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 (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 CDCO, 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 JRA, 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% ( 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 (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 CDDA, which gives courts with a verdict alternative for
chemically dependent youth. Drug treatment is the primary responsibility of the CDDA,
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 (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 ( 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 (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. These
laws are helpful for the society, as they assist local governments and authorities to
restrict and reinforce activities that would encourage juveniles and adults alike to
engage in drug and alcohol-related activities. 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 (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 (2005). In addition,
inpatient medical treatments take place either in medical and general psychiatric
settings, and offer a higher level of medical supervision (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 (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 (2006). A past research indicated that
recent estimates from the National Household Survey on Drug Abuse and the Uniform
Facility Data Set report that approximately 5 million drug users needed immediate
treatment in 1998, but only 2.1 million received it, and the number of individuals who
wanted or who would have agreed to undergo treatment was unknown (2003). In
relation to this is the specific data regarding juveniles as reported by the SAMHSA’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
(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, and
perhaps provide relevant data in the future.

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 offender population 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 populations in the state of South Carolina, United States, particularly in its
three counties, namely, Greenville County, Lexington County, and Charleston County.
Specifically, the study intends to answer the following queries:

1. What could be the most recommended chemical dependent rehabilitation program for offenders?

2. What are the risks to be taken note of in undergoing such rehabilitation program?

3. What are the barriers to be considered in allowing a criminal offender in undergoing the treatment program?

4. Are there other alternative treatment programs available that could present the same effects and treatment

for offenders?

5. What are strengths, weaknesses, opportunities, and threats that can be attributed to undergoing such

programs?

Hypothesis

The study intends to test the following hypothesis:

“The most effective chemical dependency treatment program must be adopted

in all rehabilitation institutions to treat the chemical dependent offender 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 populations, 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 populations 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 data will be
obtained from treated chemical dependent youth populations in three counties in South
Carolina, specifically from Greenville County, Lexington County, and Charleston
County. 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:

• Are the results of the research study valid?

• Was the data relevant to the research questions?

• Were the data collection methods appropriate for the research objectives?

• Was the data collection comprehensive enough?

• Were the data appropriately analyzed, with the findings adequately supported?
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 (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 (2004). With such prevalence, it can be perceived that several causes might
be attributed to such large occurrence in adolescents. However, the causes to be
identified may also be attributed to the large occurrence of chemical dependency
among other members of society, which leads to committing various crimes, and forms
the chemical dependent offender populations. The causes of chemical dependency
among the juveniles may also be attributed to the occurrence of chemical dependency
among other members of the society. 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, (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, (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 (2006), authors like
Petraitis, 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 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, 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 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 (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.
These causes can be also perceived the causes of chemical dependency among the
adult population, as their tendency to become alcoholics and drug addicts can be
possibly traced back from their childhood, thus, indicating their current condition.

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 (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 (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 ( 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
(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 (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 (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
(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 (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 (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
( 1990). Documented prenatal substance exposure presented effects on fetal and child
development, thus, affecting 20% of newborn children in America and causes 1 in every
10 cases of mental retardation (2002). In addition, the increase in alcohol intake,
particularly in women makes them sexually aggressive and promiscuous (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 ( 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 (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 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. 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.

(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 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
(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 ( 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
AVRT, 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 (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 ( 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 ( 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 (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 ( 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 (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
( 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 (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 (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 Wolberg in 1948, who treated alcoholism by using
hypnosis to enhance dream imagery (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 ( 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 (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 (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. 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 ( 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 neuro-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 ( 2007).

Aside from these alternative methods for treatment are other treatment
strategies or techniques that can also be helpful in helping the chemical dependent
populations obtain recovery. These alternative treatment methods are considered
outcome-based therapies, as being implemented based or according to planned results.
Several methods can be named, but only a number were chosen to be considered an
effective means of treating addiction. The following methods were considered as they
are the ones more popular among other outcome-based methods, namely,
aromatherapy, reflexology, massage therapy, art therapy, and dance/drama/music
therapy.

Aromatherapy is a form of an alternative treatment, focusing on the treatment of

a patient holistically, using different pleasant smelling scents from botanical oils,
including lemon, rose, lavender, peppermint, and other essential oils, which affects the
moods or the health of the individual as a whole. This form of therapy is based on
alternative medical practices and spiritual beliefs that place a high regard on the
synergy or harmony between the body and aromatic oils, thus, creating a pleasurable
sensation and healing on the part of the individual. The essential oils used in
aromatherapy are added to the bath, massaged directly to the skin, inhaled, or even
diffused in an entire room, and this process helps an individual to have relief from pain,
to care for the skin, to release and reduce tension, fatigue and stress, and to energize
and rejuvenate the entire body. It is said that the aroma of the different essential oils
used in aromatherapy affect the mood of an individual, reduce tension and stress, and
promote relaxation, as the scent of the essential oils work on the brain and nervous
system of individuals through the stimulation of the olfactory nerves in the nose ( 2007).
The use of essential oils as an alternative treatment for chemical dependency is
relevant because unlike the medicines and other substances used for the conventional
treatment of addicts, the oils directly affect the chemistry of the body of the individual
that has no side effects. They enter and leave the body with great efficiency, leaving no
toxins behind, thus, considered to be more sophisticated than most modern drugs. In
addition, the use of essential oils directly affects the physiology of the body of an
individual, thus, affective on the mood, as the olfactory nerves connected to the limbic
system of the brain regulates sexual urges and emotional behavior (2007). This form of
alternative treatment is applicable and appropriate for the treatment of chemical
dependence because it also presents the same rewards and pleasurable effects in the
individual, thus, helping to alleviate the addiction from harmful substances. Because
essential oils are biologically and systemically-friendly, administering such substances
would enable the chemical dependent to achieve a much better disposition during the
treatment. Moreover, given the effects of using essential oils, the chemical dependent
would be able to regulate his or her emotions, urges, and behavior, which could help the
individual gather respect for him or herself and for others. Furthermore, the use of
essential oils in the process of aromatherapy not only help in the treatment of the
addiction per se, but also help with the treatment of its causes and symptoms, such as
stress, anxiety, and other, emotional problems. Thus, this form of alternative treatment
can be perceived as an appropriate form of treatment for chemical dependency.
However, this type of alternative treatment is considered a complementary treatment
only, which could be more effective if combined with other chemical dependency
treatments.

In relation to aromatherapy is another complementary treatment, which can be

done along with aromatherapy. This is commonly known as massage therapy. Massage
therapy is said to be a combination of both science and art, as it provides a relaxing
experience by a variety of artistic hand strokes on the body, in its aim to invigorate the
mind and the body and eliminate stress scientifically ( 2005). In this sense, massage is
used for the benefits of an individual in terms of physiological, mental and mechanical
aspects, and thus is termed as therapeutic or manipulative therapy (2007). As a
complementary form of alternative therapy, it can help in the alleviation of the addiction
of patients as it aims to improve circulation in the body, to eliminate wastes and toxins,
to serve as a lymphatic drainage, to ease muscular pain and to promote relaxation, to
improve the immune and the digestive system, to promote a feeling of wellness, and to
reduce anxiety, tension and depression (2005). For this to become more effective, it
would be helpful if essential oils would be used for the massage of the body. In this way,
the total relaxation of both the mind and the body will be achieved in the process. In
essence, it can be perceived that this form of alternative therapy can be used
simultaneously with aromatherapy, and does not present any negative side effects. This
is relevant and appropriate for the alternative treatment of chemical dependency
because, there are no harmful chemicals or medicines used in this type of treatment,
and there are no known side effects. Similarly, administering such treatment also
participates in the reward and pleasure systems of the brain, as massage therapy is
done with the use of essential oils and other aromatic substances. In this process, not
only the olfactory senses of the individual are being stimulated, but his or her whole
body as well. Specifically, the use of essential oils in massage therapy works into the
skin and breathed in, thus, triggering brain responses through receptors present in the
nose and pores in the skin. In turn, the brain signals the different organs in the body to
produce chemicals that act on the body in various ways, such as the increase in blood
flow or the slowing down of circulation, which produces a calming effect in the body
(2007). There are a number of different types of massage therapy available for use,
depending on the preferences of the patients. However, because this form of alternative
treatment is only considered a complementary therapy, it would be most effective if it
will be done along with other chemical dependency treatments.

Another relevant alternative treatment that can be used in line with

aromatherapy and massage therapy is reflexology. Reflexology, or also known as zone
therapy is the application of pressure, stretch, and movement to the feet and hands to
target other parts of the body, as both the feet and the hands are viewed as a mirror
image of the body (2003). In reflexology, each body part is represented on the hands
and the feet, and pressing on these parts can have therapeutic effects that would aid in
the stimulation of the flow of energy, blood, nutrients, and nerve impulses (2004).
Reflexology involves putting pressure on the feet of the patient, where pressure signals
the peripheral nervous system, enter the central nervous system, where the signals are
processed in the various parts of the brain. The signal is then relayed to the internal
organs to provide with needed adjustments in oxygen and other nutrients, thus,
improving the function of the organ (2003). In this sense, improvement of the organs
and other bodily parts of an individual can be achieved through the simultaneous flow of
nerve impulses from the feet and hands that would be processed in the brain. Becoming
chemically dependent involves the destruction or impairment of the nerves of the
individual, as the different substances used in the process largely affects various brain
receptors, neurotransmitters, and parts. Specifically, alcohol acts as a depressant of the
central nervous system of the brain, having effects including vitamin deficiency , and
damage and overall reduction in brain size, while drugs cause various sensory and
motor problems, as it damages the myelin sheath surrounding the neurons, which is
responsible for the normal transmission of impulses (2007). Thus, this damaged caused
by excessive use of substances can be repaired through reflexology, which can induce
the flow of nerve impulses through massage, pressure and movement in the feet. With
this type of alternative treatment, the nervous system of the chemical dependents would
become repaired, thus, helping them to think clearly as functional individuals in the
society. Because this type of alternative treatment can help repair and strengthen the
nervous system of the chemical dependent, it can enable the chemical dependents
attain normal brain function, thus, enabling them to think logically and correctly.
Somehow, this alternative treatment can also help them become fully recovered, thus,
gain back their lives as functional and productive individuals in their communities.
However, similar to previously discussed alternative treatments, reflexology is also a
complementary treatment and must be done along with other treatments.

Another alternative treatment that can be used for the recovery of chemical
dependents is art therapy, which explores the psyche of the chemical dependent. It is a
form of an expressive therapy, which uses art materials like paints, chalk, and clay, and
combines traditional psychotherapeutic theories and techniques. This type of therapy is
employed both in clinical and non-clinical settings, wherein children, adolescents, and
adults are the patients, and services are provided to individuals, couples, families,
groups, and communities ( 2007). From this, it can be perceived that no particular client
or patient can undergo such treatment, meaning all types of chemical dependents can
undergo the process of treatment through art therapy. Art therapy is said to be based on
the belief that the creative process involved in making art is on a basic level healing and
life-enhancing, thus, helping an individual to increase insight and judgment, cope with
stress and traumas, improve cognitive skills, work through addictions, build better
relationships, and enjoy life’s pleasures (2007). Because art therapy involves and
targets the mental hygiene and emotional expressions of individuals undergoing the
treatment, this type of therapy enables them to undergo a creative process that would
help them express their hidden feelings, emotions and ideas they suppress.
Suppression of such ideas and emotions can be perceived as one of the causes of their
addiction, as most of these individuals are considered “misunderstood” by their
communities. Because they are not understood, the tendency for drug and alcohol use
and abuse is possible, as through this they are able to gain peers who would listen to
them more than their families or friends would. In addition, because art therapy utilizes
drawing, painting, sculpture, photography and other forms of visual art expression
(2007), chemical dependents would be able to express and explore their feelings,
emotions, dreams, memories, and ideas, thus, enabling them to build in-depth
relationships and appreciation of themselves and of others. Art therapy can develop and
improve the creativity of individuals, most especially of chemical dependents, for there
is a possibility that they were not able to explore this aspect of themselves prior to their
addiction or dependency. With this type of therapy, they would be able to know
themselves better through creative expressions, as creativity can provide a means of
expression for that which has no words, or is not yet fully understood ( 2004). Art
therapy can be used by chemical dependents as with this, they would be able to have a
means of expressing themselves in various ways, which would give them the chance to
become understood by their families and peers.

Along with art therapy are other forms of expressive arts, which include dance,
drama, and music therapy. Dance or movement therapy is one of the creative arts
therapies, along with drama and music therapy, which stems in the expressive nature of
dance itself. It is based on the belief that dance is the most fundamental of the arts, as it
involves direct expression and experience of oneself through the body, characterizes by
authentic communication, and that the body, the mind, and the spirit are interconnected
with one another (2005). Because it believes that the action of the body is interrelated
with the activity of the mind, this type of alternative therapy can be beneficial for the
chemical dependents, as they would be able to exercise and develop their creativity
through bodily movements and expressions. With this, the American Dance Therapy
Association defined dance or movement therapy as “the psychotherapeutic use of
movement as a process that furthers the emotional, cognitive, social and physical
integration of the individual” (2005). Dance therapy is a suitable alternative treatment for
chemical dependent populations as it is suitable for all types of individuals, for
individuals having any kind of illnesses, and for creatively and effectively expressing
emotions, feelings, and ideas. This type of alternative treatment is suitable for chemical
dependent populations for with this therapy, they will be able to enhance communication
with other individuals, keep them busy and preoccupied, practice and develop creativity
and express feelings and emotions, and similar with art therapy, be able to express
themselves without the use of words, which can complicate their messages. Moreover,
the use of dance or movement can improve their talents in the dancing, which they can
further develop and consider a good option in terms of profession or hobby.
 Another type of expressive art is in the form of drama, which helped develop
drama therapy. Drama therapy is said to be the intentional use of drama or theater
processes to be used in therapy; it is active and experiential, and can provide its
participants the opportunity to tell their stories, set goals, solve problems, express their
feelings and emotions, and explore interpersonal relationship skills. It involves activities
including improvisation, puppetry, role-playing, mask work, pantomime, theatrical
production, psychodrama, developmental psychology, theories of personality, and group
processes ( 2006). Similar to dance and art therapy, drama therapy could be utilized by
the chemical dependent populations to give them the opportunity to develop and
enhance their talents in drama and acting. This form of alternative treatment can assist
the chemical dependent populations with coping with their problems for this would give
them the opportunity to play roles that have large significance to their lives. Playing
roles would develop and inculcate in them the value of life and the value of themselves,
as it depicts the reality of their situation or the situation of other individuals. Problem
solving and critical thinking can also be developed, as this type of therapy would involve
creating situations and experiences that depict real-life situations. In this way, they
would be able to learn from such situations, and use such knowledge for practical
applications. Similarly, drama therapy provides the means for the chemical dependent
populations to express themselves through the characters they would be portraying,
with the intention to express their feelings and emotions using that particular character.
Through this type of therapy, they can develop their interests and talents in acting,
which can provide opportunities in this kind of field after undergoing treatment.

The last form of expressive arts is with the use of music, or through music
therapy. Music therapy is said to be the use of music by a trained professional to
achieve therapeutic goals, which may include developing motor skills, social and
interpersonal development, cognitive development, self-awareness, and spiritual
enhancement. Because this type of therapy deals with the different aspects in music, it
involves activities that include songwriting, listening, rhythmic entertainment, learning
musical instruments, and many others (2007). As such, this type of alternative treatment
is similar with dance, drama and art therapy in its aims and goals, which include helping
individuals to express themselves creatively through music. Because not all individuals
are into creating works of art using art materials, or not into dancing, or not into acting,
music therapy serves to be a good alternative or option, as music serves to be one of
the most used means of self-expression and creativity. Using music as an alternative
treatment and therapy for the chemical dependent populations can be deemed
successful and very useful, for using music and the instruments used in creating music,
a specific individual would have the chance to express their emotions and feelings.
Similar with other expressive art forms, music therapy can also develop and enhance
the musical skills of individuals, thus, can be an option for a career or business after
treatment. Through music therapy, one will be able to communicate with him or herself,
and with other people, in order to inform them of their ideas and feelings regarding life.
Thus, with these different expressive art forms, the chemical dependent populations
would be able to have a number of options or alternatives depending on their interests.

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 (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 (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 (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 (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 involve 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 ( 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 (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 (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 (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 (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 positivity 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 (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 (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.

(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 Hazelden 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 (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. Mcmenamy 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 ( 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, correlational, experimental, and descriptive method. The correlational 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 correlational 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 ( 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 offender populations.

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 (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 (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 (2003). In
addition, the emphasis is on a highly structured methodology to facilitate replication
(1997) and on quantifiable observations that lend themselves to statistical analysis
(2003). The assumption is that the researcher is independent of and neither affects nor
is affected by the subject of the research (1998; 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
(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 (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 (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 (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. 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
( 2003). Another important aspect to take note of is that the concepts are
operationalised, 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 (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 (2000). In
addition, this descriptive research 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 (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 (1996). In addition, this method allows for longitudinal measures of
subsequent performance of research subjects (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.
Research Instrument

The researcher designed a questionnaire for the purpose of the interview or

interaction process. The primary aim of the questionnaire is to obtain data from
respondents on the most effective rehabilitation methods for chemically dependent
offenders. This research will use closed questions, which has pre-coded answers.
Through closed questions, the researcher will be able to limit responses that are within
the scope of this study. Using a multiple-choice method, the answer of the respondents
would be within one of the limited expected answers of the researcher. Thus, the
researcher will design a closed question type to remain focused on the statement of the
problem and on the main purpose of the study. In addition, closed questions will be
used in the survey because the answers are easy to analyze and are straightforward, as
target respondents do not have enough time to answer open-ended questions. (WHY?)
Closed response questions save the respondent having time to think of possible replies.
However, despite the use of closed questions, the interaction or interview session would
be used for direct observation of the respondents.

The questionnaire consists of mainly two parts. The first part was a set of
categorical questions to identify a respondent’s personal data and information, which
corresponds to the demographic data the study will be needing, including the age,
occupation, status, and gender. The second part of the questionnaire, which is divided
into two, includes a number of questions to measure the attitudes, preferences, and
factors that may affect the rehabilitation treatment of respondents. A 5-point Likert Scale
was used in both the two parts of second part of the questionnaire to measure each
construct. The variable used in the scale were mainly derived from the exploratory
research results and from some related literature. In the Likert technique, a set of
attitude statements are presented, where subjects or respondents of the study are
asked to express agreement or disagreement using a five-point scale. The degree of
agreement is given a numerical value ranging from one to five, thus a total numerical
value can be calculated from all the responses (2004).

Hence, the primary source of data will come from a questionnaire, interviews or
direct interaction and observation conducted by the researcher to selected respondents
belonging (ADD MORE INFO) to the chemically dependent offender populations in
rehabilitation institutions in three counties in South Carolina. The secondary sources of
data will come from published articles related to the topic, including books and related
journals and magazines.
 From the research design, the researcher gathers data, collates published
studies from different local and foreign universities and articles from related journals.
The researcher also makes a content analysis of the collected documentary and verbal
material. Afterwards, the researcher will summarize all the information, make a
conclusion based on the findings, and provide insightful recommendations in relation to
the concepts and implications covered.

Sampling Size

In order to have first hand information, the researcher has respondents of the
study, who are composed of _________________________________. From the three
counties, namely, Lexington, Greenville, and Charleston counties, three rehabilitation
institutions will be chosen from each, for a total of nine different rehabilitation
institutions (). The first option was to have as many respondents as the research will
have. However, because of unfavorable circumstances, the researcher has decided to
consider ___ respondents who have responded to the questionnaire provided. ____
respondents were considered in Lexington County, ____ from Charleston, and ____
from Greensville respectively. The total number of respondents from each county was
summed from three different rehabilitation each (). Primarily, the questionnaire has been
used to collect data on the respondents’ demographic profile to check that the sample is
appropriately stratified and representative. Second, the questionnaire has been used to
provide further information about the sample for analysis purpose. Due to travel
distance and time limitation, brief interaction and interview was done in order to observe
and meet the respondents of the study. Nonetheless, data obtained using the
questionnaires were sufficiently considered for the research study.

Sampling Method

[This research study utilized a multi-stage sampling method, where the selection
of the sample is accomplished in two or more steps. The population is first divided into a
number of first-stage units from which a sample is drawn. From this first-stage units,
second or third, more stage units can be derived. This is usually done when the
research is dealing with a large number of respondents (1978). Along with multi-stage
sampling is the use of a cluster sampling method, which was used to sort the samples
in every stage of sampling.] Because considering the entire chemically dependent
populations in all rehabilitation institutions would not be feasible for this research study,
the research has chosen the participation of the chemically dependent youth offenders
among the larger population of chemically dependent populations. This is in line with
the consideration and assumption that young offenders are more flexible and
understanding in participating in such surveys. In addition, because they are younger,
their memory can still serve them better, compared to older offenders. Moreover, this
research study concerns the youth in order to inform and alert the local and
international government on their current situation. The respondents considered in this
research study were considered to be in the “prime of their lives”, thus, more needing
change in their lives in order to function normally in their communities. ()

[In the multi-stage sampling, the first-stage sample units were done by selecting
only three among the 46 counties in South Carolina. The second-stage samples were
derived from choosing only 3 rehabilitation centers or institutions among the many
rehabilitation institutions present in all 3 different counties. The third-stage samples
were derived from choosing only the chemically dependent offenders from the
chemically dependent populations undergoing treatment and recovery from
rehabilitation institutions in each county.]

From the final stage of samples, the _____-page questionnaire was used to measure
the theoretical constructs of the attitudes, preferences and choices of the chemically
dependent offenders in relation to their addiction, treatment, and recovery. A 5-point
scale with endpoints like “strongly agree”, “strongly disagree”, “agree”, “disagree”, and
“uncertain” were used to measure the items. On the scale, number 1 indicates the
strongly positive response and number 5 indicates the opposite extreme.

The equivalent weights for the answers will be:

Range Interpretation

5 Strongly Disagree

4 Disagree

3 Uncertain

2 Agree

1 Strongly Agree
 The research opted to use the questionnaire as a tool since it is easy to
construct, having the rules and principles of construction easy to follow. Moreover,
copies of the questionnaire could reach a considerable number of respondents either by
mail or by personal distribution. Generally, responses to a questionnaire are objectified
and standardized, and these make tabulation easy. More importantly, the respondents’
responses are of their own free will because the interviewer will not be influencing them.
This is one way to avoid biases, particularly the interviewer’s bias. The researcher will
also use graphs and charts for data presentation.

Validation of the Instrument

Closed type questions were used in the administered questionnaires of this

research study, as closed-type questions can be used for efficient and easy tabulation
of the gathered data. For the purpose of validation of data, the researcher pre-tested a
sample of the set survey questionnaires. This was done by conducting an initial survey
to at least five respondents each from the chosen sample units of the population. After
the respondents answered, the researcher then asked them to cite the parts of the
questionnaire, which needs improvement. The researcher even asked for suggestions
and corrections from the respondents to ensure that the survey-questionnaire is
effective and substantial. Automatically, these five respondents were not anymore
included as final respondents of the study.

Data Collection Plan

The researcher excluded the five respondents who were initially used for the
validation of the instrument. The researcher also tallies, scores, and tabulates all the
responses gathered from the answers in the questionnaires, with consideration of
observations. During the administering of the questionnaires, the researcher can
interact and speak to the respondents, however, not influencing the respondents
regarding his or her answers for the questionnaire.

Statistical Treatment of the Data

 After the collection of the entire survey questionnaires, analysis and collation of
such data must be done next. With this, the researcher will be using statistical tools and
methods to analyze all the data, and will be assisted by the SPSS or the Statistical
Package for the Social Sciences in coming up with the statistical analysis for this
research study. Because of this research design, the results of the data gathered were
limited to the determination of the opinions of the target population regarding the most
effective rehabilitation method for chemically dependent youth offenders. Thus, other
possible findings in the field of study are also analyzed.

Comparisons were drawn between the overall responses to the questions and
the differing responses (Creswell, 1994). The following statistical formula will also be
used:

1. Percentage – to determine the magnitude of the response to the questionnaire

% = ___ x 100 ; where n is the number of responses, and

N N is the total number of respondents

2. Weighted Mean

f1x1 + f2x2 + f3x3 + f4x4 + f5x5

X= ______________________

xt

where: f is the weight given to each response;

x is the number of responses; and

xt is the total number of responses

 The researcher will be assisted by the Statistical Package for the Social
Sciences or SPSS in coming up with the statistical analysis for this research study.
SPSS is one of the most widely available and powerful statistical software packages
that cover a broad range of statistical procedures. It allows a researcher to summarize
data, such as compute means and standard deviations, determine whether there are
significant differences between groups through t-tests and ANOVA, examine
relationships among variables through correlation or multiple regression, and graph
results including bar charts and line graphs (2003).

Chapter 4

Presentation, Interpretation and Analysis of Data

This part of the research study will be discussing the findings, which are based
on the self-administered questionnaires answered by the respondents. The primary aim
of this study is to examine and determine the most effective rehabilitation program for
the chemically dependent offender populations in the state of South Carolina,
particularly in its three counties, namely, Greenville County, Lexington County, and
Charleston County. This study also aims to help increase knowledge and information
regarding the rehabilitation methods for chemically dependent offender populations, and
the effectiveness of a number of rehabilitation methods for their treatment.

For this research, primary and secondary research data were used, wherein the
primary research materials came from the self-administered questionnaires that were
answered and distributed to the supposed participants of the research study. The
questionnaires were used to collect quantitative data. The conduct of this study entails
the level and position of the respondents. It was assumed that the attributes of the
respondents or participants influence their behavior and answers on the questionnaire.

The researcher has used closed questions for the questionnaire. These
questionnaires were used to gather quantitative data, and the direct observation and
interaction with the respondents were used to provide qualitative ideas into the gathered
data.
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 Recom

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 18 _____ 18 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 _____

Masteral Studies _____ Doctorate Studies _____

Vocational_______

Occupation:

(A) Student

(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 Likert-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. Are you unhappy with how your life has been going?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

2. Do you find yourself always having thoughts of drinking or using drugs?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

 Agree Disagree

3. Do you recognize that you have a problem?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

4. Has anybody informed you that you might have a problem?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

5. Have you drank or used substances regardless of the consequences?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

6. Do you recognize the fact that you are a chemically dependent individual?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

7. Do you recognize that your situation affects your behavior entirely?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

8. Has your occupation (or schooling) or relationships been affected?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree
9. Are you in jeopardy of losing your job or family because of chemical use?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

10. Do you refuse to go to places where you won’t be able to use substances or drink?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

11. Do you believe that your chemical dependency has given you any advantages?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

12. Do you perceive drugs or excessive use alcohol a tool for the disruption of your
future?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

13. Have you ever spent on chemical or substance use more than you should have
spent on bills or other needs?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

14. Do you hide or lie about using substances to friends or family?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree
15. 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

16. Do you need to drink or use to have fun or to enhance your social life?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

17. Is it uncomfortable for you to participate in social institutions without substance use?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

18. Do you have any legal problems because of substance use?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

19. Do you constantly live in fear or anxiety?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

20. Do you drink or use substances to cope with feelings of pain, anger, fear, anxiety,
and depression?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree
21. Do you compromise your values or morals?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

22. Do you feel that you are different from others and no one understands you?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

Sample Questionnaire 3

All items are responded to using a 5-point Likert-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. Has your treatment make you feel more relieved and comfortable?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

2. From your own assessment, has your condition improved from the time you entered
the institution?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree
3. Are the activities facilitated in this institution successful in treating your addiction?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

4. Has your attention been completely diverted from the use of alcohol/drugs?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

5. Have you been feeling secured from the facilities provided in the rehabilitation center
or institution?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

6. Has your treatment been improving your self-esteem?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

7. Has your treatment been helping you improve your relationship with yourself?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

8. Has your treatment been helping you improve your relationship with your family and
friends?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree
9. Are you satisfied with the extent of treatment provided to you?

1 Strongly 2 Agree 3 Uncertain 4 Disagree 5 Strongly

Agree Disagree

10. 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

11. 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

Read more: http://ivythesis.typepad.com/term_paper_topics/2009/11/most-effective-rehabilitation-method-of-

chemically-dependent-offender-populations.html#ixzz12RSFYV1M

Read more: http://ivythesis.typepad.com/term_paper_topics/2009/11/most-effective-rehabilitation-method-of-

chemically-dependent-offender-populations.html#ixzz12RRyUGLA