        Summary

Counseling and Alcoholism

Counseling and Alcoholism Effective Ways of Motivating Treatment for Alcoholic Adolescents Introduction Alcoholis...

Early pregnancy of teenage causes maternal mortality and high population growth in Bangladesh research proposal paper

Introduction             In much of the developing world. Adolescent and child marriage continues to be a strong social norm, particularly for girls. Early female marriage is associated with a number of poor social and physical outcomes for young women and their offspring. On average, girls who marry as adolescents attain lower schooling levels, have lower social status in their husband’s families, report less reproductive control and suffer higher rates of mortality and domestic violence. In Bangladesh, many Bangladeshi girls are married soon after puberty, partly to free their parents from an economic burden and partly to protect the girls’ sexual purity. Where a girl’s family is very poor or she has lost her parents, she may be married as a third or fourth wife to a much older man, to fulfill the role of sexual and domestic servant. It is estimated that about 51 percent of Bangladeshi girls are married by age 18.             Customs surrounding marriage, including the desirable age and the way in which a spouse is selected, depend on a society’s view of the family – its role, structure, pattern of life, and the individual and collective responsibilities of its members. Early marriage is one way to ensure that a wife is protected, or placed firmly under male control; that she is submissive to her husband and works hard for her in-laws’ household; that the children she bears are legitimate, and that bonds of affection between couples do not undermine the family unit.             In addition to negative social and physical consequences of early marriage, larger social consequences of early marriage were also identified including higher population growth, more rapid spread of disease, and a higher incidence of orphans. As a result of these patterns, early marriage is an issue of significant concern to policy-makers and human rights advocates. Governments in developing countries face increasing pressure to eradicate the practice with legal sanctions against parents who marry daughters before a standard age of consent. Proponents of “child protection” and age of consent laws argue that forcing parents to delay marriage will increase female educational attainment and reproductive control and decrease incidence of domestic violence. For the same reason, social programs such as education scholarships for girls increasingly contain program rules excluding girls who marry young in an effort to discourage the practice.   Research Problems 1. What are the reasons for early marriage in Bangladesh? 2. What are the negative effects of early marriage to women? 3. What are the negative effects of early marriage to children? 4. What are the negative impacts of early marriage to the society. 5. How is the Bangladeshi Government dealing with the problem of early marriage?   Research Objectives 1. Identify the reasons for early marriage in Bangladesh. 2. Determine the negative effects of early marriage to women. 3. Identify the negative effects of early marriage to children. 4. Determine the negative impacts of early marriage to the society. 5. Identify the ways by which the Bangladeshi Government is dealing with the problem of early marriage. Methodology             Data will be drawn from the most current Demographic and Health Surveys (DHS) in Bangladesh.             A survey questionnaire will be designed to be disseminated to the respondents. Survey research can be described simply as a means of gathering information, usually through self-report using questionnaires or interviews. In Research 1, the survey method was used to examine relationships between variables (Hutchinson, 2004). The survey method is popular among social researchers because of its utility in countless research situations. Surveys are used for diverse purposes. Another strength of the survey method is its applicability in situations where direct manipulation of variables is unethical (Hutchinson, 2004). With an appropriate sample, surveys may aim at representation and provide generalized results. Surveys are relatively easy to administer and need not require any fieldwork. Surveys may also be repeated in the future or in different settings to allow comparisons to be made. Lastly, with a good response rate, surveys can provide a lot of data relatively quickly.             The survey questionnaire will be given to teenage girls in a poor rural area in Bangladesh who are already married. The questionnaire will ask respondents about their demographic characteristics, reasons for marrying young and their experiences in the household. Health, information about their use of antenatal and delivery care will also be studied. The samples that will be analyzed in this study will be restricted to 15 to 19 year old married women.

Early pregnancy of teenage causes maternal mortality and high population growth in Bangladesh research proposal paper

Introduction In much of the developing world. Adolescent and child marriage continues to be a strong social norm, particul...

Sample Most Effective Rahabilitation Method of Chemically Dependent Offender Populations Essay

Most Effective Rehabilitation Method of Chemically Dependent Offender Populations   Outline: (flow of discussion) –Plan – refer to abstract Title page Table of contents Introduction Background Objectives Statement of problem Significance of study Scope and limitations Review of related literature Methodology Results and findings Analysis, discussion and interpretation Conclusion, summary and recommendation References           Chapter 1 Introduction               Several problems are being faced by many societies nowadays, given by the fact that the society is continually changing. The changes the society encounter leads to the modification of the lifestyle of many individuals, most especially the younger generation, who become easily influenced and swayed by a number of factors that surround them. Changes in the society are evident in terms of economy, politics, education, industry, and in technology, which depends upon the use and the need of a particular society. Such changes can be perceived as advantages in terms of its use in globalization and internationalization, such that particular nations become associated with a number of countries worldwide to expand their businesses through different strategies and approaches. Such changes also enhance and develop the skills of many individuals to learn the universal language and become globally competitive in different aspects of learning and knowledge. The sciences also become much more developed and improved, thus, improving the lives of many through its various practical, advanced, and revolutionizing applications. In this regard, changes in the mentioned fields can be seen to bring success and prestige to individuals and societies. However, these changes not only bring about success, prestige, and development to the members of society, but disadvantages and problems as well. Unlike the previously mentioned advantages brought about by the changes in the society, problems and challenges effect chaos and discord among individuals and families. Along with the success and development of societies are the problems its face, including the upsurge cases of drug and alcohol addiction, crimes, graft and corruption, unsafe working and living conditions, poverty, unemployment, illnesses, and deaths. From this, it can be seen that along with the development of societies are its drawbacks that may become part of its consequences.             In relation to all these challenges in the society is one of the gravest problems, which is chemical dependency. The issue of chemical dependency is associated to certain concepts, including habit, disorder, disease, abuse, substance, effects, and criminality. Because it is associated with such concepts, it is generally thought of connoting negative impressions and impacts. Generally, the concept of chemical dependency is associated with terms such as alcoholism, drug addiction, and substance use and abuse. Nevertheless, this concept is defined as a disease, disorder or illness that is characterized by addiction to a mood-altering chemical, including drugs and alcohol, thus, transcending age, gender, race, religion, or economic status (“Chemical Dependence or Dependency”, 2004). It can become a progressive, chronic, and fatal disease if untreated, that is why treatments and preventions are given importance and emphasis, especially with the younger generation. In addition, the concept of chemical dependency is commonly associated with criminality and mental disorders, which are considered the effects of becoming chemically dependent individuals. In this sense, such individuals are termed as Chemically Dependent Criminal Offenders or COCO, who commit grave violations against other individuals, the community, and the State due to the strong influence of alcohol or drugs. Nowadays, given the changes that take place in the society, most criminal offenders are comprised by adolescents or the younger generation, who become as such due to the influence of drugs or alcohol. According to the Juvenile Rehabilitation Association or JAR, 82% juvenile offenders use chemical substances. The most common major problems among the youth today include substance abuse and drug related crimes. In this regard, several governments come up with ways on reducing criminality and juvenile delinquency through different rehabilitation programs and treatments that would improve the situation of the chemical dependent adolescents in order to improve the society as a whole. However, despite the number of chemical dependence rehabilitation programs, not all are considered to be effective, as many criminal offenders presently convicted were influenced by drugs or alcohol during their crime. As reported, 3 in 4 violent offenders in prison committed their crime offenses under the influence of drugs, with a percentage of 72% (Mumble and Kornberg, 2007). In addition, more than half of the prisoners in the United States indicated symptoms consistent with drug dependence or abuse, having a percentage of 53%, and such dependence was associated with a range of symptoms, including behavioral, cognitive, and physiological problems (Mumble and Kornberg, 2007). These data indicate that despite the efforts of governments to help the society alleviate the impacts of drug and alcohol dependence, crimes attributed to chemical dependence continue to increase. With this problem at hand, this research study aims to examine the most effective rehabilitation method or technique for the chemical dependent offender population. This research study will be divided into five chapters in order to provide ease and consistency on the discussion of the topic. The first part will be discussing the problem uncovered by the researcher and provide ample background on the topic. The chapter will constitute an introduction to the whole research study, the statement of the problem in order to present the basis of the study, a discussion on the scope of its study, as well as its effects to individuals and its significance to the society as a whole. The second chapter will be discussing the relevance of the research study in the existing literature. It shall provide studies on the different drug and alcohol rehabilitation methods currently used, their process, duration and development, and the elements that foresee substance exploit problems. In addition, the study shall also provide an ample assessment of offenders with chemical dependency problems, the evaluation processes and tools presently in use for testing, the chemical dependency treatment effects of the offenders, the constructive dependency treatment results, and its impacts to the individuals being treated and to the society. After the presentation of the existing related literature, the researcher shall provide a synthesis of the whole chapter in relation to the study. The third part of the research study shall be discussing the methods and procedures used in the study. The chapter shall comprise of the presentation of the utilized techniques for data collection and research methodology. Similarly, it will also contain a discussion on the used techniques in data analysis as well as the tools used to acquire the said data. The fourth chapter will be an analysis of the collected and tabulated data. Computations and correlations will be made in order to uncover relationships and to address the statement of the problem noted in the first chapter. The last chapter shall comprise of three sections, namely, the summary of the findings, the conclusion of the study, and the recommendations. With these three portions, this chapter will be able to highlight the implication of the findings in relation to the data obtained.           Background of the Study             Given the problem at hand, House Bill 3900 (sec 26 - 28) indicates the enhancement, implementation and examination of the Chemical Dependency Disposition Alternative or CODA, which gives courts with a verdict alternative for chemically dependent youth. Drug treatment is the primary responsibility of the CODA, thus, becoming responsible for providing immediate solutions to the factors that contribute to the problems that the youth in the society are facing today. According to a particular study, adolescents are the recurrent patients in abuse treatment programs of the government (Brown, 1990). Although they have less duration of substance abuse, their bigger participation with alcohol and marijuana can probably make them become poly-drug addicts and have illegal records. Because of this, the call for the guidance of their family and various academic institutions becomes crucial. In addition to this is the Juvenile Justice Act, which was created for juveniles who are chemically dependent to ensure that they would benefit from treatment. Under this Act and the mentioned House Bill, the court may order an examination to determine if the juvenile is chemically dependent and amenable to treatment, and may also order a second examination if so requested by the state (“House Bill Report SUB 1337”, 2001). Moreover, with persistent action, the government also came up with other laws, such as the ‘Social Host’ Laws in the United States, which would allow police to enter private homes to break up underage drinking parties and impose fines on adults who allow gatherings to take place (“Social Host Laws Proliferate in U.S.”, 2007). In this regard, this law becomes a preventive measure that would restrict juvenile drinking, which can be causes for committing crimes and damage to the community. With the help of these laws and regulations, the importance of preventing chemical dependence and crimes can be promoted.             Despite such restrictions and regulations, increase in the incidences and cases of crimes related to chemical dependency can still be observed in the society. In the event of chemical dependency of juveniles and adults, it would be very helpful to determine and consider the possible and necessary treatments that they can undergo to provide them with a safe and decent life and well-being, which reinforces their right as an individual in the society. With this, several types of chemical dependency treatment programs are recognized, which can help chemical dependents, most especially chemical dependent offenders to start anew. There are five types of chemical dependency treatment programs, and most of theses originated from adult treatment programs. The first program is through Therapeutic Communities, wherein a patient lives in a drug-free residence. Its main principle is to treat drug abuse as social and not medical in nature. The duration of this treatment is from three to 15 months, depending on the cooperation and recovery of the patient. Its completion rate is only 10 to 18% of the total patient population (Hengelo, 1996). The second type of chemical dependency treatment program is the Residential Settings, wherein the patient is placed in a boarding school that usually has an inpatient non-hospital based treatment program. Through the program that caters residential settings, the substance abuser is made to believe that he or she can still be a prolific member of the society, given the natural residential features of the boarding school. The duration of this program is usually 7 to 90 days, depending on the program principles. In relation to this is the hospital-based or the inpatient medical treatment, such as the Short-Term Residential Programs that offer relatively brief residential or inpatient medical treatment based on a modified 12-step approach. This residential or inpatient medical treatment model consists of a 3 to 6 week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in self-help groups (“Types of Treatment”, 2005). In addition, inpatient medical treatments take place either in medical and general psychiatric settings, and offer a higher level of medical supervision (“Treatment”, 2007), such as the provision of medicines and other medical-related facilities. The third type of chemical dependency treatment program is the Outpatient Treatment, which is a less limiting type of treatment program among the rest. It lets the patient live with their families and communities, thus, giving them the immediate opportunity to exercise newly attained skills or behavioral transformation learned from the program. Specifically, Outpatient Treatments are classified into two, namely, Intensive Outpatient and Regular or Normal Outpatient Treatment Programs. Intensive Outpatient Treatment broadens the continuum of care model, which attempts to match the specific needs or levels of treatment that the patient needs in particular (Roadster, 1999). On the other hand, the Regular or Normal Outpatient Treatment offers general health care services to the patient. The fourth type is the Community Monitoring, wherein the patient may be presently using a substance, along with monitoring. Monitoring can be done through routine analyses and counseling with a probation officer or a social worker. In this program, the patients are considered to undergo a house arrest, to be imposed on curfew, or be electronically monitored by their district officers. The last type of chemical dependency treatment program is the Self-Help and other community based groups, which involve the contribution and assistance of community groups in the treatment of substance abusers. This program is often considered as an effective aftercare because it gives positive role models and emotional supports from the elder members of the program. Identification of such treatment or rehabilitation programs enables recognition of advantages in determining the best rehabilitation program.             Primarily, knowing the best chemical dependency rehabilitation program would enable increase knowledge in the treatment of substance abusers. Many researchers would be able to engage in further research and observation that would entail the advancement and the development of the recognized most effective rehabilitation program. Thus, in this case, the recognized most effective rehabilitation program would be further developed and enhanced to help many chemical dependents with their treatment. Second, recognizing the best chemical dependency rehabilitation program would improve the services and facilities of rehabilitation centers, which would help further address the needs and the problems of substance users and abusers. It has been reported that most clients valued visiting rehabilitation center facilities beforehand, for these facilities play a very important role in helping the chemical dependent with his or her recovery, such that they influence life-changing experiences and understanding of the nature of chemical dependency of clients (Wilkinson and Mistral, 2006). It has been reported by the Smash's National Survey on Drug Use and Health that there were about 1.5 million youths needing alcohol treatment, and 1.4 million youths needing illicit drug use treatment (“The NCU Report: Substance Use Treatment Need among Adolescents, 2003-2004”, 2006) ), and with no available data on how many were treated from rehabilitation centers. In this sense, improving the facilities and services of rehabilitation centers may provide an increase in the number or percentages of treated chemical dependents.             Third advantage that can be recognized is the fact that recognizing the best rehabilitation program available would support the community and the local and the national government with its endeavors of promoting peace and order in the country, which would encourage safety, development, and progression. In this regard, having a safe and peaceful society can promote development and improvement in the country, such that many individuals and establishments would gain the trust of other businesses and in turn, promote its economic prosperity. With fewer crimes due to the influence of drugs and alcohol, more business establishments and firms would have the chance to function effectively in the society, through having increased transactions and negotiations from foreign investors, who would bring success, profit and advancement to a number of companies.             Fourth and last recognized advantage of recognizing the most effective chemical dependent rehabilitation program is providing additional knowledge with the families of chemical dependents that would give them the confidence and the hope that their loved one will be able to be treated from its condition. If this research study would become successful in so doing, the determined most effective rehabilitation program can be recommended to the government and other health-related institutions and organizations to further provide assistance to chemical dependent offenders.  With these reasons, determination of the most effective chemical dependent rehabilitation program would be able to help many individuals in terms of treatment and acceptance in the society.   Objectives of the Study             This research study will be done to help increase knowledge and information regarding the rehabilitation methods for chemically dependent offenders and the effectiveness of a number of rehabilitation methods for their treatment. Hence, this research study will be conducted to determine which of the rehabilitation methods for chemically dependent offender populations is the most effective. The specific research objectives for this study can be summarized as follows:   1)     To find out causes of addiction and chemical dependency in the target population; 2)     To determine the effects of chemical dependency to individuals and to the society; 3)     To determine the different drug and alcohol rehabilitation methods currently used, including its process, duration and development; 4)     To identify the elements that foresee substance exploit problems or the problems that lead to chemical dependency; 5)     To provide an ample assessment of offenders with chemical dependency problems; 6)     To evaluate processes and tools presently used for testing; 7)     To determine alternative treatment methods available for chemical dependents; 8)     To determine the chemical dependent treatment effects of the offenders; 9)     To identify the constructive dependency treatment results in offenders; 10)  To recognize the impacts of such actions to the society; and 11)  To give recommendations to the readers, to the government, and to the society   Statement of the Problem             The increase in the number of chemically dependent criminal offenders in the society of the United States leads to the recognition of a number of chemical dependent rehabilitation programs. Due to the perceived significant and essential role played by chemical dependency rehabilitation programs in the treatment of drug and alcohol dependents, it is important to recognize the different rehabilitation and treatment methods that would help in the recovery of substance dependents and in the alleviation of the number of criminal cases related to substance use in the U.S. society. This study intends to examine the most effective rehabilitation program for chemical dependent offender population in the United States. Specifically, the study intends to answer the following queries:   <li class="MsoNormal" style="text-align: justify; line-height: 200%"> What could be the most recommended chemical dependent rehabilitation program for offenders?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> What are the risks to be taken note of in undergoing such rehabilitation program?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> What are the barriers to be considered in allowing a criminal offender in undergoing the treatment program?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Are there other alternative treatment programs available that could present the same effects and treatment for offenders?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> What are strengths, weaknesses, opportunities, and threats that can be attributed to undergoing such programs?</li>   Hypothesis             The study intends to test the following hypothesis:             “The most effective chemical dependency treatment program must be adopted and implemented to treat the chemical dependent populations.”   Significance of the Study             This research study will be a significant in knowing the perceived best and most effective chemical dependent treatment programs for offender population, which could be suggested to the government and to the families of the substance dependent. It will be significant in the development of more scientific and research-based approaches in addressing the different problems regarding the relationship of substance abuse and the increase in criminal cases in the U.S. society. In addition, this research study can also be significant in providing wider knowledge and alternatives for the government and the families of the substance abusers regarding other available treatment and therapies for the chemical dependent offenders. Moreover, this study can be significant in the endeavor for the improvement and development of the services and facilities of different rehabilitation or treatment programs that would further cater to the needs of the chemical dependent offender population in the society of the United States.   Scope and Limitations             The research study intends to examine the most effective rehabilitation or treatment program for the chemical dependent population. For this study, primary research will be conducted using anonymous questionnaires that will be sent to the general population in _________ of legal age. The questionnaires will be used to collect quantitative data. Qualitative data would be gathered using secondary research based on related literatures.               In relation to the previous discussion, limitations and other key assumptions were also considered, and are as follows: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Are the results of the research study valid?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Was the data relevant to the research questions?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Were the data collection methods appropriate for the research objectives?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Was the data collection comprehensive enough?</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> Were the data appropriately analyzed, with the findings adequately supported?</li> </ul>   Obstacles of the Research Study             Despite the aim and the perceived significance of this research study, a number of obstacles or problems could be encountered. Essentially, there are a small number of sensible and pragmatic barriers in this research study or dissertation. The main practical apprehension is the expensiveness of purchasing journals online. This is a practical concern because monetary costs are one of the main important factors that will keep this study going. Another practical obstacle is the availability of resources regarding the rehabilitation programs for chemical dependent offenders. There are limited studies that are related to the focus of this study. Limited local references can affect the development of this research study. On the other hand, in terms of empirical obstacles, there might not be sufficient statistics to show what program is the most effective in treating offenders with substance abuse. In simple terms, there could be difficulty in obtaining relevant and sufficient statistics from financial service institutions. This is where secondary research will come to play. The surveys and interviews to be conducted with families and social institutions are intended to make bridges that will lead to the acquisition of important references. Overall, resources and cooperation are the two major obstacles in the study. In addition, another difficulty that can be recognized is in the process of the model to be used in the research study, which is the input-process-output-model. Difficulty would rely on the different issues that the study might be able to face. In this regard, the information required should be arranged conveniently for a more effective and efficient analysis. The effective execution of the process will be the main importance and concern of the research study because it will determine the quality of the output.   Ethical Considerations and Standards             The position of the researcher in the research study is crucial because he or she will be the one to conduct the whole process of the research study. This particular research study has a political influence in nature because many laws and regulations under the judicial and community sectors govern rehabilitation programs of chemical dependent offenders. The role of the researcher is to attain the necessary information needed in the study as much as possible, and to create connections with important people who will be helpful in assisting the progress of the study. In relation to the role of the researcher is his or her responsibility to deem ethical considerations that will be applied in accomplishing the research study. Given the sensitive situation being experienced by the families of chemical dependent offenders and the social institutions handling their cases, most of the target respondents would be hesitant to share their views because of certain factors they are afraid of or uncomfortable with. As an ethical stance, confidentiality of the identity and participation of the respondents will be ensured throughout the research. Furthermore, important but confidential information that respondents do not want to talk about or give away would also be respected, especially in the process of an interview. As part of the ethical consideration of this research study, complete information, such as the goal and aim of the study would be provided to the respondents thus, respecting their right to be informed. Racial discrimination would not be observed in this study, for all races would be considered sources of relevant data. With regards to the accomplishment of the paper, strict compliance with citing references is to observed in order to avoid plagiarism of literatures to be used.               Chapter 2 Review of Related Literature               This part of the paper will review the related literatures conducted on the area of study. By doing this, the research may be guided consequently by primarily discovering where the research is coming from, what and how much have been studied regarding the topic, and what it is yet to discuss. Aside from providing the background of the study, this chapter will provide its readers the necessary backbone and support for the research study to stand credible and reliable. In addition, by appraisal or evaluation of past researches related to the study, a historical perspective may be given. The researcher will be able to gain new insights on how much venture has been explored before, which will enable reflection, comparison, learning, and producing a stronger and more efficient study. This chapter will also present the research study a rich source of data, both new and old, which will augment and enrich the study. This part of the research study will also accentuate how it will contribute to the field of study it has chosen and further improve it.   Causes of Addiction and Chemical Dependency             According to the United States census in 2000, adolescents make up the largest generation in American history (Clemens, 2004). However, with such dominance, substance use among them becomes prevalent. In 2002, more than 11% of youth, having an age range of 12-17 years were current drug users, with drugs including marijuana, cocaine, heroin, hallucinogens, inhalants, tranquilizers, and stimulants, while 28.5% were alcoholics (Clemens, 2004). With such prevalence, it can be perceived that several causes might be attributed to such large occurrence in adolescents. In this regard, it would be helpful to determine the several causes of substance use and abuse to further understand the concept of chemical dependence. Primarily, Chenier (2001) summarized the causes or factors that may trigger drug or alcohol addiction among juveniles or adolescents, and in so doing, it would be helpful to adopt a medical, psychological, sociological, economic, legal, criminological, pharmacological, and philosophical approach. The author stressed that chemical dependence may be attributed to a genetic component, to an addictive personality type, to critical environmental circumstances, and to a physiological connection. In this sense, as previously stated, no one is excluded from the list of individuals who may be able to become chemical dependents. However, Chenier (2001) pointed out that the male gender, the unemployed, the aboriginal peoples, and the street youth are the ones having a higher chance of becoming dependent on such substances. In support of this, several other authors have attempted to explain the causes of chemical dependence among the youth. As cited in the work of Alvarez-Niemeyer, Nun-Gutierrez and Rodriguez-Credo (2006), authors like Petridis, Flay and Miller in 1995 proposed a conceptual model that includes three kinds of influences, namely, cultural and attitudinal, social and interpersonal, and individual baggage. Another study cited is the study done by Castro-Sari nana in 2001, which identified a total of 50 factors that relate to teenage chemical abuse. These factors were classified into three groups by using an epidemiological model. The model includes a predisposing environment, the drug itself, and the individual. The third study cited was done by Medina-Mora et. al in 1995 who suggested that easy access to drugs and other substances, drug users among family or peers, peer approval, a perception of low risk, and an unpleasant mood state are also linked to cause chemical dependency in the younger generation. From this aspect, it can be seen that personal and social factors contribute to the tendency of individuals to become chemical dependents. In addition, Sanchez-Huascar et. al. 2002 pointed out that domestic violence and sexual abuse could also be considered as causes of chemical dependence. Along with that, Bryant et. al 2000 considered school-related factors such as academic failure, absenteeism, peer drug use, and psychological distress can be linked to teenage chemical dependence. This particular study cited placed an emphasis on a related study done by Sanchez-Huascar et. al in 2002, stressing that teenagers who engage in misconduct and had low school performance scores had higher chemical dependence and tendency compared to teenagers who are highly motivated and focused with their studies. In support of such claims, a number more authors have considered the influence of family factors such as faulty and triangulated communication, inter-parental conflicts, affection-deprived family environment, ineffective problem-solving patterns, low familial satisfaction levels, type of religious practice, family disintegration, and low levels of parental monitoring are also attributed as causes of chemical dependence (as cited in Alvarez-Niemeyer, Nun-Gutierrez, and Rodriguez-Credo, 2006). As such, it can be seen that in the social point of view, the school and the family of the younger generation, or the immediate sub-society of the younger generation, determine their tendency to become chemically dependent. In summary, the perceived causes of chemical dependence in the younger generation may be grouped into three. First cause involves the genetic or the hereditary influence one has from being a chemical dependent, which determines his or her ability to become more susceptible of developing a tendency to become a substance user. A particular study supports this claim, with the emphasis on the influence of the brain chemical dopamine that mediates intercellular communication, and with which substance use may be determined by variants of genes that regulate it (Droves, 2002). Second cause involves the individual per se, and his or her preferences, control, choice, physiology, attitude, and mood towards the use of drugs or alcohol. One possible cause of addiction or chemical dependence involves the loss of control in one’s self, which could determine their ‘gusto’ over alcohol or drugs. Likewise, their preference over the use and abuse of substances also depends on how they handle taking them. Last cause involves the social network or the community from where the individual functions, and includes the influences given by one’s family, peers, school, and culture. In this regard, it can be perceived that this involves one’s exposure to drugs and alcohol, thus, determining his or her extent in becoming chemical dependent. However, it does not follow that the more exposure to such substances leads to chemical dependency. In this sense, the preferences and the choice of an individual in terms of using drugs and alcohol become the decisive factor. From this, it can be understood that the range of problems and causes determine the extent of chemical dependency one will be able to experience and go through.   Effects of Chemical Dependency             It is a given fact that chemical dependency has several known negative effects that may create havoc within the individual or the chemical dependent and within his or her community and the larger society. Determining such effects leads to knowing the mechanism of chemical dependency and addiction, which would later be crucial in understanding the larger picture. As previously defined, chemical dependency is a progressive and chronic disease that is due to addiction or craving of a particular chemical or drug. Fairly similar is the concept of addiction, which is defined as a disease or complex phenomenon with important psychological and social causes and consequences, and involves a biological process, involving a repeated exposure to a drug over time (Starr, 2002). With these similar definitions, it can be perceived that the two concepts are both considered a disease that affects the biological and physiological functions of an individual. However, aside from seeing addiction and chemical dependence as a disease, the society also perceive them as more than mere drug use, but as a behavior exhibiting a compulsive pattern of drug-seeking and drug-taking that takes place at the expense of most of their other activities (Bridge and Robinson, 2003). This definition helps many understand that the concept of chemical dependence affects the individual and social behavior of a person, thus, it is perceived rooted at one’s biological and physiological processes. As such, the mechanism of addiction or chemical dependence can be stressed out, thus, helping individuals understand the concept and the situation of chemical dependent offenders.             The mechanism of addiction or chemical dependence relates to the biological and physiological function of the human body, and determines one’s pleasure responses towards a chemical or substance. Usually, chemical dependents take drugs or alcohol to attain ‘highs’ and escape social, mental and physical stresses. However, they also take drugs and alcohol to avoid withdrawal ‘lows’. This process can be explained using the Opponent Process Theory, which explains that a pleasant dose of drug or chemical activates a dose-dependent a-process in the brain reward circuit system that in turn, triggers the activation of a negative or opponent b-process. This b-process helps restore homeostasis in the brain and brings it back to its normal state. The summation of the actions of the two processes creates the final subjectively experienced state by the person, resulting to the A-state or the pleasant state, caused by the a-process, and the B-state or the negative state that is caused by the b-process (Bridge and Robinson, 2003). During repeated drug use, the dopamine system is being induced, which is a brain neurotransmitter that mediates the communication among brain cells in certain brain regions, and play a role in the pleasant or rewarding effects of substances, such as drugs and alcohol (Droves, 2002), thus, creating changes in the function of the brain. The neurological, chemical, and physical structure changes in the function of the brain results from the repeated exposure of an individual to addictive substances, thus, creating the chemical conditions that produce changes in the behavior of the person, in terms dependence, tolerance, sensitization, and craving (Starr, 2002). From these explanations, it can be understood that the changes in the behavior and responses of chemical dependents depend on the changes brought about by their continued and prolonged exposure to various chemicals or substances. The changes in their physiological and behavioral response determine their actions towards themselves, their family, and their society.             Several effects are recognized in relation to chemical dependency or substance addiction. Primarily, the sensitization of individuals is affected with the increase of drug or alcohol use. Sensitization refers to the increase in a drug effect with repeated drug administration, depending on the biological system of the person that mediates different drug effects and adapt in different ways to repeated drug exposure. Sensitization can be seen in two ways, either affecting the individual’s psychomotor activities or one’s motivation. Psychomotor changes in the individual may include increase or decrease in arousal, attention and motor behavior, producing heightened movement, exploration, and approach. In terms of behavioral or motivational sensitization, changes are exhibited in the physical structure of neurons, changing the patterns of synaptic connectivity within brain regions thus, alter the information processing of the brain (Bridge and Robinson, 2003). In simple terms, a known effect of chemical dependence is the changes in terms of the physical and behavioral aspects of the person that may affect his or her actions toward his or her family and community.             The second known effect is the development of tolerance to both the pleasurable and aversive effects of substance use, which supports the development or maintenance of an addiction. The development of tolerance of substances in substance users requires the individual to consume increasing drug amounts to achieve the desired pleasurable or rewarding effects (Droves, 2002). With the development of such tolerance, the rate of substance use greatly increases, thus, enabling the individual to become more drug or alcohol dependent. In this regard, a substance user is able to attain pleasure or reward from the use of the substance through continued use in high doses. With this, the substance dependent would be more reliant on the substances, thus, making him or her lose control of his or her behavior.             The third effect of chemical dependence is the prevalence of a variety of physical, mental, and behavioral disorders, such as AIDS, HIV, tuberculosis, hepatitis, and other reproductive related diseases in both genders. The unsafe use of intravenous drugs is both directly and indirectly responsible for more than one-third of all AIDS deaths in the United States, including the increasing transmission of tuberculosis and hepatitis B and C. With this, addiction or chemical dependence and HIV infection is one of the major public health challenges in the country. In addition, chemical dependence, particularly alcoholism causes liver disease and other neurological and pathological diseases that are fatal (Starr, 2002). Becoming an alcohol or drug addict leads to the tendency of using other substances or drugs, such as nicotine that is present in tobaccos and cigarettes. In this regard, the use of many and various substances presents the tendency of acquiring a number of different diseases, thus, shortening the life expectancy rate of chemical dependents. Another point to consider is the damage produced by alcohol and other substances to fetal and neonatal development, being contributory to the causes of birth defects and neonatal morbidity. In this regard, the issue of the increasing number of female chemical dependents must be addressed, as having physical diseases attributed to alcohol and drug use significantly similar to males (Blame, 1990). Documented prenatal substance exposure presented effects on fetal and child development, thus, affecting 20% of newborn children in America and causes one in every ten cases of mental retardation (Starr, 2002). In addition, the increase in alcohol intake, particularly in women makes them sexually aggressive and promiscuous (Blame, 1990), thus, increasing the incidences of rape, early pregnancy, single parenthood, and abortion in the society. In this regard, the issue of chemical dependence cannot only be regarded as a medical or behavioral issue, but as a moral issue as well.             Fourth known effect of substance abuse and dependence brings impaired judgment, depression, hopelessness and desperation on the part of the addict, leading him or her to suffer from mental disorders that would lead the person to commit suicide or inflict injuries (Muslins, 1999). These incidents lead to the substantial increase of use of the healthcare system, and particularly of expensive emergency rooms and trauma care services in hospitals and healthcare centers, as 60% of all emergency room visits are related to drug and alcohol problems. In addition, substance use causes close to half of all fatalities in motor vehicular accidents, with more than 100,000 American citizens dying (Starr, 2002). With this, it can be perceived that the influence of the use of either alcohol or drugs impairs the ability of individuals to control not only their mental behavior but their physical and motor skills as well.                     Another evident effect of substance or chemical dependence is the break up and deterioration of family ties, which causes child abuse and family violence. A study cited in Starr in 2002 reports that 78% of female victims who survived domestic violence attacks reported that their attacker had been using drugs or alcohol. Moreover, substance use also leads an individual to commit rape and sexual assault, thus, committing violations and crimes against other individuals and the society. It leads to the abuse and neglect of children, and in some instances, fathers even sexually abuse their children due to the influence of drugs or alcohol, leading to a rough estimate of ten million children affected because of such causes. Substance use and abuse also leads to high rates of divorce and broken families, causing at least three-fourths of cases where children are removed from their families and placed in foster care (Starr, 2002). With this, it can be understood that due to chemical dependence, most children are deprived of their rights to live peacefully and rightfully, thus, affecting not only their lifestyle, but their perception and view of life as well. This event influences them to either disregard or give importance to the value of having a family and of becoming influenced by substance use.                 Muslins (1999) reports that due to chemical dependence, important social, occupational, or recreational activities are being abandoned, and this increases the costs of U.S. employers annually. A study cited in the work of Starr in 2002 estimated that addiction costs U.S. businesses a total of $200 billion yearly, due to lost workdays, premature deaths of workers including on-the-job accidents, and half treatment costs such as fetal alcohol syndrome and AIDS. This leads to the increase in costs of the U.S. society, due to the loss of productivity, increase in direct financial burdens on government programs, and even social deterioration. A study done analyzes economic data stating that alcohol and drug abuse cost the U.S. society a total of $246 billion (Starr, 2002). In this regard, it can be perceived that chemical dependence not only affect the individual user but the whole society as well. It provides the individual with diseases and mental disorders, which cause him or her to commit crimes and other violations towards other individuals and towards the society. Furthermore, due to chemical dependence, children and families are not able to obtain their rights in the society that would allow them to live peacefully and rightfully in their communities.   Chemical Dependence Rehabilitation Methods Currently Used             As previously discussed, there are five types of chemical dependency treatment programs or methods used today, namely, Therapeutic Communities, Residential Settings, Outpatient Treatment, Community Monitoring, and Self-Help. These five treatment programs are general treatment or rehabilitation programs helping many substance or chemical dependents to overcome their condition, thus, enabling them to function effectively and normally in the society. Historically, formalized testing in the field of addiction began in the late 1970s with the National Board of Medical Examiners, which developed examination modules for medical students. Following this is the California Society for the Treatment of Alcoholism and Other Drug Dependencies, which established an examination for demonstrating expertise in addiction in 1983. In 1986, the American Society of Addiction Medicine began the development of a related national chemical dependence examination, which led to the development of other procedures that developed and improved training standards in relation to substance abuse academic medical training. These training standards provided a model for the development and improvement of substance abuse training programs, assisted fellowship applicants in the evaluation of their training needs, and helped in the establishment of certifiable specialty training for the field (Burns et. al., 1991). With the development and improvement of such standards and fields, the problems and the causes of chemical dependence were identified and given importance in terms of treatment and recovery. As such, specific models and treatment programs are being used today.             Specifically, the AA model is one of the most popular chemical dependence treatment programs being used today, including a twelve-step program for any self-defeating or compulsive behavior, such as Cocaine Anonymous, Debtors Anonymous, Dual Disorders Anonymous, Ethics Anonymous, Gamblers Anonymous, Nicotine Anonymous, Overeaters Anonymous, Sex and Love Addicts Anonymous, Survivors of Incest Anonymous, and Workaholics Anonymous. The AA model characterizes or perceives addiction as a progressive, chronic, and deadly disease that leaves the substance dependent or addict “powerless” and experiencing a “loss of control” in the ability to desist a drug of choice. It requires a commitment to total abstinence, the embrace of spirituality, and life-long participation in AA or other twelve-step programs, because it sees an addiction as something that is treatable but never entirely curable. Another treatment program is termed as SOS, which stands for Secular Organizations for Sobriety that was founded by James Christopher in 1986. The program is a non-religious, abstinence-based self-empowerment program that uses the principles of cognitive therapy and visceral synchronization. In views addiction as having three components, namely, a physiological need, a learned habit, and a denial of the need and the habit. The third known treatment method in the United States is the RR or Rational Recovery program that employs an addictive voice recognition technique or the AVERT, which is based on the experiences of former addicts. It views chemical dependence as personal matters that have nothing to do with acquiring, maintaining, or ending an addiction, but develops a thinking skill that aids addicts to recognize and resist the internal “voice” that pressures them to use chemicals for their pleasure. Fourth treatment program is the SMART or Self Management and Recovery Training, which assists its members in maintaining abstinence from various substances, through a continuum of recovery that focuses on the quality of life. It achieves its goals through scientific practice and knowledge, abstinence from addictive chemicals, nurturance of emotional independence and self-reliance, and assistance in giving dependence on support groups (Leman ski, 2000). These and other treatment or rehabilitation programs are being used by the families of chemical dependents in the United States to ensure treatment and recovery of their chemical dependent relatives.   Alternative Rehabilitation or Treatment Methods             Most of the chemical dependency rehabilitation and treatment organizations use the AA model or approach in administering treatment of substance dependents. As a matter of fact, more than 93% of U.S. treatment centers are still locked into the AA approach (Leman ski, 2000). However, despite the success of the use of such an approach, which lasted for more than 60 years, many criticisms have been made regarding the approach that made many researchers to come up with the use of alternative methods for chemical dependency treatments. The major criticism for the AA model and other twelve-step programs is that the treatment is not scientifically-based, but instead is based on religion, spirituality and talk-therapy (Leman ski, 2000). Nowadays, more and more medical practitioners are open to using alternative methods that can be regarded as cost-effective and less conventional.             One alternative method is the use of acupuncture. Acupuncture is a traditional Chinese medical technique that involves the insertion of stainless steel needles into different points in the body. These needles are inserted at particular points in the body, called acupuncture points, in order to balance the opposing forces of yin and yang. This technique unblocks the chi, or the energy that permeates all things in nature, and is believed to flow through the body along 14 main pathways termed as meridians. It is said that when yin and yang are in harmony, the chi flows freely within the body and the person is said to be healthy. However, the presence of sickness and disease obstructs the flow of the chi, thus, needing acupuncture to restore smooth flow of the chi within the body (Carroll, 2005). In addition, the idea behind acupuncture is that the presence of a disease entails the loss of balance between the yin and the yang energies, thus, disrupting the function of the whole biological system. The treatment of the disease through the activity of needles, pressure, and heat on the sensitive parts of the body may treat the patters of disharmony (“Acupuncture”, 2007). Through the extent of the use of acupuncture in both Eastern and Western countries, several ailments are said to be treated through therapy, including allergies, arthritis, kidney problems, constipation, depression and anxiety, headaches, colds, dizziness, fatigue, flu, paralysis, sexual dysfunction, stress, stroke, smoking, and high blood pressure (Carroll, 2005). In the perspective of chemical dependency, becoming substance dependent is considered the disease in this sense, thus, blocking the chi of the user. In addition, substance or chemical dependency is said to be a symptom of a system or society that is out of balance, and the lack of that balance leads to the lack of calm inner tone, which results to aggressiveness, and causing crimes in the society. The use of acupuncture as an alternative treatment of chemical dependence helps the user in stimulating his or her yin points or positive points, in order to restore inner calm tone. Acupuncture detoxification works by releasing blockages of energy or chi and correcting imbalances of energy flow, which involves homeostatic action in the autonomic nervous system, various neurotransmitters, and elements in the pituitary actions and responses in the brain (Serrano, 2007). In this sense, the use of acupuncture as a treatment alternative presents positive effects for the use of the needles in the body would eventually lead to the release of more positive energies in the body that would stimulate the smooth process of the biological functions of the body. Proper stimulation of the nerves and blood circulation in the body improves the flow of nutrients in its parts, thus, improving the distribution of minerals and nutrients in the body, essential in its vital functions. This improvement thus improves also the disposition of the substance user, and eventually, improves his or her way of thinking that would lead the individual to realize the importance of his or her life in the society.             Another alternative treatment for substance dependence is through hypnotherapy. Hypnotherapy involves psychological therapy and counseling, and is a treatment of emotional and psychological disorders, unwanted habits and undesirable feelings, using psychological techniques. Through hypnotherapy, therapeutic mental suggestions are introduced into the mind of the client in a relaxed and receptive state, in order to find meaningful alternatives to their present unsatisfactory ways of thinking, feeling or behaving (Broom, 2007). It helps clients overcome their anxiety, insomnia, stress, panic attacks, phobias and addiction, which are considered the altered state of the consciousness of the individual. During hypnotherapy, the person is in his or her relaxed state, wherein the breathing, heart rate, metabolism, and brain waves slow down, thus, becoming more receptive to suggestion and able to exert control over normal involuntary processes (Young, 2007). During this relaxed and highly receptive state, the chemical dependent can overcome his or her substance addiction through enhancing imagery techniques. A specific study points out that a reward center is present deep within the brain, where emotion-laden memories of past positive drinking or drug-taking experiences become associated with cues. Exposure to cues activates the reward center of the brain, leading to craving during abstinence. However, through hypnotherapy, experiences are changed to positive ones, thus, reducing craving, through using suggestions, reframes, metaphors, and positive imaging. A study that proves this is the study done by Walberg in 1948, who treated alcoholism by using hypnosis to enhance dream imagery (as cited in Potter, 2004). Aside from aiding in the treatment of addictions, hypnotherapy is also helpful in treating the symptoms of Post Acute Withdrawal that occurs in acute withdrawal from an addictive drug. A study done by Whitehouse et. al in 1996 reports that stress levels were lowered through hypnosis, thus, making it an alternative treatment for chemical dependency (as cited in Potter, 2004).             The third type of alternative treatment for chemical dependency is homeopathy, which involves providing an extremely small dose of substances that produces characteristics symptoms of illnesses in healthy people when given in larger doses, thus, being termed as an approach with a belief that “like cures like”.  Similar to acupuncture, a key premise in homeopathy is the belief that every individual has an energy termed a vital force or self-healing response, and the disruption of such energy causes health problems (“Questions and Answers about Homeopathy”, 2007). This type of alternative strategy was discovered by a German physician, Samuel Hahnemann, who proved that same substances, in large amounts could cause disorders within the body; however, in minute doses could cure the same disorders. In the general Western medicine, strong drugs can help cure illnesses, and symptoms are caused by the illness. However, a positive outcome cannot occur with the increasing dose of medicines, and oftentimes lead to chemical dependency and masked symptoms. On the other hand, in homeopathy, the symptoms of the illness become indicative of the desire of the body to fight the illness and the type of substances required to produce a positive response by the body’s own natural healing forces of recovery (Better, 2007). Although this might be a good alternative for curing chemical dependency, it has been reported that research studies on homeopathy have been contradictory in their findings, such that some analyses concluded that there are no strong evidences that support it being effective for any clinical condition, while some positive effects were not readily explained in scientific terms (“Questions and Answers about Homeopathy”, 2007). With this, it can be understood that although homeopathy is suitable in treating chemical dependency due to its use of minute amounts of substances in the belief that it would lead to the same effects, not enough findings and studies have been able to support its effectiveness as an alternative treatment method. For this matter, it would be best if other more studies and supports should be done, before considering it an alternative treatment process for chemical dependency.              Another type of alternative treatment for chemical dependency is termed as NLP that stands for neuron-linguistic programming therapy, which is a method, set of techniques, or personal development system about human communication, perception and subjective experiences. It teaches that a specific individual can develop successful habits by intensifying helpful behaviors and reducing negative ones, and such change can be done by carefully reproducing the behaviors and beliefs of successful people, through the process of modeling. This approach or method aids individuals in terms of self-help, personal influence, and business communication. This approach is related to the treatment of substance or chemical dependency because this approach recognizes the notion that experiences are processed by the sensory systems of the brain, and the processing of that information in the brain lead one to see images and hear sounds and voices along with the creation of feelings. Processing of such information lead to the creation of representations, thus are being activated during any type of activity. The organization and arrangement of such images create impacts on the behavior of individuals. NLP techniques interrupt the maladaptive patterns in the brain, and replace them with more positive and creative thought patterns that would affect the behavior of the person. NLP techniques involve modeling, or adopting a specific behavior or belief of successful individuals, the meta-model or widening the map of the world of the person through language patterns, the Milton model, a form of hypnotherapy that uses language patterns to contact the hidden resources of one’s personality, and the representational system (“Neuron-linguistic Programming”, 2007). …             However, despite the large number of treatment programs available for chemical dependency recovery, its selection can be confusing to a family in the middle of a crisis. For this reason, the National Council on Alcoholism and Other Drug Dependencies and various community programs can provide a summary of local treatment resources. Moreover, these programs can suggest levels of care based on interviews with family members and the addicted family member, which in this case is the chemical dependent offender. Nevertheless, a more accurate recommendation would only be made after the patient has been assessed by healthcare professionals. A number of treatment programs provide free assessments and give out recommendations regarding the required level of treatment (Landry, 1994).   Assessment Used for Chemical Dependent Offenders             The treatment of chemical dependents involves first the evaluation and assessment, treatment planning, medical and psychiatric management, psychosocial rehabilitation, and continuing care (Landry, 1994). It is important to assess and evaluate first the condition of the chemical dependent to be able to administer an effective treatment program suitable for his or her condition. A number of evaluation and assessment phases must be undergone by the chemical dependent to ensure that all stages of his or her condition would be properly examined. Primarily, screenings would be done to help determine whether the individual has a substance disorder and whether further evaluation is recommended. After this evaluation, the diagnostic evaluation is done, which documents the presence of a substance use disorder and describes that disorder, thus, providing health professionals with useful and relevant information regarding the problem of the offender. An intake evaluation is also done to trace the medical history of the patient, and becomes the basis for the decision in admitting the patient or to make a referral to other treatment programs (Landry, 1994).             Specifically, in treatment settings, patients are provided with medical assessments to determine their current medical problem. Medical assessments include detection of addiction-related problems, such as withdrawal, AIDS, hepatitis, or other diseases. The patient undergoes a physical examination, a thorough drug history, x-ray, electrocardiogram, urinalysis, blood tests, and other drug screening tests. Another form of assessment done is the nursing assessment, which takes place during detoxification in inpatient settings. Daily nursing assessment involves the patient’s response to drug cessation, to medication, interactions with other patients and staff, and early response to treatment. Third assessment done is the psychiatric assessment, which is used to confirm the presence and severity of substance use disorders. This type of assessment is a question-and-answer type of assessment, with self-report tests, structured interviews, and personality tests (Landry, 1994). The next assessment done is the nutritional assessment, which is necessary because during active addiction, nutritional needs are unmet. For this reason, the nutritional needs of the chemical dependent is being evaluated to determine other diseases that may have been caused by his or her condition, thus, requiring additional treatment and care. Nutritionist and other healthcare professionals use structured interviews and laboratory tests to determine the presence and severity of nutritional problems. The fifth assessment to be utilized is the family assessment, where family therapy specialists interview the patient and other family members of the chemical dependent to obtain a clearer understanding of the addict’s family dynamics, effects of addiction on the family, and the effect of family structure on the individual’s addiction. This type of assessment provides information on the expected level of support and understanding of the family of the addict for the treatment and recovery. The next type of assessment done is the social and emotional assessment, which recognizes the fact that different social and emotional problems may have contributed to the drug or alcohol use of the individual. These problems or issues must be identified for a more effective prevention and recovery. In this regard, the social and emotional strengths and weaknesses of the chemical dependent, which would be helpful in administering treatment that would involve the enhancement of poor skills and the encouragement of the use of such skills for personal growth. Another type of assessment that must be done is the recreation, stress, and leisure assessment that involves participation in various activities and exercises that promote pleasure, and this includes sports, hobbies and games. This form of assessment recognizes the fact that during the course of addiction or chemical dependence, the addicts seize to participate in recreational and leisure activities, thus, with this form of assessment, the chemical dependent would be able to enjoy his or her life through interactive and social activities. The next type or form of assessment is the legal assessment, which helps the chemical dependent to address problems such as court appearances that would contribute to the severity of stress and anxiety, thus, reducing the effectiveness of treatment. The last type of assessment to be done is the vocational assessment, which would help the chemical dependent obtain and maintain their jobs or employment. Through this assessment, the chemical dependent is monitored to help them return to their jobs, thus, making them realize their importance to the society and to their community. This form of assessment examines and evaluates the individual skills, interests, job history and addiction-related occupational problems of the chemical dependent, thus, determining the areas that need to be addressed during the treatment and recovery period (Landry, 1994).                Aside from the use of such assessment methods is the frequently used form of assessment, which is with the help of counselors or through counseling orientations. These counseling orientations are usually facilitated by psychiatrists, who use a clinical model in determining problems related to chemical or substance dependence. This form of assessment can be used effectively because it is scientifically and research-based, thus, facilitating a scientific approach concerning the treatment of chemical dependents. Counseling orientations use a clinical model that helps the patient and the clinician to understand or treat a clinical problem (as cited in Johnson et. al., 1994), where in this case addiction or chemical dependency is treated as a clinical problem. This specific type of clinical assessment uses an instrument to measure substance abuse through the Powerless-Empowerment Scale, which is a substance abuse counseling assessment method that involve the degree of responsibility of clients should assume for their recovery and how much power they have to overcome their addictions (Johnson et. al., 1994). With such assessment methods, chemical dependent offenders are able to have an idea on the extent of their addiction and on the extent of their treatment. Furthermore, assessments are important in the effective administration of treatment of chemical dependent offenders.   Testing Chemical Dependent Populations             After proper and effective assessment is done, drug testing is appropriate. This should be observed in order to assist the chemical dependent and his or her treatment on rehabilitative and punitive interventions, to reduce drug consumption by the increase in the access to treatment services, to obtain balanced punishment, justice, protection, and offender rehabilitation, and to provide needed information regarding policing and treatment policies and strategies (Matrix Research and Consultancy and NACRE, 2007). These must be taken note of in order to observe effective drug testing strategies and methods that would enable the further improvement and development of treatment methods for chemical or substance dependency.         Types of drug testing includes pre-employment drug testing and the Post-incident drug testing, which are commonly done in businesses, and the random drug testing, which is the most controversial type, as being used primarily for controlling illicit substance use in the society. This is done most especially in determining the extent of substance use of chemically dependent populations, such as in rehabilitation centers, prisons, different government agencies, and in schools.               Drug and alcohol tests are divided into two general classifications, one is through giving a sample of bodily fluids or hair and the other one is with on-site screens. The commonly used method for drug testing is through urinalysis, where a specific individual provides a sample of urine, and the amount of substance is detected either through a test card or through laboratory tests. Tests done in the laboratory may include gas chromatography or mass spectrometry and high-performance liquid chromatography or immunoassay analysis. Another way of detecting the amount of substances in the biological system of chemical dependents is through hair drug testing. This is an accurate test, as the hair can go back normally in 3 months, thus, would clearly show the use of drugs by the individual. Substances are contained in the hair shaft, and with longer strands of hair, the more the drug history of the individual can be easily detected. The third type of drug testing methods is through saliva drug screen or the oral fluid-based drug screen, where substance detection occurs after a few days. This is being used, as this type of drug test cannot be adulterated or cheated. Saliva testing can be compared to the accuracy obtained using blood samples. The last type of drug screen is in using sweat, where sweat test patches are attached to the skin of the chemical dependent for 10 to 14 days. This type of drug test is very applicable with the detection of substances for child protective services, parole departments, and other government agencies concerned with the use of drugs over long periods, and when urine samples are not applicable (“Drug Test, 2007). After gathering relevant data from the use of the different drug test methods, samples would be taken to the laboratory for additional confirmatory tests in order to determine the positivist or the negativity of the samples. This would in turn, confirm and indicate the amount of substances present in the biological systems belonging to the chemical dependent population.             With such drug test methods, the extent of chemical dependency among the target populations would be effectively and efficiently examined. The mentioned tests are not enough to confirm the presence of substances in the system of the chemical dependent. Rather, confirmatory must still be done in order to strongly indicate the presence or absence of substances.   Chemical Dependency Treatment Works              Given the above information, it would be necessary to take note if the chemical dependency treatment methods and strategies are essential and effective in the treatment and recovery of the target population. This is necessary to know the most used chemical dependency treatment used by most rehabilitation centers, and to become the basis of this research paper’s conclusion and recommendation. In addition, it would also be essential to take note of the effectiveness and efficiency of chemical dependency treatment programs to enable further investigation, study, and development that would cater to the needs of the chemical dependent populations in this study.             It has been reported that despite the number of chemical dependency treatment programs available, there are relatively few outcome studies of treatment programs for chemically dependent adolescents. A cited study in Macmenamin and Ralph (1996) indicated that relapse rates from treatment programs range from 35 to 70%, and that there is minimal information indicating the type of program used, (whether inpatient or outpatient), and whether it is effective or not. Another study indicated that adolescent chemical dependency programs that employed counselors with longer tenure, larger number of volunteers, increased delivery of mental relaxation techniques, and more practical problem solving were attributed to higher completion of treatment. However, this study did not indicate the success rate of such a program. In the comparison of different races in the American society, a specific study of American Indian and European American adolescents found out that following a four to six week inpatient treatment program, 27% of European Americans, and all American Indians continued using alcohol. On the other hand, 46% of American Indians and 41% of European Americans never used marijuana or hashish. This indicates that behavioral changes attributed to the recovery of chemical dependents from drug and alcohol use is not much written, while more literature indicating that chemical dependent populations are under treatment (as cited in Macmenamin and Ralph, 1996). With this data, it can be perceived that the success of the treatment programs were not indicated in most studies related to chemical dependency, and that most of the literatures being recovered indicate that many continue to use alcohol or drugs after being subjected to treatment. From this, it can be hypothesized that either the chemical dependency treatment program or method used in the recovery of the patient is not effective, or the chemical dependency treatment used does not suit the needs of the patient. However, despite such records, some studies indicate the effectiveness and the success rates of such chemical dependency treatment methods.             Starr (2002) reports that most studies on chemical dependency show that treatment programs on average have an effectiveness rate of 30 to 60%, if measured in terms of the number of people who remain totally abstinent for one year or longer, and where individual treatment programs may achieve higher abstinence rates. In addition, according to the Partnership for Recovery, which is a coalition of top treatment centers, success rates ranges from 51 to 75%, while the Hazel den Foundation boasts a 77% rate of keeping people clean and sober at the end of one year, having 54% being completely abstinent from substance use, and the rest having had just one episode of use during that time. Nevertheless, although addiction treatment is perceived to be not universally successful, its success rate can still be compared to the success rate of treating other diseases, including hypertension, diabetes, and asthma. Thus, as a specific study reported, addiction treatment ranked in the top 10% of medical treatments reviewed for savings in money and lives (as cited in Starr, 2002).             Another possible measure indicating the effectiveness and success of the chemical dependency treatment programs is through taking note of the lives of the treated patients after undergoing the treatment program. A study indicates that after undergoing the treatment recovery program and the discharge of the patients, significant changes in the patients’ behavior were observed. Macmenamin and Ralph (1996) reports that before admission of chemically dependent adolescents in the treatment program, 75.9% of students were enrolled in regular high school, 12% in a continuation school, 2.8% in independent study, and 6.5% were not in school. However, after the treatment program, 37% were enrolled in regular high school, 9.3% in a continuation school, 26.9% in independent study, and 9.3% were not in school, which included graduates. This study also pointed out that among their respondents, 2 out of 81 students did worse in school after discharge, while 64 out of 81 students improved. In addition, 40 out of 108 students were working before admission, while 58 out of 108 were working after discharge, resulting to an increase number of graduates and improved lives after discharge and treatment. Moreover, the behavior of the adolescents also improved, indicated by the improvement of their relationship with their family after their discharge, having 82 out of 107 parents having improved relationships, while only 5 out of 107 parents who had worse relationships (as cited in Macmenamin and Ralph, 1996). With this data, it can be perceived that although the success rate of chemical dependency treatment programs are not always indicated in figures, it can still be regarded as an effective and efficient tool that improves the lives of the patients. However, such studies failed to indicate the most effective chemical dependency treatment programs being used and implemented in different rehabilitation and treatment centers and institutions.                                            Chapter 3 Methodology               This part discusses the research methods available for the study and what is applicable for it to use. Likewise, the chapter presents how the research study was implemented and how it came up with relevant findings. Moreover, this chapter also presents the various procedures and strategies in identifying the sources for the needed information to know the relative preferences of the chosen respondents in terms of the treatment of chemically dependent populations. It specifies the research design that was followed, the process of data gathering, and the data analysis method that would be used.   Research Method             Three kinds of research methods can be used in doing research studies, namely, correlation, experimental, and descriptive method. The correlation method is used with regards to ethical and practical problems with experiments. In addition, inferring causality from correlation is not actually impossible but very difficult, so this mode of study is widely acceptable, cheap and usually ethical. Nonetheless, there exist some “third variable” issues and measurement problems in the use of this type of method. In essence, this type of research method refers to studies in which the purpose is to discover relationships between variables through the use of correlation statistics.             Another type of research method is the experimental method, which is the only method that can be used to establish cause-and-effect relationships (Creswell, 1994). That is, this type of research method is the only method that can be used to explain the bases of behavior and mental processes. In this method, the subjects are split into two or more groups, where one group is called the experimental group and gets the treatment that the researcher believes will cause something to happen. This treatment is formally called the independent variable. The experimental and control groups are compared on some variable that is presumed to reflect the effects of the treatment or outcome. This is formally referred to as the dependent variable.             The third and final approach is the descriptive research method, which uses observations and surveys. In this method, it is possible that the study would be cheap and quick. It could also suggest anticipated hypotheses. Nonetheless, it would be very hard to rule out alternative explanations and especially infer causations. Thus, this study will use the descriptive approach to utilize observations in the study.             The research study started by conducting an exploratory type of research in the aim to identify the variables needed. The research study included personal interviews and self-administered questionnaires. In addition, a set of articles and other literature were used in the process of building constructs and identifying variables. After identifying constructs and variables, a questionnaire was made and distributed to respondents from different chemical dependency treatment centers and rehabilitation institutions. Particularly, the method utilized in this research study is termed the research onion process, which will be used in order to ensure that the researcher will be able to obtain the necessary data to examine which rehabilitation program is the most effective treatment for chemically dependent offenders.   Research Onion Process             In order to come up with the most suitable research approaches and strategies for the study, the research onion process was utilized. The process was termed as such because the conduction of the research is like peeling the layers of an onion, in order to come to the central issue of how to collect the necessary data needed to answer the research questions and objectives. In this research process, important layers should be first peeled away, before arriving at the core of the process. With the said process, an outline on what measures to be applied are most appropriate would be made. In addition, it is not unusual for a researcher to first think of his research understanding by considering whether one should for example, administer a questionnaire or conduct interviews; this is why thoughts of this question should belong to the center of the research onion (Saunders, 2003). That is, in order to come to the central issue of how to collect the data needed to answer one’s research questions, there are important layers of the onion that needed to be peeled away. The first layer raises the question of the research philosophy to adopt, particularly of positivism. With this research philosophy, a researcher prefers to work with an observable social reality in order to come up with law-like generalizations similar to those produced by the physical and natural scientists (Remedy et. al., 1998). In this tradition, the researcher becomes an objective analyst, coolly making detached interpretations about those data that have been collected in an apparently value-free manner (Saunders et al, 2003). In addition, the emphasis is on a highly structured methodology to facilitate replication (Gill and Johnson, 1997) and on quantifiable observations that lend themselves to statistical analysis (Saunders et al, 2003). The assumption is that the researcher is independent of and neither affects nor is affected by the subject of the research (Remedy et. al., 1998; Saunders et al, 2003). The second layer considers the subject of the research approach that flows from the research philosophy. Specifically, this research study adopts a deductive research approach, which moves from general ideas or theories to specific particular situations. An example of the application of this kind of research approach is knowing the number of definitions of the word ‘professional’ from a number of professional associations. The definition can be obtained by using a questionnaire, interviews, or group discussions, and through selecting a sample on the basis of age, gender, occupation, etc. The data obtained can then be collated and results presented. This research approach is relatively easy and a systematic way of testing established ideas on a range of people (Neville, 2005). In addition, this approach has five sequential stages, namely, deducing a hypothesis, expressing the hypothesis in operational terms, testing this operational hypothesis, examining the specific outcome of the inquiry to either confirm the theory or indicate the need for its modification, and modifying the theory in the light of the findings, if necessary (Robson, 1993). The third layer examines the research strategy that is most applicable, and adopts the case study research strategy. This type of research strategy uses a particular case study or situation, which will be the basis for the collection of data, analysis of information, and report of results. Through this case study, the research would be able to understand as to why the situation happened, and the important aspects that should be given attention in the future. This research strategy also helps in generation and testing of hypotheses (“Case Study”, 2007). The fourth layer refers to the time horizon a researcher applies to his or her research, which in this research study is referred to as the cross sectional time horizon. It has been reported that in the cross-sectional type of research, data needed in the research study are collected from the respondents at a single point in time or during a single, relatively brief timeframe. Particularly, the data are collected from multiple groups or types of people, such as from males and females, from people belonging to different socioeconomic classes, from multiple age groups, and from people with different skills and accomplishments. The advantage of using such a research approach is that the needed data can be collected from different respondents in a relatively short timeframe (“Cross-Sectional Research”, 2006). The fifth and final layer is the data collection methods that are to be used in the research study. The data collection method used in this research study would be useful in obtaining the secondary data needed, particularly the data from the target population or respondents.   Research Design             It has been previously mentioned that the second layer of the research onion process refers to the subject of the research approach, and identifies the deductive research approach as a means of obtaining the necessary data. Furthermore, the deductive approach has a number of important characteristics. Primarily, this approach is a search to explain causal relationships between variables, which consequently lead to the development of a hypothesis. Second, it involves the collection of a quantitative data and/or qualitative data, and these data are important to test a hypothesis that has been previously developed. The third characteristic of a deductive approach is that it controls to allow the testing of hypothesis. However, one must remember that with this approach, it is important that the researcher is independent of what is being observed – that is, the researcher should be objective and not subjective. In this sense, the principle of scientific strictness will be pursued, as this approach emphasizes scientific principles (Saunders et. al., 2003). Another important aspect to take note of is that the concepts are operationalisation, which will enable facts to be measured quantitatively. Finally, the deductive approach is a generalization, and to be able to do so, a sufficient numerical size of samples is needed (Saunders et. al., 2003). However, along with the guide of the sequential stages in adopting the deductive research approach, effectively and properly obtaining data from respondents involve both a qualitative and quantitative research, using exploratory methods in describing the variables, such that the data situation and other facts collected were explained and correlated with other data. This form of research design is useful when conducting a study where data are immeasurable, such as feelings, beliefs, and thoughts (Mays and Pope, 2000). In addition, this descriptive study focuses on the conditions set and the nature that surrounds the data, and not on the correlation with other collected facts. Specifically, the qualitative method permits a flexible and iterative approach, while the quantitative research method permits specification of dependent and independent variables and allows for longitudinal measures of subsequent performance of the research subject. During data collection, the choice and design of methods are constantly modified, based on ongoing analysis. This allows investigation of important new issues and questions as they arise, and allows the investigators to drop unproductive areas of research from the original research plan. The value of qualitative research can best be understood by examining its characteristics. One of the primary advantages of qualitative research is that it is more open to the adjusting and refining of research ideas as an inquiry proceeds. In addition, the researcher does not attempt to manipulate the research setting, as an experimental research study, but rather seeks to understand naturally occurring phenomena in their naturally occurring states. In comparison, the quantitative method is compatible with the study because it allows the research problem to be conducted in a very specific and set terms (Cooper and Schindler, 1998). Besides, the quantitative research plainly and distinctively specifies both the independent and the dependent variables under investigation. It resolutely follows the original set of research goals, arriving at more objective conclusions, testing hypothesis, determining the issues of causality, and eliminating or reducing subjectivity of judgment (Kelley and Pothered, 1996). In addition, this method allows for longitudinal measures of subsequent performance of research subjects (Mated, 2002). Finally, it provides achieving high levels of reliability of collected data due to, namely, controlled observations, laboratory experiments, mass surveys, or other forms of research manipulations. This study should be based on surveys and statistical treatments, such that the quantitative approach suits well with it.                   To find out causes of addiction and chemical dependency in the target population; 12) To identify the elements that foresee substance exploit problems or the problems that lead to chemical dependency; 13) To determine the effects of chemical dependency to individuals and to the society; 14) To determine the different drug and alcohol rehabilitation methods currently used, including its process, duration and development; 15) To provide an ample assessment of offenders with chemical dependency problems; 16) To evaluate processes and tools presently used for testing; 17) To determine alternative rehabilitation methods available for chemical dependents; 18) To determine the chemical dependent treatment effects of the offenders; 19) To identify the constructive dependency treatment results in offenders; Chapter 4 and 5  To recognize the impacts of such actions to the society; Conclusion and Recon   Issues  (1) Fortunately, although no cure exists, medical treatment can enable recipients to live normal, healthy, and productive lives. Treatment is cheap compared to many other common medical procedures and is highly cost-effective. (2) Now consider this: For the vast majority of victims of this disease, effective treatment is inaccessible. Most health insurance plans either do not cover it or put a variety of limits on coverage that do not apply to other diseases. Unless they can pay out of pocket, victims cannot get the treatment they need. To make matters worse, they are often told that their condition is not a real disease, or that it is their fault, or that suffering from it makes them a criminal. The disease is drug and alcohol addiction, and the facts are real. Ubiquitous benefit caps on insurance coverage of substance abuse treatment put effective recovery out of reach for most addicts. In this Note, I assess the nature of this problem and some possible ways to address it. The general principle that I advocate is substance abuse treatment parity, which means that insurance plans should provide coverage for addiction treatment that is equivalent to that provided for analogous conditions. In some cases, failure to provide such parity should be considered illegal disability discrimination on the part of employers and insurers. Moreover, new laws should be adopted to require insurance parity explicitly. In Part I, I review the current status of insurance coverage of addiction treatment and assess the scope of the shortfall and possible reasons behind it. In Part II, I set forth the case for insurance parity, including the nature and costs of the disease of addiction and the efficacy and cost-effectiveness of treatment, and consider some counterarguments. In Part III, I analyze the requirements of the Americans with Disabilities Act (ADA) as they pertain to insurance parity, drawing on the precedents set by recent challenges to other types of insurance discrimination. I conclude that the ADA should be interpreted to require parity in some cases, but that the potential effectiveness of this litigation strategy is limited--new reforms are necessary. In Part IV, I consider the strengths and weaknesses of current legislative proposals to accomplish insurance parity, and focus especially on the Substance Abuse Treatment Parity Act. Finally, in Part V, I offer my conclusions and recommendations for legal change and advocacy.     Sample Questionnaire 1   Personal Information of Respondent Please provide necessary answers on the space provided after each item. On items with choices, please mark the corresponding answer in line with the respondent’s preference.   Name: _____________________________               Date: _________   Gender: Female ______           Male: ______   Rehabilitation Institution: ___________________________ Location: ________________________________________   Age Range: Below 20 _____          20 to 25 _____            26 to 30 _____            31 to 35 _____   36 to 40 _____          41 to 45 _____            46 to 50 _____            Over 50 _____   Race: Native American _____            European American _____       African American _____                       Asian _____                 Others (pls. specify)___________   Religion: Christian _____            Muslim _____              Catholic _____ Buddhism _____ Hindu _____                Protestant_____           Others _____   Marital Status: Single _____                Married _____             Divorced/Widowed _____       Children (if any): _____   Educational Background: High School Education _____   University Education _____ Masterly Studies _____                        Doctorate Studies _____ Vocational_______   Occupation: (A) Student (pls. specify) _____________ (B) White Collar Job – doctor, lawyer, nurse, accountant, etc (C)  Blue Collar Job – construction, domestic helper, plumber, factory worker, etc (D) Unemployed   Substance/Chemical Used upon Arrest (A) Alcohol (B) Drugs (pls. specify what kind) _____________________ (C) Others (pls. specify)   Type of Chemical Dependency Treatment Currently In: __________________   Duration: (A) Once a week (B) Twice a week (C) Thrice a week (D) Daily (E) Monthly (F) Occasionally (G) Full In-house Treatment             1. Regular             2. Intensive (H) Outpatient Treatment             1. Regular             2. Intensive   Stage of Treatment (A) Newly Enrolled (B) Regularly attending sessions (C) Near recovery       Sample Questionnaire 2   All items are responded to using a 5-point Liker-type scale with the following points: 1 for Strongly Agree; 2 for Agree; 3 for Uncertain; 4 for Disagree; and 5 for Strongly Disagree. Please mark the corresponding space for the points.   1. Do you recognize the fact that you are a chemical dependent individual?         ⁮ 1 Strongly            ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   2. Do you recognize that your situation affects your behavior entirely?         ⁮ 1 Strongly            ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   3. Do you believe that your chemical dependency has given you any advantages?        ⁮ 1 Strongly             ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   4. I perceive drugs or excessive use alcohol a tool for the disruption of my future.        ⁮ 1 Strongly             ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree 5. Do you realize the negative effects of your situation to your family and friends?        ⁮ 1 Strongly             ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   6. Are you satisfied with the extent of treatment provided to you?       ⁮ 1 Strongly              ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   7. Do you believe that the currently administered treatment is suitable to your condition?      ⁮ 1 Strongly               ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   8. Has your attention been completely diverted from the use of alcohol/drugs?      ⁮ 1 Strongly               ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   9. Has your condition improved from the time you entered the institution?      ⁮ 1 Strongly               ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree   10. With the extent of your knowledge, do you perceive another type of chemical dependency treatment more applicable to your condition?      ⁮ 1 Strongly               ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree 11. Are the activities facilitated in this institution successful in treating your addiction?      ⁮ 1 Strongly               ⁮ 2 Agree         ⁮ 3 Uncertain       ⁮ 4 Disagree       ⁮ 5 Strongly                    Agree                                                                                                     Disagree

Sample Most Effective Rahabilitation Method of Chemically Dependent Offender Populations Essay

Most Effective Rehabilitation Method of Chemically Dependent Offender Populations Outline: (flow of discussion) –Plan – refer to ab...