Psychology

Helping people out of a situation can vary depending on a number of reasons, including the age and gender of the one helping, and the nature of the situation or the kind of problem involved (Kazdin,  Cormier, 2006).  I once was in need of a car but did not exactly know which make or model to buy as I had specific needs for which I needed the car. So I went to a showroom in downtown London without any idea where to start. The salesperson there offered to help me out of the dilemma. She firsts of all tried all she could to ensure that she and I could have common grounds where we would both feel free to share what we thought was important for the occasion. So, she developed a therapeutic relationship with me and soon, although I was a little reserved and wary of opening up to strangers, I managed to explain my problem to her. Next, we engaged in an assessment of the problem at hand, and together she helped me understand how I could locate a good car based on factors such as applicability, place of use, and number of expected users (Textbook Revie Cram101 Textbook Reviews, 2009).

Through this assessment process, we managed to come up with goals which we had to achieve in order to have the problem solved (Cormier, et al., 2008). Therefore, we moved on with the goals and selected the best strategy that would allow both of us to meet our goal  getting the best sports car that would perform greatly on all road surfaces. Then, the strategy was implemented once we knew which way was the most ideal to go about. Finally, she helped me evaluate her to find out if the help she accorded me was useful (Sommers-Flanagan, 2004). Indeed it was helpful as I got the right automobile. Throughout the process, she avoided referring to me by anything else but as a client. She would reassure me through various body languages like eye contact, and at the end of it all, I felt really glad I sought her help.

On another occasion, I tried to get help from a school administrator regarding a good school for my two-year old daughter. The administrator, a man, was not so much helpful. He began by asking whether or not I was married, then why I needed the school. He went on to ask many other questions which were clearly not related with my problem or to his duties. Actually, the man kept asking all the wrong questions, making me to regret ever seeking assistance there (Zunker, 2002). The worst remarks he made was his offer to show me a better school if I could cooperate. As far as I was concerned, I had cooperated all along In frustration, I backed off, leaving him staring at me in disbelief.

Conclusion
These two situations, although closely related, were handled very differently. While in the first case I found help, I failed to find it in the second case because the would-be helper seemed to be interested in more personal matters than the official services which I needed. In the former case, the helper acted professionally, sticking to business codes of behavior. Having been very sensitive to issues like age, gender, race, and profession, she epitomized what professional help is all about. In the latter case, the man was mixing business and personal affairs and seemed to use his position for personal gain at the expense of the school. He was not sensitive to issues like gender, age, and the need.

A British drug chief, Professor David Nutt called for drug classification legislation to have a bearing on the real health risks. According to the Daily Mail, the government advisor held that taking ecstasy exposed individuals to similar risks as horse-riding. He wrote in a medical journal proclaiming that taking the drug has no difference with those individuals addicted to horse-riding (Nutt, 2008). These statements have drawn mixed reactions across the world with many people keen to see any sense in what the Professor meant. This paper will explore the positive and negative impacts of both ecstasy and horse-riding before making a conclusive position on the issue.

In his article that was entitled Equasy an overlooked addiction with implications for the current debate on drug harm that was published in the Journal of Psychopharmacology Nutt establishes that the difference between ecstasy and equasy is insignificant. Equasy is a terminology that is used to describe Equine Addiction Syndrome (Charlie, 2009). To him, both addictions lead to individuals being exposed to unnecessary risks hence putting their lives in danger (Valdez, 2008). He goes on to elaborate that horse-riding causes up to 100 deaths annually whereas ecstasy use may cause about 30 deaths in the same period (Daily Mail Reporter, 2009).

Effects of Ecstasy
The impacts of ecstasy are paradoxical in the sense that they can be painful and pleasurable to the very user. The gratifying impacts of ecstasy use includes a relaxed upbeat mood and feelings, reduction in anxiety, high sympathy for others, and an increased level of energy which is sustainable for much longer hours (Parvaz, 1999). On the negative side, ecstasy can cause numerous problematic impacts that by far outweigh the few pleasurable impacts. Ecstasy is known for causing confusion, sleeping problems, anxiety, paranoia, nausea, brain damage, depression, blurred vision, among other detrimental impacts to the health of the victims. In addition to the above, impaired memory and lessening in serotonin and dopamine may lead to disruption in the normal brain functioning (Omnibuspress.com, 2000). There is also a general decrease in performance of the addict accompanied by general financial problems. Depression and other emotional problems may lead to isolation from friends and family members who are not using the drug (Elk, 2009).

Effects of Horse-riding
Apart from the general pleasure gained in horse-riding, there are other more important but hidden positive effects that horse-riding has to the riders. Horse-riding can be therapeutic in some instances as shall be seen in the subsequent arguments. It has been found that horse-riding stimulates righting and equilibrium reactions and normal adjustments in posture. It also inhibits tonic neck together with tonic labyrinthine reflexes. It has also been found to prevent or cause reduction in contractures and tightness, physical and mental complications secondary to inactivity feelings of inferiority and helplessness, (Anfenson, 2010 Para 1). These are just but a few positive impacts of horse-riding.

Nevertheless, this should not be interpreted to mean that horse-riding does not have the negative aspect. The most pronounced negative impact of horse-riding is the injuries sustained during horse-riding expedition. Most injuries result from falling off the horse that is known to lead to severe and fatal incidences. According to Hughston Health Alert, horseback riding has a higher injury rate when compared to motorcycle riding. Averagely, motorcyclists reports an injury after every 7000 hours whereas horseback rides better known as equestrians records a serious accident in every 350 hours (Beim,  Butte, 2009). Horse riding injuries may range from bruises, strains, and sprains affecting soft tissues. Other form of injuries may include fissures, dislodgments, and concussions. Of more concern are the injuries on the spinal cord and the head which may result to permanent damages including paralysis and seizures resulting from head injuries (Socallocal, 2009). To the extreme, these injuries may result to the death of the horse rider. Apart from falling off the horse, these accidents can occur in the stable during handling, grooming or feeding of the horse.

Conclusion
The drug issue has continued to draw negative perception in our society giving drugs a different and a more nerve-racking status according to Professor Nutt. The society in doing this has failed to look at consequences of equally dangerous activities which seem to enjoy sanctioning from the society. Equasy as described by Nutt has been well elaborated as a dangerous activity that may be more fatal than some d rugs. Apart from the fatalities of horse-riding, this leisurely activity may involve the use of other sanctioned drugs like cigarettes which have been known to be harmful to human health. The issue is some drugs like ecstasy have been overrated regarding their detrimental impacts to the health status of the individuals. Professor Nutt, who was the chairman of the Home Offices Advisory Council on the Misuse of Drugs (ACMD), was agitating for the downgrading of ecstasy from being a class A-drug to class B. He likened the ecstasy drug to horse riding basing on the overall negative consequences of both issues. I support the professors argument that some activities sanctioned by the society are even more dangerous than some of the drugs we know of.

The ability of a society to effectively identify, prevent and address issues related to substance abuse forms one of the most critical outlines towards maintaining a highly productive economy.  Substance abuse in the society remains a highly destructive societal aspect in that it affects the peoples personalities and ultimately reduces their ability to fit within the wider societal reams.  Modern substance abuse specialists argue that the current problem of substance abuse requires a new approach that is more holistic by incorporating all the stakeholders.  Cocaine, one of the hard drugs in the society as Robert et al 92007) and Moore (2008) explain, has some of the most negative implications to its abusers that require further understanding and new approach in addressing it.  It is from its high level use and related implications that this paper intrinsically evaluates its history, prevalence, diagnosis of the addicts, related treatment and treatment theories.

History of Cocaine abuse
Though recent scholars are increasingly viewing cocaine and its associated problems to be a problem of the 19th century, its history could be traced back to the 15th century.  Chermack and Blow (2002) record that most South American indigenous people chewed the cocoa leafs which was believed to give them additional energy.  By late 18th century, the cocaine alkaloids were successfully separated and its medical application intensified and highly popularized during the last decades of the 18th century.  Apart from its use in anesthetics, it was largely incorporated in most beverages such as wine (Goldberg, 2009).  Notably, its use by the onset of the 20th century further developed and it could be smoked, injected directly into the body or taken with beverages and food.

As Galanter and Kleber (2008) record, the turn of the 20th century revealed the cocaine addictive properties.  Particularly, it was associated with majority of the criminals, prostitutes, burglars and bell boys in the community.  Following Dr. Christopher Koch from Pennsylvania confession that cocaine was the major threat to the peoples personalities, the government passed the Harrison Narcotics Tax Act in 1914 that prohibited distribution and sale of cocaine in the United States (Richard et al, 2009). It is worth noting that this acts wrong reference to cocaine as a narcotic and not a stimulant led to its continued sale by the legalized companies in the nation.  Though cocaine use has been strongly prohibited by the government and medical experts, its use around the world is still very high a consideration that makes the employed techniques to address it becomes questionable Cohen, L. (20009It is from the above historical orientation that the following key questions have remained unanswered over the years. Is it possible to fully stamp out cocaine production and use Are the treatment mechanisms effective in addressing emergent problems for the addicts

Prevalence and statistics of Cocaine
As indicated earlier, Galanter and Kleber (2008) and Lowinson (2005) argue that the current cocaine related statistics are worrying especially with reflection of the extended benefits.  In the year 2006, ten percent of total public substance abuse centers admissions were from cocaine crackdown.  Besides, it is estimated that about 33.7 million people in the United States of the ages beyond twelve years have tried to use cocaine in their lifetime at least once (Goldberg, 2009).  For those between the ages of 24 and 34 years, most of them as Goldberg (2009) continue to say, have used cocaine in their lifetime.  This high percent puts the existing social institutions and their contribution towards a healthy and morally upright society questionable.  By the year 2005, Richard (2009) reports that over 34milion people of the total population by then had used cocaine making it the second mostly used illicit drug in the nation.

Comparing its use between men and women in the nation, Galanter and Kleber (2008) record that the former are more likely to use the drug compared to the latter.  Between the years 2003 and 2007, the percentage of young adults who were reported using cocaine increased from 5 to 8 respectively.   Further from their study, Goldberg (2009) concurs with the findings of Moore et al (2008) that over 80 of the cocaine users understood the possibility of getting addicted and other related problems.  Over 52.2 of the cocaine abusers in the United States often access enough updates about cocaine and its associated problems though the press.

Diagnosis and related issues
Notably, the effects resulting from cocaine use are largely correlated to the level of addiction that an individual is suffering from.  Therefore, people with low addiction become hard to diagnose of cocaine use as its symptoms are not distinct.  In his view, acute cocaine users often experience hallucinations, tachycardia and paranoid delusions (Cohen, 2009).  However, it is very hard to effectively differentiate its impacts from those of other drugs such as tobacco, alcohol and marijuana.   Indeed, this makes it very hard for psychologists to identify and may result to addressing the wrong drug especially where the user is not cooperative.    

However, chronic intake leads to the brain cells adapting to functionally stronger imbalances especially towards key body extreme demands. The changes recorded in the monoamine transmitters and the brain protein neurofilaments culminate to long term damaging of dopamine neurons.  As a result, the diagnostic criterion for withdrawal is characterized with strong dysphoric mood, hypersomnia, anxiety, erectile dysfunctional, psychomotor retardation and unpleasant dreams (Lowinson, 2005).  It is worth noting that even at chronic levels, the depicted characteristics still resemble with those from other drugs such as marijuana and further testing may still be required.

To address the above uncertainties in diagnosing cocaine, clinicians and psychologists have resulted to testing its presence in the urine.  According to Conner, Pinquart and Amanda (2008), cocaine is metabolized extensively by the liver and only about 1 remains unchanged and released to the urine.  Depending with the efficacy of the liver and kidneys of the user, it is possible to detect its metabolites in the urine as early as four hours after its consumption.  

Theories related to its addiction and impacts
The theoretical explanations of the high addiction levels of cocaine as Cohen (2009) explains are related to the effects reported in monoamine transmitters and the brain protein neurofilaments reduction.  As indicated earlier, chronic use of cocaine creates a highly insatiable demand that can make the addicted person go any length in acquiring large amounts of the drug.   Once cocaine reaches high levels in the blood, Moore et al (2008) explain that the users heart rate and blood vessels often constrict leading to users high feeling being intensified.  At this instance, the addict could also experience aggression and restlessness.

The rising high use of cocaine in the society as Galanter and Kleber (2008) argue is also largely linked to negative peer influence among the people in the society. As statistics indicate, most people in the United States will have tried cocaine at least once in their lifetime.  In his theory of social comparison, Festinger Leon indicated that most people in the society will always seek to compare their views and equate them with their role models or key personalities (Richard et al, 2009).  As a result, with the largest cohort of cocaine users being in the teen and early adulthood, the strong desire is derived from influence by key role models using the same drug to achieve specified status especially in the media.   Though the drug may not be directly advertised in the media due to its illegality, Conner et al (2008) indicate that most of the users are viewed to possess extra powers.  The desire to get similar status therefore pushes majority of the people to use the same drugs despite clear understanding of the related body and legal repercussions.

In his view, Galanter and Kleber (2008) argue that the social theory underscores the special pressure that people undergo through makes them adhere to the group norms without resistance.  Notably, groups especially in the teen and early adult ages specifically develop their own cultures that members often conform or drop from the group.   With cocaine as indicated earlier being considered to make one more powerful, the group norms easily assimilate it to create the superiority notion among other peers (Chermack and Blow, 2002).

Robert et al (2007) on the other hand explain the ever rising levels of cocaine abuse by indicating that most people lack the necessary understanding of the drug and its repercussions though the society inoculation theory. The theory postulates that people develop key beliefs and values in their lives which they internalize to seek specified achievements (Richard et al, 2009).  Under this consideration therefore, the strongly publicized negative impacts resulting from cocaine use become a major factor to consider and perhaps explore the facts.  It is indeed considered tricky for cocaine in that mild consumption have minimal effects.  However, continued use results to chronic effects.  It is critical that the problem is brought out more openly and all concerns constantly addressed to remove possible causes of doubt and the need for experimentation.  

Treatment for the drug addicts
Use of motivational therapy
While agreeing with prior substance abuse therapists, Galanter and Kleber (2008) explain that it is not easy to address at the advanced stages of the addiction.  Motivational therapy therefore forms one of the most effective methods in that the therapist and the cocaine addict are both involved in addressing the problem.  Though scholars indicate that the efficacy of this method is dependent on the therapist, Goldberg (2009) argues that the addicts decision to reduce drug consumption is the key facet towards assimilation of a new positive perspective in their lives.  Notably, specialists employing motivational therapy are considered to be more effective in that they operate in a reverse mode whereby the addict takes the sense of empathy and encouragement from the therapist towards achieving the targeted change.  As opposed to condemning the addict, the therapist takes a lot of time in fitting within their situation and therefore appearing to develop towards the expected goal together (Moore et al, 2008).  Notably, most of the addicts are usually segregated by others and therefore views the therapists to fill the left gap which is very critical for their recovery.

Use of cognitive behavioral therapy
Application of the cognitive behavioral therapy as Lowinson (2005) explains, involves a combination of different methods towards creating a differentiated thoughtful approach in their consideration of cocaine usage. Though its application is mostly short term, the cognitive therapists employs two key mechanisms to address the problem.  First, the therapist uses functional analysis where all the information on the cocaine user before and during the consumption time is gathered (Richard, 2009). At this point, the therapist is able to know why the cocaine user is indeed using the drug and therefore use the same consideration in creating a platform for positive reinforcements.

Secondly, therapists engage the addicts in major training of clear coping skills that facilitate them to establish the need for change.  Most cocaine users operate in groups and therefore fail to consider the personal orientation and focus when consuming it.  As a result the training focus on interpersonal skills such as refusing drug offers, coping with craving and analyzing the expected results (Robert et al, 2007). Therefore, CBT for cocaine users focuses on motivation towards abstinence, the need to cope, reinforcing the change orientation and finally managing the possible painful effects. Of critical importance as Robert et al (2007) continue to say, is enhancement of social support by the community to foster acceptance in the community.

Conclusion and recommendations
It is from the above discussion that this paper concludes by supporting the thesis statement, the ability of a society to effectively identify, prevent and address issues related to substance abuse forms one of the most critical outlines towards maintaining a highly productive economy.  The problem of cocaine abuse came out to be historical when it was naturally used by the indigenous American population. However, with its negative effects establishment and its illegalization, its use has remained highly secretive.  It addiction was further brought out to have key negative implications to the users and the whole society in general.  Though its treatment appears to have a string effect in addressing the problem, there is need to intensify it and therefore reduce the current high level prevalence in the nation.    

There are four major factors that researchers have associated with risky sexual behavior among young people increase in sexual activity, success of anti HIVAIDS drugs, lack of education and unsafe sexual practices, and sharing of drugs through syringes.

Young people are more sexually active than ever before, engaging in sexual activities at a very young age, and having several different partners over short spans of time. More often than not, those who are sexually active do not use latex condoms consistently, if at all (Rathus et al). Some choose not to use condoms because they believe that it will still be safe since the female partner is on birth-control pills. However, birth-control pills prevent pregnancies not STIs. Furthermore, increasing oral and anal sexual tendencies have increased the number of cases of STIs each year The fact that drug use is also increasing at an alarming pace contributes to the spread of STIs  it does not take sexual activity alone to transmit STIs since a person may pass it on through blood transfusion or the sharing of instruments such as syringes. Riskier, however, is the fact that the appearance on the market of HIVAIDS treating drugs which has made todays sexually active and adventurous youth to throw whatever caution they were turning to, to the wind (Owens et al, 2009).

As a counselor in a clinical situation, working with adolescents, I, understanding the nature of adolescents who tend to deny advice regarding safer and healthier lifestyles, (especially related to sex, drugs and alcohol related), would share my concerns with this person diplomatically. I would quote statistics, and will try to illustrate what is risky as compared to what this person previously considered perfectly safe, such as oral sex (given misconceptions among young individuals surrounding safe and unsafe sexual practices  lack of such education is in itself is a risky start to sexual activity).

Education and coaching will help me immensely in changing the sexual lifestyle of this person toward a healthier, more positive sexually active life (Owens et al, 2009).

Many theories and perspective exist in the field of psychology.  Mood disorders and personality indifferences are just a few of the oddities within the chosen field.  Behaviors often procreate in patterns, but some behaviors are learned by example.  The American Psychological Association (AMA) has given great insight and clinical advice for addressing these issues.  Abnormal psychology is credited with theories and perspectives characteristic of specific behaviors patterns and abnormal behaviors.

Background
Amanda is a vibrant young, nineteen year old, single mother living in a suburban community.  She is unemployed and receiving state issued public assistance.  She does not attend school and reported having dropped out in the tenth grade due to her learning disability in comprehension.  She presents with severe symptoms of depression and several obsessive compulsive symptoms as well.  She is accompanied by her biological mother.
   
Amanda was raised by her father following a long divorce from her mother.  Her father is an alcoholic not in recovery.  Amandas mother suffers from panic disorder and post traumatic stress disorder (PTSD).  When Amanda was thirteen, she went to live with her mother due to her father overdosing on crack cocaine.  Amanda found her father passed out and barely breathing and was reported to have been doing CPR on him when the ambulance arrived.  Amandas mother initiated contact with a local mental health organization in order for Amanda to have an outlet for any residual psychological dysfunction due to the traumatic events that she had endured.  During her outpatient treatment, Amanda was hospitalized for suicidal ideologies.  She spent ten days in the adolescent psychiatric unit.  Upon her release, she continued with outpatient therapy, but did not seem to be improving.  Her grades suffered immensely, and she became more withdrawn.  Her daily activities consisted of sleep.  One evening, Amanda woke from a nightmare and ran to her mother sobbing and hyperventilating.  Amanda indicated to her mother that she had a dream that her father had died.  She continued sobbing and stated emphatically that she wanted to die, over and over.  Amandas mother contacted the crisis worker on call, and Amanda was admitted again to the adolescent psychiatric unit.
   
During her second inpatient stay, the treating psychiatrist performed several pathological tests as well as a psychiatric assessment.  It was determined that Amanda had Bipolar Disorder I.  She was stabilized with Depekote and Zoloft.  Fourteen days later, Amanda was discharged.  She continued with outpatient cognitive behavior therapy and prescription regimen for the next year until she chose to move back in with her father.
   
Amanda reports loss of memory from the time she returned home to her father to the present.  She stated that she quit taking her medications within days of moving into her dads house because they were not doing anything.  Amanda reports becoming pregnant as a result of a one night encounter.  Amanda states that she was drunk and does not have any recollection of the evening.  She also states that she drinks frequently because it helps her to relax and think better.  Shortly after becoming pregnant, she found out that she had contracted Genital Herpes.  Amanda gave birth to a healthy daughter eight months later.  She moved back in with her mother within a month of giving birth.
   
Amandas mother initiated contact with the local mental health agency due to the symptoms that Amanda is presenting.  She constantly sleeps, screams at her newborn for wanting a bottle, and refuses to participate in any activity other than sleeping.  The newest and most concerning symptom, according to her mother, is of an obsessive compulsive nature.  Amanda became angry and verbally outraged at her mother for feeding the baby a bottle with a yellow nipple ring.  Amanda stated that it was Tuesday and only the blue nipple rings were to be used.  During the
last month of Amanda cohabitating at her mothers home, her mother reports one incident of Amanda getting up and cleaning the entire house and doing a load of laundry.  Just as quickly as Amandas energy came, it left and Amanda fell right back into the sleeping all day pattern.  The treating psychiatrist reassessed Amanda via tests, both biological and psychological.  It was again determined that Amanda had Bipolar Disorder and obsessive compulsive disorder as a secondary condition.

Methodology
Abnormal psychology contains five major theories and perspectives within the discipline.  The first theory is the Medical Perspective, also known as the biological or physiological aspect.  The second theory is the Psychodynamic Perspective.  The next theory is the Behavioral Perspective.  The Cognitive Perspective is the next theory to be examined.  Finally, the last theory is the Social and Cultural Perspective.  Each of these perspectives holds reasoning behind the psychological reasoning of ones behavior.  The behaviors and behavior patterns are definitive within each respect as is the treatment and prognosis of each individual being addressed under a specific theory (Corner, 2010).      
   
The Medical, or biological, Perspective focuses on the biological and physiological factors as a course of origin for abnormal behaviors.  Genetics has been accredited to some conditions such as Schizophrenia and some mood disorders.  Family history of a pre-existing condition is said to pre-dispose an individual and make one vulnerable to the consequences of the same mental disorder.  In Amandas case, it can be asserted that her mothers history of panic disorder and PTSD could have had a genetic effect on Amanda developing Bipolar Disorder.  It can equally
be asserted that her fathers history of substance abuse could be a form of self-medicating due to an undiagnosed mental illness.  Medical testing has proven that some medical conditions can give the impression of an existing mental disorder when in actuality the condition was solely medical in nature (Ware  Johnson, 2000).  Amanda did present with a determined medical condition, and it should be noted that her medical diagnosis of Genital Herpes could be a contributing factor.  Amanda stated that she is being treated for Genital Herpes with the medication Valtrex.  Treatments used with regard to the Medical Perspective typically involve temporary hospitalization, medications to enable stability of any condition, and outpatient therapy.
   
The Psychodynamic Perspective believes that behaviors produce anxiety and discord in ones life due to repressed memories, most likely stemming from a past childhood experience.  These sometimes unconscious memories could only be resolved through speaking candidly with a well trained therapist (Corner, 2010).  Amandas repressed memories of child abuse, neglect, feeling abandoned by her mother, and her fathers overdose is suggested to have attributed to her developing Bipolar Disorder.
   
The Behavioral Perspective suggests that ineffective learning and conditioning play a major role in the abnormalities of ones behavior and inability to make rational decisions.  Phobias and compulsive disorders are distinguished within this perspective.  Amanda taking issue over the color of the nipple rings is indicative of this perspective.  The main focus of treatment associated with this perspective is identifying and changing the way in which one behaves (Ware  Johnson, 2000).  This can be accomplished through the use of desensitization strategies.  
     
The Cognitive Perspective teaches a patient to think differently.  Abnormal behavior is centered on false reasoning and thought based on ill teaching.  These teachings may have come from parents, teachers, and other role models in ones life.  Amanda for the greater part of her life has been taught to deal with stress via alcohol or illegal drugs.  This erroneous thought process contributed to her engaging in unprotected sexual behavior resulting in an unplanned pregnancy and contracting Genital Herpes.   Her compulsive behavior is associated with this perspective as well (American Psychiatric Association, 2000).  The use of Cognitive Behavioral Therapy could benefit Amanda in the form of modeling by using a mentor.
   
The Social and Cultural Perspective or Humanistic approach focuses on the environment and social influences as it relates to abnormal behavior.  Mentally ill individuals, including Amanda, have suggested that low self-esteem, anger issues, and every day stressors are contributing factors to her behavior dysfunctions (Ware  Johnson, 2000).  Amandas abnormal behaviors are associated with her financial burdens, unemployment, poor education, and low standards of living.  Cognitive modeling therapy, individualized therapy, group therapy, and medications in some cases have proven to be effective measures to be used when dealing with this perspective of abnormal psychology.

Analysis
In order to make operational determinations in abnormal psychology, the psychological community refers to the Diagnostic and Statistical Manual of Mental Disorders (DSM).  This resource manual offers information on diagnostic classifications, criteria required, and descriptions (American Psychiatric Association, 2000).  A patient generally is not diagnosed for just one abnormality, but several other contributing factors are taken into account and utilized for a more formative diagnosis.  The V Axes are used to diagram and represent the full diagnosis of a patient.  There are five levels of diagnosis on the Axis, and each one represents a different perspective.  Axis I pertains to Clinical Disorders. Axis II focuses on Personality Disorders and Mental Retardation.  Axis III is dedicated to General medical conditions.    Axis IV includes the Psychosocial and Environmental factor.

Medications can be attributed to this axis as some medications produce an unwanted behavioral effect on the patient.  Lastly, Axis V is dedicated to the Global Assessment and Functioning Scale.  This scale is used to determine the level of risk proposed by each patient individually.   Amandas V Axes would be defined as follows  Axis I- Bipolar Disorder II Axis II- Learning Disabilities, comprehension related Axis III- Genital Herpes Axis IV- Valtrex Axis V- Score of 20 at present.  

Conclusion
Abnormal psychology is full of many theories and perspectives based on human behavior and functioning.  Psychologists have worked to develop theories over the years and have made great contributions to a better understanding of human patterned behaviors.  Biological factors, learned behaviors, environmental changes, thoughts, and memory can have a loitering effect on the way one process thought and behaves.  Each individual case involves many different factors that may have had a direct affect on the formulation of a mental illness.  Psychologists are especially trained to uncover other behaviors that may suggest another condition that would be treated differently.  Patients put much faith into how their psychiatrist diagnoses and treats their emotional issues.  Unfortunately, some patients are in denial and believe that they are not ill.

These patients sometimes require hospitalizations in order to stabilize their mental illness and protect the patient from their own destructive behaviors.  Abnormal psychology contains patterns of behavior which have been theorized upon and abnormal behaviors which are definitive of many perspectives.

Pini, Queiroz, DellOsso, et al., (2004), states that, there are three types of psychological disorders that are commonly confused by people. These include the most common one the bipolar disorder, also referred to as manic depression, schizophrenia and multiple personality disorder. The general use of these terms, by media as well as by people referring to anyone who have a mental problem, has resulted to the confusion revolving around them.  These disorders however, do not have much in common except for the fact that those who have them are severely stigmatized by the society.

Similarities and differences between bipolar disorder and schizophrenia to determine a correct diagnosis
Bipolar disorder and schizophrenia are both over-diagnosed and misdiagnosed. Both are disorders affecting the thought process of an individual. These disorders have characteristics that are so similar that non-medical personnel cannot differentiate. In comparison to schizophrenia, bipolar is a very common disorder. It is well comprehended and treated through a combination of various drugs as well as psychotherapy. The major characteristic signs and symptoms of bipolar are, changing moods of mania and depression which can last for weeks or even months. Bipolar though treatable can pose a very great challenge in the course of treatment, because those who are on antidepressants during depression phase are more likely to abandon them during a manic episode. Very few people maintain treatment during the manic phase of the disorder. A number of people however manage to cope with their mood alteration and live a normal live in the society without using medications
Schizophrenia on the other hand is less common. It is usually detected during late teenage. Men are the ones who are mostly affected by this disease as compared to women. The major characteristic signs and symptoms of the disease are delusions and hallucinations. People with delusions normally perceive things that are false in normal live as true and real. They usually hold on to their beliefs even after being shown evidence that contradicts their beliefs. Just like bipolar, as noted by Pini, Queiroz, DellOsso, et al., (2004), schizophrenia is also not easy to treat. People with schizophrenia do not function normally in societal functions and have problems in following their prescriptions. Treatment for people with this disorder usually involves drugs as well as psychotherapy.  Day programs can also be included in the treatment for people who have severe cases of this disease and those who are resistant to medication. The social life of those who have this disorder is severely affected. These people also cannot conduct normal lives such as holding a job.

There are various types of schizophrenia which cannot be mistaken for bipolar because the patient is more withdrawn, but still someone could have bipolar with psychosis thereby looking as if it is undifferentiated schizophrenia or have bipolar that does not display psychosis. The major cause of misdiagnosis is the hasty behavior of psychiatrists, who do not inquire extensively concerning the precipitating factors or may be too impatient to make any sort of diagnosis. The other thing that may lead to misdiagnosis is that, there are people who live with suppressing feelings for a very long time or have feelings that go unrecognized that finally result to manic behavior or a behavior that is just unusual that can be diagnosed as psychosis easily.  If mood disorders are allowed to go for a long time without consulting a therapist they may appear as psychosis (Torrey, Bowler, Taylor, et al., 1995).

People with schizophrenia do not lead a normal life in the society.  They often experience difficulties in sticking to a particular medication.  The social life of people with schizophrenia is adversely affected and they face the worst form of stigmatization in the society. They are totally withdrawn and do not participate at all in social functions. Schizophrenia mostly affects all people at any age. Sufferers of schizophrenia usually experience hallucinations, delusions and thought disorders. The behavior of sufferers of schizophrenia changes from normal to abnormal during the course of the disease.

According to Bhosale (2004) these people experience things that are not real, and which they cannot explain with normal words. They tend to believe that strange things are happening around them. The person may experience happy moments that are not in line with the normal surroundings. People who suffer from schizophrenia experience intense hallucinations. They hear strange voices of people calling out their names and see visions of things happening in front of them and in a fraction of a second these things are gone and the patient acts as if nothing was happening. People who suffer form schizophrenia have a totally different perception of reality as seen by normal people. They act as if they are in a world of their own. Their life is totally distorted by delusions and hallucinations making them live in fear and confusion. They have no emotions and tend to lose hope in life.

These people experience compulsion from an external force. They display no behavioral pattern they may be laughing and instantly they start crying. They laugh and cry for no obvious reasons. Their emotions rise and fall suddenly. These people also show no response to specific emotional situations. The cognitive capability of a person suffering from schizophrenia is highly affected. The normal pattern of life for a person with schizophrenia is totally distracted. They do not participate actively in social matters. They also loose motivation and do not have a sense of belief. They experience difficulties in locating a coherent sense of self. They cannot integrate personality in a usual manner (Grohol, 2010).

Schizophrenia may be caused by heredity. Children, whose one or both parents have the disease, are more likely to have it. Viral infections during early stages of pregnancy and complications during birth are risk factors to development of schizophrenia. Brain abnormalities are also other factors that may lead to development of the disease. Sufferers of schizophrenia have a specific family history of the disease. Genes are particularly associated with the cause of the disease.

As indicated by Chandler (2005), there are various types of schizophrenias each with its characteristic symptoms. Catatonic schizophrenia is one of them. In catatonic schizophrenia patients may either experience extensive loss of motor skills or elevated motor activity. These patients also tend to repeat phrases that do not make sense and imitate sounds made by other people or objects. These people are also socially isolated and perform poorly in normal life activities. They have no emotions and are easily angered. The other type of schizophrenia is the disorganized schizophrenia. Disorganized schizophrenia is highly delusional. Patients suffering from it have no emotional feelings and are very suicidal. They tend to walk in an aimless manner and do not respond appropriately to emotional situations. These people also display unmotivated behavior. The other type of schizophrenia is paranoid schizophrenia. This type of schizophrenia is dominated by delusions and auditory hallucinations. Residual schizophrenia is another type of schizophrenia. This type of schizophrenia is displayed by those who have been diagnosed with schizophrenia in the past but do not experience psychotic problems, only that there are some remaining symptoms of the disease such as irrational thoughts, emotional blunting, social withdrawal and unusual behavior. The last type of schizophrenia is the undifferentiated type. This is the type in which patients who fails to display the symptoms of all other subtypes but have mental disorders are classified.

Bipolar disorder is the other psychological disorder. The major symptoms of bipolar disorder are the extreme shifts in an individuals mood as well as temperament. An individual experiences episodes of intense mania followed by spells of severe depression often with phases of normalcy in between. This disease is characterized by alternation of mood between two different extremities. A person may experience extreme sadness for a moment and immediately shift to euphoric happiness. Bipolar spectrum disorder or the entire range of disorder levels can be defined as a single, mild, or multiple adverse clinical mood swings (Grohol, 2010). Depression and manic, though are often separated by periods of normalcy may at times alternate rapidly, a phenomenon referred to as rapid cycling.

There are two different types of bipolar bipolar I and bipolar II. Bipolar I involve spells of severe mood swings. Women are the ones who are mostly diagnosed with bipolar I. sufferers of bipolar I experience adverse spells of depression as well as hypomania. Bipolar disorder type II is a more mild type of disorder as compared to type I. As stated by Jirage (2008), the exact causes of bipolar disorder are not known. However, genetic, biochemical and environmental factors are attributed to the cause of bipolar. Patients suffering from bipolar, display physical as well as chemical changes in their brain. Neurotransmitter imbalance is a biochemical factor that contributes to the development of bipolar. Hormonal imbalance may also be a factor leading to the development of this disease. Bipolar disorders do not have a specific time when they develop, but usually occur in the late teenage.
Manic episodes of bipolar disorder are marked by an increase in energy, aggressiveness, irritability, euphoria, sleeplessness, illogical thoughts, and lack of concentration. Other symptoms of manic phase of bipolar disorder are high self esteem, risky behavior, increased physical activity, loss of concentration, increased sexual desire, rapid speech, drug abuse, easy distraction, euphoria, agitation and extreme optimism (Amadan, 2006).

The depression phase of bipolar disorder on the other hand is marked by increased feeling of sadness, guilt, helplessness, agitation, distrust, loss of weight, irregular sleep patterns, and loss of interest in life as well as hope.  A depressed person may also have suicidal thoughts. Other symptoms of depressive phase of bipolar disorder include increased anxiety, aggressiveness, loss of appetite, fatigue, loss of concentration, and persistent pain due to unknown reasons. People with bipolar often lead a normal life. These people are very social especially when depressed.  They do not experience delusions like those with schizophrenia. However, episodes of depression and mania occur throughout the life of a patient. At certain times patients of bipolar may feel that, they are not worth being alive, helpless, very sad, and hopeless and at other time they may feel very excited thinking they are at the peak of the world (Maier, Zobel, and Wagner 2006).

The nature of the condition of bipolar disorder in many patients is the cause for misdiagnosis and therefore it is very important for the symptoms to be clearly understood. It is also very important to understand the symptoms of schizophrenia to minimize chances of over diagnosis.

Conclusions
Schizophrenia and bipolar disorders are psychological disorders that affect people of all age and gender. Though they have some differences, the symptoms of bipolar disorder and schizophrenia are very similar. In order to differentiate these symptoms, one has to critically analyze the psychotic and specific mood disorder symptoms. If the symptoms that are detected involve elevated mood, lack of sleep, loss of appetite, irritability, and then psychosis, they qualify as bipolar disorder. Schizophrenia on the other hand is characterized by development of paranoia, disorganized thinking, hearing voices and delusions followed by loss of appetite, lack of sleep, and grandiosity. Whereas schizophrenia occurs for a lifetime, episodes of mania and depression in bipolar disorder are separated by spells of normalcy.

 In schizophrenia, though a person may act as if normal during psychotic phases, there are some residual symptoms characterized by low energy, loss of motivation, and social withdrawal. That may not be a clear cut difference between bipolar disorder and schizophrenia because, a person may rapidly move from a manic to a depression phase displaying low energy, lack of motivation, and social withdrawal. Patents with bipolar disorder are usually social especially when depressed, than those suffering from schizophrenia that are socially withdrawn and have no reasonable behavior. To correctly diagnose schizophrenia and bipolar a physician should gather accurate information by extensively inquiring for the history of the patient form the family members as well as close friends.

Some movies and novels talk about socio-psychopaths who are out to murder their victims. In some cases, victims are linked with a common object that interests their killer and in some instances killings are a source of personal satisfaction for the killer. Silence of the lambs is a story that talks about two offenders who kill only for their personal satisfaction.

Introduction
Main plot of the story of Silence of the lambs is to psychoanalyze a serial killer by utilizing information provided by another cannibalistic psychopath serving in a mental asylum, Hannibal Lecter. Silence of the lambs written by Thomas Harris features Dr. Hannibal Lecter, a cannibalistic psychopath serving in a mental asylum who was reached by a young FBI trainee, Clarice Starling. Starling was investigating into the psychological background of a serial killer, Buffalo Bill who was a serial killer responsible for murdering many women in a ritual manner. The common method used by Bill on his female victims was removal of their skins after murder. The psychological analysis was carried out by Starling based on the findings on crime scene and information provided by Hannibal Lecter (Ebert 24).

Clarice Starling was a young FBI trainee in the department of Behavioral Profiling. With the help of local police officers, Clarice was required to carry out the behavioral profiling of Buffalo Bill. Using psychological profiling based on the crime scenes Buffalo Bill was to be apprehended by the police officers for murdering women. Clarice reached Hannibal Lecter in order to gain information about the psychology of this serial killer. Hannibal Lecter does not help Clarice without a price. He was guided by his curiosity into finding ways to manipulate Clarice to expose her confusing and complicated demonized past for him. Here develops a relationship that was twisted enough to let Clarice open up her complicated past life in front of Hannibal thus being weak enough to stop a heinous and a deadly killer.

The movie focuses on two offenders, Buffalo Bill and Hannibal Lecter. Bill has killed and de-skinned five women. Hannibal can sturdily manipulate his prey to get a desirable outcome. Two instances relate to his manipulative demeanor. During Carlings first visit to the asylum to meet Hannibal, a fellow prisoner misbehaved with Clarice horrifying Hannibal, and he candidly disliked such misconduct. On her next visit, Clarice learnt that the fellow prisoner was dead as Hannibal manipulated him into committing suicide. Second instant was when Hannibal manipulates Clarice to open up her past in return of information that Hannibal provided about Bill. A person can have more than one psychopathologies at same time and Hannibal had two he was antisocial as well as a narcissist (BFI modern classics 67).

Buffalo Bill and Hannibal Lecter had been acquaintances in the past and Lecter does not provide this information to Clarice easily. The acquaintance was before Hannibal was abducted in prison. A link noticed in the murdered victims of Buffalo Bill was the presence of a Deaths Head Moth in victims mouths. It has been observed that the offender followed a ritual in his killings and these ritual-like killings increased his hunger even more. During the investigation, Bill abducted his seventh victim, daughter of US senator, heightening FBIs fears of them taking more time in apprehending Buffalo Bill.
A white male in his 30s, Buffalo Bill is a character who was seeking a change. Buffalo was shown as a serial killer who thinks of himself as a transvestite. Bill had once tried to get gender reassignment surgery but he was refused because of his criminal record. Bill was keen on checking records of people who have been turned down for the gender reassignment surgery owing to any criminal convictions in the past.

Buffalo Bill was a serial killer who grew in the society without affection and love, especially his mother. Originally, Buffalo Bill was named as James Gumb. He was born in 1948 and his mother was a beauty contestant. Bill passed his childhood without the love of an affectionate mother as she abandoned Bill in his childhood. His grandparents took him under custody from the foster home, who were killed by Bill after a period of two years. He was imprisoned in a mental asylum where he learnt tailoring (Ebert 89). After his release from the mental asylum, he tailored for Mrs. Lippman. It was at this time that he met Hannibal Lecter and started abducting and murdering women whose bodies he stored in a cellar. During her investigation, Clarice learnt that skins removed from female victims bodies were being used by the killer to prepare a suit for women that would be made up of real skin, by using tailoring skills (BFI modern classics 90).

Killers like Hannibal Lecter and Buffalo Bill are shown to have the same psychological traits. Both of these offenders are antisocial and used charms, intimidation and manipulation to prey on their victims. Both lack conscience and cold bloodedly prey on their victims to satisfy their inner needs (Ebert 56).

Conclusion
American pop culture will always be remembered for greatest horror classics ever produced.  The movie Silence of the lambs was released fifteen years ago and it has been loved since the time it was first seen. This flick has been known as a pioneer in many other psychological thrillers using ideas as psychological profiling as well as realistic looks.

Some American TV shows depict adolescents as violent, unruly, addicts, and simply out of control. They portray American adolescent as someone who hates school, loves sex, likes partying, and wants to experiment on everything and anything that is new. They are also viewed as mischievous people who cannot recognize the consequences of their actions and who are unwilling to think before they act (AD). In this paper, I have chosen to expound on a TV show that is very popular in America The Simpsons. This is a TV show created by Matt Groeing, a renowned cartoonist. According to Nielsen, The Simpsons is a show that is very popular among 12-17 year old boys. Hence it has a lot of impact and influences on young Americans. Though animated, this show contains heavy content that depicts adolescence in one way or another. It also depicts the characters, problems, and tribulations that the adolescents experience. I will base my arguments on Bart, the adolescent character of this show. The name Bart is an anagram from the word brat. He is the only son of Homer and Marge Simpson. He is the eldest and a brother to Maggie and Lisa Simpson. Bart is viewed as emotionally unsecured, disobedient, and rebellious person who will do anything to get recognition. He is also mischievous and disrespectful to the authority.

The influence of media on adolescents
Research findings carried out in America shows that the average time that young people spend watching television in America is 4 hours each day (Jamieson and Romer, 2008). With 109.6 million homes with TV and 54 of kids having a TV in their bedroom, it has been found out that kids spend more time watching television than in doing any other activity (Parentstv.org, 2009). On average, young people in America watches TV for around 25 hours per week.  Television shows and the media play a role in influencing the behaviors and characters of adolescents. This is mainly due to the fact that the media is full of sexual messages, violence, and drug abuse (Gaylan, 2009). The adolescents watching television shows or programs acted by adolescent actors are not as likely to be influenced by them compared to those shows acted by their favorite adult actors.

The Simpsons
Bart is a student at Springfield Elementary and he is constantly punished in class due to his disobedience. His hallmark characters include the prank calls he makes to Moe, the bartender, and the catchphrases he commonly uses like Eat my Shorts and Dont have a cow.  Within the first two seasons in 1989-1991, his characters were so popular, talked about, and even imitated. This captured the imagination of the audience such that Bartmania ensued. But his rebellious characters, attitude, and great pride towards his parents, who were underachievers, made many parents and educators view him as a bad role model to their children. A study titled Statistics on Children and Television (1995-1999) showed that 65 of the children who watched The Simpsons were encouraged to disrespect their parents. While this may be what some adolescents are, it does not necessarily represent an average American adolescent. It is out of this that a T-shirt reading Im Bart Simpson, who the hell are you was banned in schools. Bart was named one of the 100 most important people of the 20th century by Time Magazine. This in essence means that many adolescents were vulnerable to be influenced by his characters. His need to be in the limelight is portrayed by his jealous when his sister was born due to the attention that she received but he later warmed towards her when he discovered that the first word she said was Bart. This is a character portrayed by many adolescents who feel that their younger siblings are getting too much attention than them. His rudeness is seen even in school when he is confronted by the principal and he tells him, Eat my Shorts (Jean et al 1997). There is no documented evidence to show that adolescents used this catchphrase in school.

Just like many adolescents, his hobbies are watching TV, playing video games, skateboarding, and playing mischief. He also appears naked in the show though only his buttocks are visible and he likes skating while completely naked. No evidence to show that his adolescent fan did the same either at home or at school.

His rebellious attitude has made him a disruptive student. He is an under achiever but very proud of it. He is dumb and his sister proves that he is as dump as a hamster. He is in constant conflict with his teacher and the Principal. He gets into many troubles, he is sometimes sadistic, selfish, and shallow but on occasions he can show high integrity. He is smarter than his dad but he is always kept in check by his mum. It is because of his mischief and his dads uncaring and incompetent behavior that makes them have a turbulent relationship. Bart never calls Homer dad and in return Homer calls him the boy. His mother, Marge, calls him a handful, is caring, but she gets embarrassed by his antics (South Africa News 2, 2007). This is very common in many adolescent homes where the dad and the adolescent son have turbulent relationship. But the cause of this is usually not the children being influenced. If so, then we can say that even parents are prone to influence. His mother first felt she was over mothering him and hence began acting differently when Bart was caught shoplifting. He protested at her mothers over mothering but he later made it up to her when she changed her attitude. He is therefore ready to undergo humilitiation to please his mom. His mom understands him and is ready to defend her. This shows that the mothers are in constant defense of their children.

Bart as a role model
Bart is rebellious and often goes unpunished. This makes many parents view him as a bad role model for their children. He is the kind of child which the parents wish they had been but fear their children will become. He has outwitted his parents and outtalks his teachers (Bianco 1990). Educators say that he is a threat to learning because of being an under achiever and being proud of it and his attitude and negativity towards his education.

Conclusion
The main question we should ask ourselves is should everyone in television be a role model In real life, the adolescents come across many people that are not role models. So we should not expect TV to be full of them. Whatever behavior that the adolescents portray is a result of the environment, they grow in and the genes of their parents. So the lesson that we learn is that if the parents do not want their children to be like Bart, they should not act like Homer Simpson. We should all therefore understand that there are other forces that come into play to influence the behavior of the child and not only watching TV. Thus, adolescents do not necessarily ape the behaviors that they see on TV, but selectively incorporate just a few values that fit with their real life.

Adolescents and children are treated in the mental health system everyday for a variety of mental disorders.  The focus of this research will be centered on Cognitive Behavioral Therapy and Client Centered Therapy as it relates to Conduct Disorder and Oppositional Defiant Disorder.  The therapeutic approach will examine both individual and group psychotherapy settings.  A thorough examination will be given on the named conditions and named therapies.  Comparatively, it will determine which therapeutic approach is most effective when treating each mental disorder in children and adolescents.

Cognitive Behavioral Therapy and Client Centered Therapy for
Children and Adolescents with Conduct Disorder and Oppositional Defiant Disorder
Children and adolescents are curious minded individuals for the most part.  They engage in various activities with an uninhibited and innocent level of insight.  Their level of logic is surprising, and at the same time can be a refreshing change.  Now suppose that the amusing behavior and logic were to take a sudden turn.  Imagine a child who constantly challenged authority from all angles and exhibited extreme fits of rage and anger.  Imagine a child who only needed two hours of sleep a night and could run throughout the entire day at full-throttle.  What would be the initial impression and reaction of the onlooker

Conduct Disorder
Children and adolescents suffering from Conduct Disorder (CD) often display the symptoms mentioned.  Parents, teachers, and family frequently appear to be exhausted after having spent only moments with the child.  It is tantamount that one understands that the child or adolescent has absolutely no control over the afflicting mental disorder.  Their behavior is unintentional.  At this juncture, the child or adolescent believes him or herself to be as normal as everyone else.
   
Clinicians have collectively termed CD as a group of behavioral and emotional problems in children and adolescents displayed through socially unacceptable behavior (American Academy of child and Adolescent Psychiatry, 2004 Burke, Loeber,  Birmaher, 2002).  Children and adolescents diagnosed with CD are known for their illegal temperaments.  They have been reported to be overly aggressive and physically threatening towards animals and people alike.  They are destructive of property of their own and that which belongs to others.  They will steal without reason and lie at will.  It should also be noted that these behaviors are correctable and manageable if the proper treatment is facilitated.
   
The origin of this childhood mental disorder has been related to several contributing factors.  The first instance pertains to possible brain damage or a neurological impairment.  Members of the medical community contend that the neurological damage could be attributed to reduced or lack of adequate oxygen during labor and childbirth.  Neurological damage could also likely be substantiated by the child being a victim of child abuse whereby he or she may have experienced blows to or about the head.  Emotional trauma and genetics are among other sustaining factors believed to be at the epicenter of the disorder.  Children and adolescents who have parents that suffer from mental illness are more apt to develop a mental disorder before completing puberty.
   
The prognosis for a child or adolescent perplexed by CD is a positive one.  Behavioral therapy coupled with medication seems to be the most effective means for managing CD. For the purpose of this paper, cognitive behavioral therapy and client centered therapy will be closely examined for accuracy in both an individual and a group clinical setting (Harty, Miller, Newcorn,  Halperin, 2008).  As a whole, the treatment for CD is individualized.  The therapist will conduct important diagnostic tests in order to find out the severity and true existence of the Conduct Disorder.  Once a decision has been made, the therapist will put together a treatment plan in order to get the child or adolescent back on a healthier path of living.

Oppositional Defiant Disorder
Oppositional Defiant Disorder (ODD) is very similar characteristically to CD.  Both disorders appear in childhood and adolescence, but they are usually seen in conjunction with other mental disorders such as depression and Attention Deficit Hyperactivity Disorder (ADHD).  ODD is surmised by uncooperative and hostile behavior absent any physical or emotional trigger (Skoulos  Tyron, 2007 Oatis, 2009).  Children and adolescents are known to throw acute temper tantrums, argue, have a lack of respect for authority in any form, act in deliberate defiance, antagonize others, refuse to assume responsibility for their actions, and have a general hateful and spiteful attitude (American Academy of Child and Adolescent Psychiatry, 2009).  This behavior significantly interferes with the child or adolescents ability to function in or out of the home.  Psychologists agree that children and adolescents diagnosed with ODD have a higher rate of developing Antisocial Personality Disorder or depression as an adult.
   
The origin and nature is believed to be of a biological, psychological, or social factor.  The biological conclusions are drawn from a family history of mental illness or in the form of a chemical imbalance.  Despite the chemical imperfection, medication is not a productive means of treatment in ODD.  The psychological aspect and how it contributes to the existence of ODD relies heavily on a child or adolescents personal life up to the present.  The child or adolescent is believed to have been a victim of child abuse or neglect.  They could be the product of an undiagnosed co-morbid condition that excels ODD behavior or a number of other psychological reasons, however the diagnosing psychiatrist will make the final determination.  There are a number of social factors that are thought to be the origin of ODD as well.  Peer hazing or taunting, low self-esteem, lack of solid friendships, or lack of a structured living environment at home and elsewhere are believed to have a direct effect on the development of ODD in children and adolescents.  ODD is one of the most commonly diagnosed mental disorders among children and adolescents.
   
The methods of treatment for ODD are limited at best (Kelsberg  St. Anna, 2006).  Children and adolescents with ODD do not generally respond well to the administration of any drug.  Therapy, either cognitive behavioral therapy or client centered therapy, is the best alternative.  Parent training is another technique endorsed for treating ODD.  Parents attend a training seminar that teaches redirection and positive reinforcement.  The how-to process of parent training enables the parent to implement the techniques therapeutically at home.  Family therapy is sometimes used depending on the demands of the child or adolescents responsiveness to other methods of therapy.

Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a form of therapy that attempts to re-program how one interprets a situation.  Actions and reactions are predetermined by the cognitive thought processes of the mind.  In children and adolescents, there are five basic concepts of thinking.  The focuses are interpersonal and environmental, physiological, emotionally functioning, behavior, and cognition (Durlak, Fuhrman,  Lampman, 1991 Friedberg  McClure, 2002).  The interpersonal and environmental concept focuses on the client being able to differentiate between a feeling and a thought.  The physiological focuses on becoming aware of thoughts that produce a negative influence on feelings.

The emotionally functioning concept learns and understands the occurrence of automatic thoughts.  In the behavioral concept, one learns to analyze the automatic thoughts for accuracy and bias.  Finally, the cognition concept develops the skill needed to control and correct any bias energy associated with independent thought (ABCT, 2010).  Children and adolescents with CD or ODD benefit from CBT because the issues of emotional rejection, secondary physical symptoms, and the illogical thinking process are addressed.

In Conduct Disorder
Children and adolescents with CD are frequently treated with CBT.  Cognitive behavioral therapy planning for children and adolescents involves the evaluation of logical and analytical structures of thought as they relate to the clients social perspective taking abilities (Kinney, 1991).  This is especially important in the individual therapy setting.  Therapists working with children and adolescents with CD tend to take on a teaching role when using CBT (Grohol, 2004).  This direct approach in counseling is validated through progress.
   
The general idea of Cognitive Behavioral Therapy in children and adolescents is based on the ideas of modeling and re-enforcement.  A productive social learning environment can be achieved through role playing, modeling, Rational Emotive Therapy (RET), and the use of other reinforcement strategies (Grohol, 2004).  These approaches are based conclusively on the exact problems associated with CD in relation to how the client presents.  CBT for children and adolescents with CD is estimated to be short-term, three to nine months in duration, and include 10-35 sessions in total.  Single sessions do not produce a positive result (Journal of American Academy of Child and Adolescent Psychiatry, 1997).
   
Some forms of CBT are found in places that many would not consider.  Young children can benefit from CBT in Head Start programs readily available in most communities.  These pre-school academic models are designed to aid in the intellectual, academic, and social dynamic of the child while in a playful and fun setting.  Visually, the head start program is a group setting, but the individual client is placed into the program for the educational, social function, and modeling benefits.  Consequently, older children and adolescents are often placed into a vocational training setting as a means of raising self-esteem, modeling, improving the educational abilities of the adolescent, and developing a positive social skill and function (Kinney, 1991 American Academy of Children and Adolescent Psychiatry, 1997).
   
Cognitive Behavioral Therapy has been found to be more beneficial when administered in the child or adolescents natural environment.  Home based CBT is a plus if available to the client.  Age is not a variable in CBT since there are many approaches that can be utilized and administered.  Younger children respond well to toy play, puppet play, games, drawing, and crafts (Friedberg  McClure, 2002).  Adolescents find a useful connection in CBT through the use of movies, television, and music as these activities incite verbal communication during therapy sessions.  Constant focus must be centered on the positive.
   
The identification of thoughts and their correlation to feelings plays an important role in CBT.  The use of a facial expression chart is often introduced into therapy sessions with young children.  Communication barriers inhibit young children from verbally expressing their feelings.  Facial expression charts allow the child an alternative form of communicating their exact feelings (Johnson, 2010).  The uses of picture books permit the same emotional components to be factored into the session.  Older children and adolescents are able to communicate their feelings without hesitation, including those of a negative connotation.
   
Some clients, both children and adolescents, are intent on remaining silent and unresponsive.  This evasive uncooperativeness can be viewed as a passive aggressive behavior aimed at retaliating against those thought to be responsible for mandating the therapy.  The therapist must then divert to other ways of communicating with the client.  This is a good opportunity for the therapist to begin working with the client on connecting the physical with the sensations of the emotional.  Questions can be proposed in relation to school or family in relation to physical areas such as the stomach or the head.  A classic example question that a therapist could ask would be, when you found out you were coming here today, how did that make your body feel  This open question allows the adolescent to answer honestly.  It opens the lines of communication for other questions and conversation.  Later questions pertaining to immediate thought and ideas associated with the clients thought process can be explored.  At this point, the client would begin focusing on identifiable thoughts and connecting them with associated feelings.

In Oppositional Defiant Disorder
Therapy is the key treatment in ODD since it is relatively unaffected by any medication (American Academy of child and Adolescent Psychiatry, 2009 American Psychiatric Association, 1994).  CBT in children and adolescents with ODD teaches them how to view situations differently than they had.  The time-out system is a form of CBT.  The brief but isolating period gives the young child an opportunity to think about how they behaved in an unacceptable manner.  When the period of isolation is over, the child is then asked why he or she was subjected to a time-out.  This question presents the child with the opportunity to show that they have learned a lesson concerning their behavior.  The question also signifies that the behavior redirection session is over for the moment.
   
Therapy is a given for children and adolescents with ODD.  Cognitive Behavioral therapy should be initiated in all aspects of the clients life including the academic setting.  CBT techniques can be put into practice on the home front as well through specialized parental training.  A ready to use routine is a plus for a child or adolescent with ODD.  Once a regular routine for treatment has been devised, the client will over time begin to experience less stress and anxiety.  Life stressors are major triggers associated with ODD.  The family, the school, and the mental health practitioner should form an open line of communication to provide a more probable outcome for the client.
   
The school system can provide a Cognitive Behavioral therapy based environment to the child or adolescent through the special education program.  Teachers in the special education program are specially trained to handle not only the educational needs of the student, but the emotional needs as well.  Mental health professionals need make their presence available for any Individualized Educational Planning (IEP) for children and adolescents who are actively in therapy.  This would ensure that the school can devise a plan that would coincide with the current treatment course of action already in place.  Parents of the child should take an active role in both planning processes as they will ultimately be spending the most time with the child or adolescent.
   
Many of the same therapeutic techniques are incorporated into the CBT for a child or adolescent with ODD as is in a child or adolescent with CD.  Sessions usually average from 10-15 depending on the progress of the client.  ODD can hinder a client from fully participating in therapy at times due to outbursts of anger, disruptive behavior, and the constant need to refocus the client.  Role playing, play therapy, and one-on-one individual CBT have proven to be a successful treatment plan in young children.  Sometimes, older children and adolescents fare better when the CBT is started in an inpatient hospital setting.  The decisions, the how and when to begin CBT, belong to the treating mental health professional.  The severity of ODD in the client has a major impact on the intensity of the treatment as well.  It is necessary to stabilize the patient before enveloping them into a therapeutic process.  One time sessions do not provide stabilization, nor are they effective forms of treatment for ODD (Kelsberg  St. Anna, 2006)

In a Group
CBT to treat CD or ODD in a group setting is very similar to that of treating just the individual client.  School and vocational locations do provide a group therapy atmosphere and encourage group participation.  Group CBT promotes increased feedback from its clients.  The modeling approach gives children and adolescents a chance to see firsthand how others, within the same age perimeter, handle and cope with specific situations (PsychCentral, 2001).
   
Coping strategies and social skills are two benefits of group CBT.  The following is an example of how these lessons are taught and learned in a group CBT session.  The lead therapist treating a group of ten adolescents with CD or ODD decides to take the group on a bowling outing as part of the group therapy session in action. The parents of the adolescents agree to go as well as this is a therapeutic outing.  While out bowling, little Johnny becomes very agitated and angry when he sees that he is the only one who has yet to bowl a strike.  His anger steadily increases and he erupts by throwing his bowling ball into the floor.  In doing so, he smashes his own foot.  The other adolescents in the group stand in awe of little Johnnys outburst.  The therapist immediately goes over to little Johnny and asks him how his foot is.  Johnny does not answer.  The therapist then asks him how his body felt when he threw the ball.  Johnny states that his body felt lighter, but his foot is pounding.  The therapist then asks Johnny how his body felt before he threw the bowling ball onto his foot.  Johnny states that he felt hot and that his body felt really tight.  The therapist explains to Johnny and the rest of the group that what Johnny was feeling was called anxiety.  She further explains that everyone feels a little anxious whenever they play a game because it is a competition.  She reiterates the fact that bowling is just a game and nothing more, but that what Johnny was feeling was very real and was because of the game.
   
The other adolescents observed the conversation between the therapist and Johnny.  In a group therapy setting, there sometimes exist live examples to learn from.  This instance also gave way for improved social skills and communication.  It allowed for a positive interaction between the therapist and the other clients as well.  Group therapy generally does not have more than twelve participants at any given time.  If there are more than twelve, then the clients can be too easily distracted and the group session becomes a sort of disorganized chaos.  In the matter of Cognitive Behavioral group therapy, less is more, and that is a good thing for all seeking treatment.

Client Centered Therapy
Client Centered Therapy (CCT) is a behavioral therapy developed by Carl Rogers in the 1930s (Rogers, 1939).  This approach to counseling places the responsibility of treatment onto the client.  Some therapists see client centered therapy as a way to increase the clients level of insight through self-understanding.  Client centered therapy is based on three fundamental basics of success.  These criteria are congruence, unconditional positive regard, and empathy (jrank, 2010).  Since no child or adolescent behavior or attitude is the same every day, it is crucial that the treating therapist be flexible in their own thinking and thoughts in order to recognize the emotional needs of the client.
   
Congruence depicts a therapists ability to be personable and equal to the client on a human level of existence.  Therapists who come off as being better-than or condescending and judgmental will assuredly fail the client.  In CCT, the client is looking for acceptance and reassurance.  These needs can be met by the therapist through unconditional positive regard.  The therapist can develop a solid therapeutic relationship with the client by merely listening without interrupting or interjecting opinions of judgment.  Finally, empathy must be asserted in CCT I order to gain trust from the client (Green, 1996).  A client will not cooperate, open-up, or express any therapeutic effort if they feel misunderstood.  Empathy is a major portion of CCT and relies solely on the treating therapist.  Much of the work in CCT is centered to the attitude of the therapist.  CCT for children and adolescents provides a safe and effective solution to many behavioral problems through a therapist who acts like a human being and not a robot (Psychology, 2010).

In Conduct Disorder
Client centered therapy gives children and adolescents the freedom to discuss concerns and relevant matters with the therapist.  Since the CCT approach puts the emphasis on the client, the therapist generally takes a passive role in therapy.  In CD, the therapist initiates some focus on issues of impulse control, problem solving, and anger management (Tryon, 1999).  This is achieved by using a four step process of understanding.  The therapist begins by using the modeling technique and proceeds by adding rehearsal and role playing.  The final outcome is delivered when the child or adolescent develops an internal voice used for self-evaluation (Kazdin, 1987).
   
There are various methods of client centered therapy used in treating conduct disorder.  The first is Parent Management Training (PMT).  Parents or caregivers of the child or adolescent are taught by the therapist, or in a group class, how to effectively set limits, redirect the child, and use positive behavioral reinforcement.  Research has shown this to be a very important and productive part of treating CD (Teusch, Bohme, Finke,  Gastpar, 2001).  The PMT is often used in conjunction with family therapy (Sanders  Dadds, 1993).  Family therapy provides outlets for all family members, and not just the child or adolescent with CD.  Sibling issues and parental power struggle issues can be addressed and resolved within this therapeutic setting.  Family therapy is used to reinforce the family dynamic through CCT (Searight  Rothneck, 2001).
   
Age is an important variable to be considered in CCT.  Children and adolescents diagnosed with CD before age ten seem to do more poorly from CCT than do those who were diagnosed with CD after the age of ten (Dishlon  Andrewa, 1995 Rogers, 1939).  It can be asserted that children and adolescents under the age of ten are still more formularizing in their thinking.  Their behavior and thought process is still in the abstract stage.  This allows the child to be more easily manipulated and thought patterns can be redirected (Cantwell  Baker, 1988 Kaplan, 2008).  Children and adolescents older than the age of ten seem far more rigid and stubborn than younger children, but in a therapeutic setting, the children are more open to suggestion and change.  It is important that the therapist include self-reflection in the CCT as a way to help the client understand their maladaptive behaviors.
   
Peer relationships are a form of CCT in a school based setting (Dulcan  Weiner, 2006).  Social skills and interactions of clients diagnosed with CD can be closely monitored and modified if necessary.  School academic clubs or sports organizations provide a good therapeutic CCT environment for the adolescent or child.  The primary purpose is helping the child or adolescent to use problem solving skills in every situation as a way to control the impulses that trigger anger and physical acts of violence.  Client centered therapy is prosocial and usually consists of twelve sessions (Rutter  Taylor, 1994).
In Oppositional Defiant Disorder
   
Early intervention and CCT treatment for children and adolescents with ODD holds much promise.  The goals of CCT in treating clients diagnosed with ODD are parallel with the treatments for CD.  Therapy focuses on self-esteem issues and self-understanding.  These individual focuses enable the client to be more open to the therapeutic process, relieve insecurities, decrease defensive cognition, and eliminate any residual guilt (Ellis, Abrams,  Abrams, 2009 Rogers, 1951).  In young children, ages 3-11 years, play therapy is very effective in an ODD diagnosis.  Essentially, treatment is short-term, 12-25 sessions (Barkoukis, Reiss,  Dombeck, 2008).  Young children are able to articulate their feelings by playing games or interacting with toys.  Therapists watch carefully for behaviors that indicate problem areas.  In turn, these areas are addressed and the focus turns to the client.  Questions can be proposed in reference to, what do you think should be done here Or what would you like to do (Martin  Pear, 1999).  Children seem to be more receptive to the questions when they feel that they are in control.
     Parental Management Training (PMT) is also used for ODD clients in CCT.  Parents have reported a high success rate and increasing positive behavior after having PMT (Casey  Berman, 1985 Forehand  Long, 1996).  Family therapy is also integrated into the treatment plan.  CCT is included in special education programs in the public school sector.  Guidance counselors and special education teachers are able to monitor the child and adolescents progress in an academic and social environment.  The social skills perspective is also examined through the child or adolescents peer group (Sungerg, Weinberger,  Taplin, 2001).

In a Group
Client centered therapy with a group consists of a group of 3-5 children or adolescents.  Desensitation exercises are introduced and used for eliminating stress (Brown  Prout, 2007).  There is much organic interaction between the children and adolescents.  The therapist opens the floor for discussion or delivers a topic for discussion to the group.  Dialogue and talk therapy help the client to develop and utilize problem solving skills and participate in a social perspective (Rogers, 1942 Shirk  Karver, 2008).  This can be performed through organized athletics, community groups, body and girl scouts, and church group activities.  Family therapy is also associated with group therapy, and is used to treat both CD and ODD in a CCT environment.  The prognosis for children and adolescents is promising.  Children and adolescents seem to respond well to CCT.

Analysis
Rutter and Taylor reported in 1994 that 5 of children in the United States have Conduct Disorder, and 20 of children and adolescents have Oppositional Defiant Disorder.  The first child to receive psychotherapy was in 1905, and the therapy was administered by Sigmund Freud (Reinecke, Dattilio,  Freeman, 2006).  Children and adolescents go through phases of oppositional behavior and conduct abnormalities as they grow.  This is considered to be a normal part of childhood development.  When the disruptive behaviors linger and persist, it is necessary to have a psychologist perform an assessment to determine if there is a mental disorder (American Academy of Child and Adolescent Psychiatry, 2007 Reich, 2000).
   
In a study performed by Shirk and Karver, it was determined that CCT and CBT produced a modest outcome for children and adolescents diagnosed with disruptive behaviors like CD and ODD (Shirk  Karver, 2008).  The study made several findings concerning psychotherapy in children and adolescents.  Children displayed a poorer response to CBT where CD and ODD were co morbid.  Hostility, as associated with CD and ODD, prevented the child from forming relationships with other children (Gresham, 1986).
   
The Helsinki Psychotherapy Study monitored patients for twelve months after the onset of therapy.  It was determined that 46.86 of patients dropped out of psychotherapy before completion (Wierzbicki  Pekanik, 1993).  Throughout their study, they discovered that different therapies required a different number of sessions.  Solution focused therapy required a maximum of twelve session, and short-term psychotherapy required twenty sessions over a 5.7 month period (Knekt  Lindfors, 2004).  Children and adolescents being treated for ODD and CD usually participate in CBT and CCT for periods of less than twenty sessions.  Solution focused therapy is very similar to CBT and CCT in that they identify the problem and work to find a solution.  It focuses on positive feedback and home assignments as well.  There is still much research needed in order to truly determine the effectiveness of CBT and CCT for conditions of CD and ODD in adolescents and children (Maxwell  Delaney, 2003).

Discussion
There are still concerns where CD and ODD are concerned in reference to the possibility of co-morbid conditions.  ODD and CD are commonly found to co-exist with ADHD, depression, and anxiety.  In these other conditions, ODD is merely a coping mechanism to the primary condition.  Over half of the children and adolescents with ODD also have ADHD (Keisberg  St. Anna, 2006).  Some clinicians have questioned whether CD and ODD are simply pre-ambles to future more serious mental disorders.  There is a correlation between CD and antisocial personality disorder.  Some would argue that intervention was not implemented soon enough therefore the original condition had more time to fester and evolve into a more damning condition.
   
Not every member of the mental health community is in agreement with regard to the conditions of CD and ODD, nor is everyone in agreement as to how the conditions should be treated.  It has been suggested that an inpatient hospitalization would be more a more productive way to evaluate a child for Conduct Disorder or Oppositional Defiant Disorder.  This is argued from the other side in that a child will naturally produce adverse reactions when taken out of their natural environment.  The initial trauma of being separated from their parents or caregivers can actually cause more damage than good.
   
If mental health intervention is delayed for too long, the likelihood of the child or adolescent becoming involved with the legal system is greater.  Some juvenile court systems are ignorant to how mental conditions can affect ones behavior.  Instead of referring the children and adolescents for mandated counseling and a psychological assessment, many judges view the child as encourageable or as a bad seed who needs to be taught a lesson.  These children and adolescents find themselves in shock incarceration, boot camps, and solitary confinements within a juvenile detention facility.  While there are licensed therapists and psychologists on staff at these facilities, there are less empathetic to the emotional needs and conditions of the child.  They are often overrun with heavy caseloads and have little time to even acknowledge the child as an inmate. This behavior is counterproductive when one has a mental disorder.
   
It must be noted that misery loves company and that monkey-see-monkey-do.  Some behaviors exhibited in children are mimicked of other children.  If a child is acting out and crying, for instance in a daycare setting, that somehow triggers every child in the room to begin whining and crying as well.  It is like a domino effect.  The true behavior patterns of a child must be examined closely against any flaw of assumed behavior.  Psychological testing and assessments can assert underlying behaviors that must be addressed immediately.  Not every child is in crisis, but when a childs behavior disrupts their ability to function in and out of the home, it is necessary to give the matter top priority.
   
Insofar as communications are concerned, it is ultimately up to the parents or caregivers to sign the necessary releases so that therapists, schools, physicians, and other authorities over the child and adolescent can keep one another informed or report any concerns.  This is a vital part of the treatment process, but it often goes overlooked.  A teacher should be able to talk to the parent and the attending physician if they feel that a medication may be too strong or too weak.  In turn, a physician should be afforded the opportunity to speak with a teacher to make them aware of any medication changes or specific behaviors to keep an eye out for.  The only way to effectively treat a child or adolescent with CD or ODD is through honesty, openness, and a willingness to aid the child in any way possible.

Conclusion
Conduct Disorder can be treated with medications in conjunction with therapy however ODD cannot be treated with medications unless there is a diagnosis of a co-morbid condition.  Children and adolescents present with many symptoms which require psychological assessment in order to determine the best treatment route.  Clinicians believe that CBT and CCT are the most effective forms of treatment for disruptive behaviors.  Parents concur to therapy as they also participate in a PMT in order to help their child from the home setting.  Special education teachers and guidance counselors are trained to aid children and adolescents experiencing emotional battles.  While treatment is relatively short-term, it can seem to drag on forever when dealing with a child who is hostile, violent, disruptive, disrespectful, and sometimes even criminal.  Parents must educate themselves as to what is within the normal confines of childhood development and what is out of the ordinary.  Parents are the first step to a child receiving the proper diagnosis and treatment for any emotional or mental condition.
   
Therapists must conduct their sessions with the upmost integrity towards the patient.  Empathy and understanding are key factors in treating children and adolescents.  Trust can be established more easily between client and therapist if the therapist is personable and relaxed.  Therapists take on the role as teachers when working with a client in a CBT setting.  A good therapist must be able to be transverse and be able to adapt to the need of the client.
   
Clients, children and adolescents, who have CD and ODD, are still human beings. They have no idea that there is even anything wrong with them.  They function within their own reality of normal.  Some symptoms of CD and ODD make therapy challenging for both the therapist and the client.  Hostility and anger issues usually present with the most problems. All in all, the prognosis for children and adolescents with CD and ODD looks good, but it will probably get a whole lot worse before it gets any better.

There is a general consensus that the use of alcohol beverages has been with us since times immemorial. Across the globe, alcohol has over the time grown to play an important role in the lives of people for one reason or another. To this end, the consumption of alcohol has undoubtedly become fully integrated in our lives. For instance, it is usually consumed with meals as well as used for religious or medical purposes. Alcohol has at the same time been used during celebrations in several special or important occasions in addition to being used as a tool for social facilitation. A closer look into the countries alcohol consumption trends reveals that its consumption per capita is arguably the highest across the globe.

Additional statistics with particular reference to the trend of alcohol consumption is based on age indicate that it is increasing sharply during early teens all the way to mid-twenties. This is then followed by a decline thereafter as it is presented by NIAAA (2000). In one of the surveys conducted by Michigan University, it was found out that there was, indeed, a positive correlation between the age and the rates of intoxication as well as lifetime amongst students in high schools within the country, according to Johnston (1998). In comparison between other drugs and alcohol, it was revealed that the latter is the most and widely consumed substance within America just as it is the case with respect to dependence prevalence (SAMHSA, 1999a).

Alcohol Related Problems in the U.S.A
Risky situations in the context of the use of alcohol refer to the drinking pattern and behavior that is characterized by blood alcohol concentration levels just below 0.08 gm. This is normal, given the much needed impetus by frequent drinking pattern, whereby an individual consumes not more than five portions of a drink at one time. Under this drinking behavior, the person normally drinks at least once during the week. It is imperative to note that this type of drinking behavior is highly risky, owing to the fact that it usually culminates into binge drinking pattern. In this regard, risky situation with respect to the consumption of alcohol is attained when the blood alcohol concentration of the drinker ranges from 0.05 gm to 0.08 gm. According to NIAAA, binge drinking behavior is attained when the blood alcohol concentration (BAC) is 0.08 gm or above. Binge drinking is normally brought to the fore when an individual consumes more than five drinks within a time span of less than two hours. If not controlled, binge drinking usually results into one becoming a bender or heavy drinker that it is characterized by an individual drinking heavily for two or more days.

Low-risk drinking pattern, on the other hand, encompasses both abstinence and low frequency of alcohol consumption. In particular, this refers to the instance when one drinks less than half an ounce of alcohol or none at all in the case of an abstainer. With regard to the age, older persons have been shown to require fewer number of drinks in order to reach binge level of drinking thus are usually at high risk. The same applies to women that have been reported to require four or more drinks to reach the said level. On a different note, data from SAMHSA, (1999a), shows that alcohol consumption rates, binge drinking as well as heavy drinking are comparatively high amongst men against women. The scenario is similar in relation to young adults in comparison to older ones. Moreover, this data indicates that young men are normally highly predisposed into turning out to become both binge drinkers and benders in the event that they drink alcohol.

In this study, it was found out that 67 percent of males within this group of age had reported as to being binge drinkers or benders in comparison to less than 50 percent of men and women that were above 26 years. Majority of women that were above 26 years old on the other hand were captured as to being abstainers, although upon opting to consume alcohol, they end up using significantly lesser amounts in comparison to their male counter-parts within the same age group. Additional findings presented by SAMHSA, (2000a), indicate that the risk of alcohol abuse varies subject to ethnic differences despite the fact that it has a positive correlation with age.

Among the young people, there is a high alcohol consumption rate among the whites according to this 2000 alcohol use study.  Asian and black respondents, on the other hand, reported the lowest consumption of alcohol rates. That not withstanding, this survey revealed that there was a high rate of binge drinking amongst American Indian as well as Whites closely followed by the Hispanics. Heavy drinking on the other hand was reported to be highest amongst the Whites and followed by Hispanics and American Indians. With regard to persons of the age of 18 to 25 years, the Asians and Afro-Americans were captured as to having lowest heavy drinking rates. In the overall, this survey found out that the American Indians accounted for the greatest proportion of both binge and heavy drinking. Furthermore, the family stability and the social class certainly play an important role in the drinking behaviors of persons. Individuals growing up or under the care of less stable families are highly predisposed to the risky alcohol consumption. This might be complicated by the high social class status, since one has the access to high amounts of disposable income. Unlike the two, disability tends to reduce this risk since it acts as a limiting factor as far as social interactions is concerned. The risk might be increased in the event that a person consumes alcohol though heshe has a medical condition. Religion, just as disability greatly reduces this risk owing to the fact that consumption of alcohol is usually prohibited in almost all the religions across the globe.

With regard to policy implications and social work subject to the relationship between violence and alcohol, it would be imperative to come up with policies or legislations that restrict the amount of alcohol that is consumed by any one person. This would take the form of the government regulating the alcohol percentage concentration by volume at the point of manufacture. The other feasible policy option would be in terms of restricting the number of drinks that an individual might be allowed to take at any given time or period. These policy implications options stem from the positive relationship between the use of alcohol and violence. Perhaps it is imperative to note that use of alcohol does not only encourage aggressive behavior, but rather victimization could also lead to excessive consumption of alcohol. According to NIAAA, (2000), it is found out that alcohol-related violence is very common within America in comparison to that associated with use of other drugs.

On a positive rejoinder, Roizen (1997), found out that the majority of offenders were usually intoxicated at the time of committing the various crimes. There is a positive correlation between the use of alcohol and domestic violence among intimate partners according to Greenfield and Henneberg, (2001). It is estimated that approximately 45 percent of all domestic violence cases involve men that were drunk at the time of this offence as it has been put forward by Roizen, (1993). Against this backdrop, it would be prudent to come up with a policy of regulating use of alcohol at homes with specific emphasis on young couples to reduce this risk. At the same time, there is need for policy that compels one of the affected partners to report incidences of alcohol-related domestic violence to reduce additional risk at home. The positive correlation between the use of alcohol and accidents also calls for stringent policy measures aimed at restricting consumption of alcohol by the motorist. In this regard, social work efforts should be directed towards sensitizing the wider public on the need to avoid alcohol all together as the surest way of curbing the increasing rates of alcohol-related accidents. With regard to the use of alcohol and health, there is the urgent need to control the amount of alcohol that one can take at any sitting. In the overall, the above policy implications would be complicated by intensified sensitization or awareness on the dangers of alcohol in general across gender, ethnicity and age.

Alcohol and the Family
Social learning constructs with respect to the use of alcohol lay significant emphasis on the cognitive constructs for example self-efficacy, expectancies, as well as attributions as pathway mediation to the use of alcohol from stimuli as response mechanism. Expectancies with regard to positive effects that are derived from alcohol use have been known to develop to become conditioned cognitions. This is normally brought about by operant parings or repeated classical as a result of alcohol use based on positive experience. Self-efficacy on the other hand, entails individual expectations that heshe would successfully be able to perform a given coping behavior subject to certain situation and that such behavior would be reinforced. Against this backdrop, the social learning construct is founded on the premise that alcoholism is brought about due to failure to cope by an individual.

Hence, the self-efficacy is significantly low among individuals that consume alcohol. Faced with this challenge, such persons therefore depending on alcohol due to continued use of the same. In relation to one of the social learning theories by Petraitis (1995), for the adolescent experimentation, it was found that individuals usually have a range of positive expectations from using alcohol. In this regard, several studies under the social learning theories are focused on indentifying the ability of alcohol to actually influence given types of behaviors for example aggression induction, sexual arousal, increase in addition to reduction of tension among others. Of importance to note is the fact that the said laboratory or experimental studies assume cognitive-related influence that is brought about by the use of alcohol. As a result, a number of alcohol use-related expectancies amongst users have been indentified. These are increase in aggression as well as personal power, tension reduction and relaxation, sexual performance enhancement and pleasure and social facilitation. The other expectancy that is usually attached to the consumption of alcohol is the need for a positive outcome in general which might be brought about by drinking.

With this in mind, several instruments have been developed in order to assess such expectancies in the wake of the use of alcohol by someone in the context of its effects. It should be emphasized that these expectancies are not usually limited to an individuals experience with alcohol but rather encompass influence towards them due to the exposure to alcoholic beverages through advertising. In addition, these expectancies might be given the much needed impetus through observation of other people drinking an aspect that can occur both in real life situation and through the media models in this regard. It is possible that this process of modeling can begin during the early stages of an individuals growth (Miller et al. 1990). In one of his study, Miller together with fellow social researchers, found out that positive alcohol use expectancies tended to increase as one becomes old especially amongst children aged between 8 and 10 years. On a positive rejoinder, Stacy (1990) and Christiansen (1989), argue that a number of additional studies have revealed that it is possible to predict to ones initiation into drinking, drinking intention as well as the rate of drinking amongst college and high school students with respect to the effects of alcohol.

Though it was originally believed that these expectancies were directly linked to beliefs and attitudes in relation to the alcohol reinforcing properties, it has emerged that they are in fact closely related to the processes of memory. In this way, positive expectancies are usually brought about due to the usual process of drinking. Furthermore, the said expectancies are easily retrievable from an individuals memory during subsequent alcohol drinking. This is attributed to the fact that such positive expectancies have been found to be closely related to the usual process of drinking. Negative expectancies on the other hand, have been found to be brought about by unpleasant drinking experiences or situations. Therefore, such experiences tend to be less associated with the usual practice of drinking. However, there is a high possibility that they are brought about due to heavy drinking practices. In this respect, light to medium alcohol drinkers are least likely to experience negative alcohol expectancies with regards to the effects of alcohol. At the same time, they might act as inhibiting factors during the usual drinking practices. Based on the social learning theories, it is justifiable to state that a lot of emphasis is usually placed on the sources of modeling with specific reference to the young ones. Also, through alcohol use expectancies, it is possible to determine the drinking practice of an individual and thus be able to come up with an appropriate control as well as a treatment regime.

The family system most certainly plays a very crucial role as far the initiation into alcohol use by other persons within the family is concerned. This can be attributed to the fact that the family system that is founded on alcoholism has the effect of providing a steady supply of alcohol to its members. In this way, it becomes much easier for one member to be initiated into alcoholism owing to the fact that alcohol is used as a means of maintaining the balance within the family. Under such instances, the use of alcohol tends to become a natural practice. Thus, family members grow to accept the fact that the use of alcohol is indeed a natural practice or element of life without however paying attention to the danger of alcoholism. In particular, this is usually given an impetus since the family normally opts to maintain this problem against the expected cost of changing the status quo. The main reason in such instances is usually founded on the assumption that accepting the use of alcohol is relatively less demanding and also enables the family to avoid tackling more disturbing issues.

A family system that is based on abstinence to alcohol or responsible drinking practices tends to offer a very strong resistance and resilience to alcoholism. By limiting the amount of alcohol within the family or restricting the same, family members tend to be less exposed to the risk of alcoholism. Furthermore, such a family system acts as an effective support mechanism to the other family members that might be affected by alcoholism.

Client Case Study

Introduction
Born in a family of four, Martin grew up knowing that alcohol was as natural as any other element of life. Being the youngest, he had seen his father come home drunk every night from work. The mother was no exception to the problem of alcohol abuse as well, although she was a light drinker and thus preferred to have her drinks during the weekends and occasionally after meals during the week. From as early as the age of eight, Martin was forced to accept the fact that alcohol was inseparable to his family. Evidently, his father had gone a step further to ensure that the family shelf was adequately stocked with his favorite whisky brands. As it was expected, the mother also had a similar stock of her spirit and whisky brands an aspect that consumed a significant proportion of the family finances. It was not uncommon for the utility bills to be accumulated at the expense of ensuring a steady supply of alcohol in within the family.

Just as it was the case with his immediate elder brothers, Martin was introduced to drinking by his elder brother. In particular, this was occasioned as a way of enabling them to cope with the constant physical abuse from the father whenever he came home late in the evening. Resigned to the fact that nothing would be remedied, his mother opted to take up drinking to save the family as well as try to get close to their father with the view of keeping peace in the family. She did not have a steady job which further complicated things. In this way, everyone in the family had to contend with the violence from the family head. A couple of years later, the parents were able to undergo the recovery process, albeit with a lot of challenges. One year later, his two brothers followed the parents example, although they had not yet fully recovered from the same problem. With a background of six years in drinking all the way from high school and now in a business school, Martin is in a desperate need for help with regard to quitting alcoholism. Faced with the risk of losing focus in his studies, Martin finally came to the realization that perhaps it was time he quit taking alcohol which had become a part of his life for quite a long time. With the help of his brothers, Martin gathered the courage to come to our centre for assistance out of alcohol addiction.

Theory of Addiction
From the above case study, it is evident that that Martins case best fits within the family system theoretical perspective. The family system model with respect to addiction is founded on the premise that development of alcoholism is greatly dependant on family interaction. This is a socio-cultural model that carries with it an intricate interconnectivity between personal, genetic, environmental as well as other closely related factors. According to Bennett and Wolin (1990), the family system model recognizes the fundamental fact that persons within a given family can best be understood as an integral component of their respective families. In this way, emphasis is usually put on the need to consider individuals to be part of the larger family but not in isolation. In the context of alcohol or substance abuse, this family systems model centers on the way family members behave with regards to drinking.

In this way, the role played by the spouse or origin of the family as it has been put forward by OFarrell and Fals-Stewart (1998). One of the fundamental assumptions of the family system model is that alcohol use normally takes centre-stage within the family. In particular, this is used by the family members as an effective way of promoting relationship amongst members. Therefore, this results to alcohol being elevated into becoming the primary facilitator of interactions within and without the family. Based on this model, the cost benefit analysis in terms of any problem within the family is usually looked at from the standpoint of being too costly or more demanding. Thus, the family becomes resigned to use alcohol as a means of maintaining the status quo within the family as well overcome family problems. A closer look at Martins family reveals that alcohol had become a source of maintaining the equilibrium within the family and thus the cost of addressing the problem of lack of stability and physical abuse to the children was too great to be born.

Martins parents in this regard were of the viewpoint that addressing such challenges would require more effort in comparison to alcohol related problems. Probably this is due to the notion that alcoholism within this family would not be tackled other than through the use of more and more alcohol. By so doing, everyone within this family would be in a comfort zone and thereby being able to avoid facing more disturbing problems facing such family. The other model that describes the above stated case study is the behavioral theory. In principle, this model pays special attention to the behaviors of individual members within a given family, especially the parents. Behaviors of family members are in this regard perceived to be the ones to reinforce and antecedents addiction to alcohol as well as substance abuse by other family members. It is believed that these responses provide the ideal platform and environment towards the development and maintenance of alcoholism within the family. According to Bennett and Wolin, (1990), there is a positive correlation between increase in alcoholism rates among off springs and interaction with their alcoholic parents. From this case study, it is clear that Martins addiction was given the much needed impetus by his parents continued dependency on alcoholism. His brothers on the other hand reinforced this when they attempted to fill the vacuum that had been left by their parents.

One of the tenets of behavioral model with regards to alcoholism is that consumption of alcohol or any other substance is usually learned. Upon learning, it is then maintained through operant or classical conditioning. Classical conditioning in this case is based on the principle that learning or development of the drinking behavior by an individual is subject to repeated pairings. These pairings include conditioned stimulus for instance a given person and unconditioned stimulus, for example a given time or location. The presence of alcohol can not be ignored in this regard. The exposure to repeated pairings usually leads to the development of conditioned stimulus and thereby resulting to the development of drinking behavior. The behavioral model therefore argues that substance abuse by an individual is normally learned.  Secondly, this model advances the view that the use of substances is in fact maintained by conditioning mechanism. The initial development as well as maintenance of alcoholic craving is caused by antecedent stimulus as response mechanism.

From the above case study, it is indeed justifiable to state that alcoholism within this family was initiated and perpetuated by the parents although his older brothers played an important role towards creating antecedent stimulus. Alcoholism within this family was also reinforced by the apparent lack of stability and control from the parents since it they paid attention on meeting the bare minimum requirements in order to keep the family together. This served to provide a reinforcing effect against the antecedent stimulus as every one within this family used alcohol as a means of getting relieved from anger or physical pain. Hence, drinking is most likely to increase due to the perceived hope of getting positive effects of alcohol or lessening negative reinforcing effect of alcohol. According to the behavioral family theory, it is thought that families that engage in rituals for example, celebrating holidays with all members, having dinner together, help to protect their children from being drawn into alcoholism. Of importance to note is the fact that the behavior of family members especially parents or older siblings are very critical towards ensuring that other members who may be alcoholic give serious consideration to changing. The conduct of family members may also help the alcoholic person to act towards change as well as maintain this change or perhaps relapse into drinking. Growing up in an alcoholic family, Martin was in doubt greatly influenced by the family members from the parents all through to his two older brothers.

At the same time, interacting with the same family members that have successfully gone through alcohol recovery program, Martin is definitely motivated to change. The possibility of maintaining the said change is high owing to the fact that all the family members had transformed from being alcoholics despite facing challenges as a result. Therefore the family would act as support mechanism for his successful recovery since he would be able to relate to any one in the event of any challenges thereafter. However, this theoretical perspective does not explain the role that is played by personality as far as alcoholism is concerned. Growing around alcoholic people would not influence any one to be an alcoholic in the event that ones personality did not appreciate consumption of alcohol. Behavioral influence is also dependent on the personality of would- be alcoholic upon which his or her personal ideals are usually founded. Furthermore, this model does not give an explanation of how the father was initiated into alcoholism considering the fact that he was initiated into alcoholism at a much later stage in his life. In this regard, environmental factors are ignored although they have significant influence in the ultimate development of alcoholism. In the overall, the above theoretical perspectives are founded on the social learning constructs since it is facilitated by interaction.

Treatment
Within the medical fraternity, there is the general consensus concerning the fact that there is no known medical cure for alcoholism. Recent developments from the scientific community have only managed to come with medications that serve the purpose of reducing an individuals craving for alcohol. By so doing, they greatly benefit the affected person since they help to reduce the risk of dependency or facilitate alcohol dependency recovery process. From the above case study, it is evident that individuals develop addiction due to social learning. In particular, this is usually facilitated by interaction amongst the family members as well as the expected benefits. In this way, persons become initiated and maintained into alcoholism by repeated pairings and conditioning. From the above case study, the most appropriate method of dealing with Martins problem is through the use stages of development approach. Though it was recently developed, this trans-theoretical approach as it is commonly known emphasizes on the role that is played by a client towards hisher successful recovery.

In a nutshell, it is the clients readiness to change that determines the efficacy of any treatment regimen that might be put in place. Understanding the readiness of an addict to change usually helps treatment providers to be able to overcome any potential or emerging barriers to the success of such treatment plan (Joseph, 2004). Also, it helps the client to anticipate relapse in addition to lowering both provider and client frustration with the overall treatment process. Improvement in the satisfaction by the client is the other benefit of this model of addressing alcohol dependency which in turn leads to a successful recovery program. Social learning and stages of change are interconnected by virtue of the fact that addition is usually as a result of social-cultural factors within the addicts environment. An individual usually considers changing and taking up drinking based on the expectancies that are in fact developed from observing the behavior of other people around him. This, together with personal experience from alcohol usually acts as a motivation towards drinking. It is worth noting that such decision is normally determined by the persons readiness to take up drinking. On the other hand, it is this readiness to change from being dependent on alcohol that forms the basis of recovery process and treatment regimen.

From the above stated case study, it is justifiable to state that the client is at contemplation stage of change. The said stage tends to be characterized by uncertainty, conflicted emotions and ambivalence. Just as it is the case with Martin, persons at this stage of change normally become aware of any risk that might be associated with such alcoholic behavior. This is usually informed on the fact that such persons become more aware of the expected or potential benefits of making such change in the first place (Joseph, 2004). Though Martin is desperate for change away from alcohol dependency, there is a high possibility that he is ambivalent about making this change since it shall amount to giving up his most enjoyed behavior. The mere prospect of giving such behavior creates a sense of feeling lost despite their awareness of the possible benefits of making such change in their drinking behavior. Addicts who are at this stage are also known to have difficulties in appreciating the perceived obstacles to the recovery and treatment for example, fear, hassle, time or expense.

Clients who are at this stage are able to benefit from the much needed professional help with respect to weighing merits and demerits of their behavioral change. Receiving the encouragement towards developing their confidence regarding them being able to change is the other help that individuals at this stage receive. Thirdly, addicts are able to get help towards the determination of the best way of overcoming any potential barriers or challenges towards their treatment and recovery. The fundamental questions that addicts at this stage are usually faced with are what is the primary reason for the change in the first place Are there challenges that would hinder this change process The third most important issue of concern is the identification of other things that would be of help towards making this change. Before an individual moves to this stage, they are usually under the pre-contemplation stage.

This stage of recovery is largely characterized by ignorance as well as denial of the problem by the addict. People who are at this stage do not even think about the need for them to change in the first place. To them, changing does not seem to be a feasible or palatable option as far as their behavior is concerned. Clients at this stage usually stand to benefit in terms of getting encouragement to take a critical look into their behaviors with the view of changing. Furthermore, clients are educated regarding the potential long and short term repercussions as well as risk that are associated with their behavior. Such addicts also get additional help towards enabling them to conduct self analysis with regard to development or addiction to alcoholism.