The Effectiveness of a Program Evaluation conducted at Lutherwood Residential Treatment Facility Aronta Bridges Martin University A Thesis Submitted

to the Faculty of the Community Psychology Graduate Program At Martin University in Partial Fulfillment of the Requirements for the Degree of Masters of Science Abstract Staff satisfaction surveys are designed to evaluate the employees satisfaction. This surveys can provide you with valuable insights to strengthen your organization in the areas where employees feel there are opportunities to improve. Benefits include increased employee retention, employee satisfaction and a reduction in turnover. There are several programs designed to treat child behavioral problems. One local program is Lutheran Child & Family Services also known as Lutherwood. Lutheran Child and Family Services of Indiana/Kentucky (LCFS) is a faith-based service organization dedicated to serving human needs through programs of compassionate care and counsel to enhance the dignity and quality of life. LCFS promotes positive healing relationships, making a commitment to deliver second to none services. The purpose of this current study is to examine staff satisfaction with services provided by Lutherwood. To provide context for the study, first a discussion of the mental health problems in children will be discussed. Next a discussion of treatment options for children, followed by a discussion of area residential treatment facilities. Finally, there will be a detailed discussion of Lutheran Child and Family Services of Indiana/Kentucky. Mental Health Problems The teen years can be tough for both parents and children. Adolescents are under stress to be liked, do well in school, get along with their family and make important life decisions. Most of these pressures are unavoidable and worrying about them is natural. But if a teen is feeling extremely sad, hopeless or worthless, these could be warning signs of a mental health problem. Mental health problems are real, painful and can be severe. They can lead to school failure, loss of friends, or family conflict. Many young people are at risk of mental health problems because of parental psychopathology. Schizophrenia, bipolar disorders, and depression in adult caretakers seem to be particularly debilitating to young people. This can have long-term effects. For example, depressed teenagers growing up with depressed parents, especially depressed mothers, tend to have more frequent and severe depressive episodes as young adults than those with mentally healthy parents (Rohde, Lewinsohn, Klein, & Seeley, 2005). Lutherwood Treatment Center specializes in adolescents that have been diagnosed with Attention Deficit/Hyperactivity Disorder, Conduct Disorder, Bipolar Disorder, Borderline Personality Disorder, and Oppositional Defiant Disorder. Because of this, these disorders will be discussed in detail. The terms attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) are used in the United States. The official term in the United Kingdom is hyperkinetic disorder. These differences in terminology can sometimes cause confusion. In both instances, these children usually have problems with attention control and being over active (Mental health matters, 2005). Attention Deficit/Hyperactivity Disorder often exhibits hyperactive an impulsive behavior that may be disruptive. Children with ADHD disorder are restless, fidgety and overactive. They continuously chatter and interrupt people. They are easily distracted and do not finish things. ADHD adolescents also are inattentive and cannot concentrate on tasks, they are impulsive, do things suddenly without thinking first. This type or behavior is common in most children. It becomes a problem when these characteristics are exaggerated, compared to other children of the same age, and when the behavior affects the childs social and school life. It is not known exactly what causes this disorder but genetic factors seem to play a part. ADHD disorder can run in families, with boys more often than girls (Mental health matters, 2005). Conduct Disorder is the most serious childhood psychiatric disorder, and it is the hardest disorder to live with as a sibling or parent. This disorder is a repetitive and persistent pattern of behavior in children and adolescents in which the rights of others or basic social rules are violated. The child or adolescent usually exhibits these behaviors patterns in a variety of settings at home, at school, and in social situations and they cause significant impairment in his or her social, academic, and family functioning. A child with this disorder often bullies, threatens, or intimidates others. Often initiates physical fights, has or will use a weapon that can cause serious physical harm to others (American Psychiatric Association, 2000, p. 99). Conduct Disorder is more common amongst boys than girls. Approximately 6% - 10% of boys and 2% - 9% of girls have this disorder. According to Scott P. Sells, girls with Conduct Disorder are six times more likely to abuse drugs or alcohol. Eight times more likely to smoke cigarettes daily. Two times more likely to have sexually transmitted diseases. Three times more likely to become pregnant and have twice the number of sexual partners when compared to girls without Conduct Disorders. Bipolar disorder is a psychiatric condition defined as recurrent episodes of significant disturbance in mood. These disturbances can occur on a spectrum that ranges from debilitating depression to unbridled mania. Individuals suffering from bipolar disorder typically experience fluid states of mania, hypomania or what is referred to as a mixed states in conjunction with depressive episodes (Wikipedia, 2007). The cause of bipolar is not completely understood, but the disorder runs in families and may also be affected by your living environment or family situation. An imbalance of chemicals in the brain is another possible cause. During the manic episode, persons with this condition may be abnormally happy, energetic, or irritable for a week or more. They may spend a lot of money, get involved in dangerous activities and sleep very little. After a manic episode, they may return to normal, but their mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness. When they are depressed, they may have trouble concentrating, remembering, and making decisions. They may also have changes in their eating and sleeping habits and lose interest in things they once enjoyed. The mood changes of bipolar disorder can be mild or extreme. They may develop gradually over several days or weeks, or come on suddenly within minutes or hours. The manic or depressive episodes many only last a few hours or for several months. Approximately10%-15% of adolescents with recurrent Major Depressive Episodes will go on to develop Bipolar I Disorder (American Psychiatric Association, 2000, p. 385). The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self image, and affects, and marked impulsivity. Individuals with Borderline Personality Disorder make frantic efforts to avoid real or imagined abandonment. Borderline adolescents can often be bright and intelligent, and appear warm, friendly and competent. They sometimes can maintain this appearance for a number of years until their defense structure crumbles, usually around a stressful situation like the breakup of a romantic relationship or the death of a loved one (American Psychiatric Association, 2000, p. 706). Borderline is a common disorder with estimates running as high as 10-14% of the general population. The frequency in females is two to three times

greater than in males. This may be related to genetic or hormonal influences. An association between this disorder and severe cases of premenstrual tension has been postulated. Females commonly suffer from depression more often than males (Corelli, 2006). Oppositional Defiant Disorder is a recurrent pattern of negativity, defiant, disobedient, and hostile behavior toward authority figures that persists for at least six months and is characterized by the frequent occurrence of at least four of the following behaviors: losing temper, arguing with adults, actively defying or refusing to comply with the requests or rules of adults, deliberately doing things that will annoy other people (American Psychiatric Association, 2000, p. 100). Children with this disorder show their negative and defiant behaviors by being persistently stubborn and resisting directions. They may be unwilling to compromise, give in, or negotiate with adults. Patients may deliberately or persistently test limits, ignore orders, argue, and fail to accept blame for misdeeds. Hostility is directed at adults or peers and is shown by verbal aggression or deliberately annoying others (American Psychiatric Association, 2000, p. 100). Oppositional defiant disorder is more common in boys than girls before puberty; the disorder typically begins by age eight. After puberty the male: female ratio is about 1:1. Although the specific causes of the disorder are unknown, parents who are overly concerned with power and control may cause an eruption to occur. Symptoms often appear at home, but over time may appear in to her settings as well. Usually the disorder occurs gradually over months or years (American Psychiatric Association, 2000, p. 101). This disorder appears to be more common in families where at least one parent has a history of mood disorder, conduct disorder, attention deficit/hyperactivity disorder, antisocial personality disorder, or a substance-related disorder. Additionally, some studies suggest that mothers with a depressive disorder are more likely to have children with oppositional behavior. However, it is unclear to what extent the mothers depression results from or causes oppositional behavior in children. ODD usually does not occur alone. According to Dr. Anthony Kane, 50-60% of ODD children also have ADD ADHD. 35% of these children develop some form of affective disorder. 20% have some form of mood disorder, such as Bipolar Disorder or anxiety. 15% develop some form or personality disorder (Kane, 2004). Area Residential Treatment Facilities There are several area facilities designed to treat adolescents with mental health problems Options Treatment Center is one such facility. OTC is a 80- bed comprehensive residential program designed for the treatment of children and adolescents 8 to 18, with mental retardation developmental disabilities and co-concurring mental illness. This program provides support and treatment in a highly structured 24-hour environment. Each resident is provided an individual treatment plan, based upon assessment of need, which supports the child in reaching their person directed future plans. The therapeutic atmosphere of support, structure, inclusion, therapy, and encouragement based upon each residents needs is the fundamental source of treatment. The child best served in this program is a child who has displayed deficiencies in a adaptive behaviors, such as emotional, sexual, behavioral, or adjustment problems. This is a child who would be at risk of either self harm or harming others if not provided with a 24-hour structured and secure environment. In many instances, the child in this program would have been adjudicated for maladaptive social behaviors if not provided treatment within the program setting. Children who are appropriate for this program often display several inappropriate social skills and are receiving or are in need of psychiatric services as well (Options Treatment Center, 2007). Another area facility is Muncie Reception & Diagnostic Center. This facility is located in Muncie, Indiana. It provides regimented and structured detention, as well as diagnostic services. The services are available for males and females, regardless of age. The mission of the Muncie facility is to provide services to counties and their children that is of the highest quality of care, supervision, security, diagnostic testing, programming, education and direct services in a detention environment (Muncie Reception & Diagnostic Center, 2006). Next, there is The Kokomo Academy. This is a residential treatment facility for troubled adolescents between the ages of 11 to 18. It is located in Kokomo Indiana. The Academy accepts youth from each county in Indiana, as well as from surrounding states. The Academy strives to maximize the potential of each youth by providing for their safety, education and emotional well being. Their mission is accomplished when all steps have been taken to ensure a successful and permanent and permanent transition home, and the youth becomes a positive contributing member to his family and community. An integral focus for each youth is behavior modification, which is channeled through a Level Program (Kokomo Academy, 2006). There is also the Ladoga Academy which is a residential treatment facility for troubled female adolescents between the ages of 10 to 18. It is located in Ladoga, Indiana. The Ladoga Academy accepts youth from each country in Indiana, as well as surrounding states. Services and programs are delivered with the singular goal of providing youth, upon their discharge, with the greatest possible chance of leading a successful life, upon which their contributions to themselves, their families and their communities are both positive and numerous (Ladoga Academy, 2006). Resource Treatment Center was founded in 1997 to provide quality treatment programs for youth aged 8 - 20 who have experienced a variety of emotional and behavioral challenges. Since joining the child welfare juvenile justice provider community in Indiana, the cornerstone of Resources growth has been a proactive response to community needs as identified by those that are served. Programs at Resource Treatment Center are designed to meet the needs of males and females with special emphasis on maladaptive behaviors, including inappropriate conduct and oppositional defiance, impulsivity, attention deficit, parent/child conflicts, mood disorders, and sexual reactivity (Resource Treatment Center, 2006). Such programs include, inpatient residential treatment for male and female children with extensive mental health and legal histories who require an intensive therapeutic milieu. Inpatient residential treatment for male and female children early in their involvement with the juvenile justice system, who are in need of a time-limited, structured setting where presenting issues may be addressed so the likelihood of further exposure to the system may be prevented. Lastly Resource offers a program of inpatient residential services for males and females remanded to the Department of Correction who can benefit from case management and therapeutic intervention to address their criminally maladaptive behaviors in lieu of incarceration in a more restrictive correctional facility (Resource Treatment Center, 2006). Lutherwood Lutheran Child and Family Services of Indiana/Kentucky also known as Lutherwood is another treatment facility that is the focus of this study. The program was started in 1883, by a small group of German Lutherans. Their purpose was to offer care and counsel for children and families. Their mission statement is as follows, In response to Gods love and grace in Jesus Christ, Lutheran Child and Family Services of Indiana/Kentucky serves human needs with the church and the community by providing programs of compassionate care and counsel to enhance dignity and quality of life ( Lutherwood Residential Treatment Center, 2007).

The program is ran by an Executive Director, Michael Johnson. There are approximately 50 youth care specialist staff that are paid employees. To obtain employment at Lutherwood, one must have at least 2 years of relevant experience, Bachelors degree or HSD/GED. They also must be 21 years of age with a valid drivers license. They must be able to pass a physical, a drug screen, and a criminal history check. Potential staff also receive training in a two week orientation, first aid, CPR, and therapeutic crisis intervention physical restraint training. The specific services provided by Lutherwood are Adoption, Foster Care Services, Therapeutic Foster Care, Counseling, Family Preservation, Mentoring, Independent Living, Sharing Place Ministries, and Residential Treatment Facility. These programs have served thousands of families and is currently serving hundreds of families. The clients range from age six years old to 21 years old. There are per diems for the residential services, the other services are billed through Medicare/Medicaid. There is no specific deadline for when services are completed. The referrals sources range from private to the board of education. Lutherwood is a residential treatment center for children who are recovering from the effects of abuse, neglect, and or abandonment. Boys and girls age six thru 21 who are experiencing chronic behavior and or emotional problems and or with a history of hurting themselves or others are eligible for admission to Lutherwood. Most have problems at home or at school and have failed hospitalizations or other less restrictive programs. They are suffering the effects of physical, emotional, and or sexual abuse and may exhibit symptoms of psychiatric disorders. Lutherwood is licensed to care for up to 73 children. Youth with a minimum IQ of 65 are eligible for placement through referral from juvenile courts, mental health centers, the DAWN Project, or similar social service agencies as well as through private placement by hospitals or individuals. Youth whose IQ are lower than 65 are considered on a individual basis. A per diem rate for the open or secure units covers the cost of: room & board, weekly allowance, daily sessions with youth counselors, spiritual growth activities (optional), 24 hour supervision, behavior management/therapy, recreational therapy, and aftercare. Lutherwood clients are able to access Medicare/Medicaid Rehab Option through collaboration with Community Health Network, which also provides psychiatric supervision, staffing, and therapy services. The per diem rate does not include intensive treatment services, psychiatric consultations, case management, and individual, group, or family therapy that is provided in collaboration with Gallahue Mental Health Network of Indianapolis. Individual treatment plans are created for each resident according to their needs and the specific emotional issues they must address. Reunification with the family and or the community is a goal established for each and every child. Each childs care team includes a psychiatrist, clinical director, clinical program manager, psychiatric nurse manager, education specialist, and a youth counselor. The facility offers a continuum of residential care settings and levels of treatment to provide greater flexibility in meeting the needs of the children. It also facilitates on campus step down care in an efficient and clinically effective manner. Depending on the severity of the childs problems, the danger presented to him or the community, and the level of family involvement, the child is assigned to a secure unit, an open unit or the family & community program. In collaboration with Indianapolis Public Schools, certified special education teachers provide remedial education in several on site classrooms with a full day, complete curriculum for grades K-12. Their goal is to prepare students for public school placement. Up to 20 students from IPS also attend Lutherwoods therapeutic day school. Children enrolled in this program still live at home, but are at risk of being removed because of behavior problems. Typically, these children have a diagnosis of mental illness. In addition to following a normal IPS curriculum, each child receives one hour of individual therapy and one hour of group therapy each week that is provided by therapists from Gallahue Mental Health Centers family preservation program. A caseworker is also assigned to each childs family to help them access community resources (LCFS 2007). Lutherwood also offers a good benefit package to its employees. During the first year of employment, each full time hourly staff member will accrue personal leave time at the rate of 12 personal leave days per year (accrued at 3.69 hours each pay period). During the second year of employment, personal leave time will accrue at the rate of 15 personal leave days per year (4.61 hours each pay period). During the third and fourth years of employment, personal leave time will accrue at a rate of 18 personal leave days per year (5.53 hours each pay period). During the fifth and subsequent years of employment, personal leave time will accrue at the rate of 20 personal leave days per year (6.15 hours each pay period). Each full time salaried employee, beginning the first year, will accrue personal time at the rate of 22 personal leave days per year (6.77 hours for each pay period). Each part time staff member will accrue personal leave time on a pro rata basis in proportion to the full time accrual listed above. Lutherwood also offers Personal Leave Time, Family and Medical Leave, Short Term Disability Leave, Funeral Leave, Jury Duty Leave, Military Leave, Conventions, Workshops and Conference Leaves, to their employees. A tuition reimbursement program is available to full tine employees and part time benefits eligible employees who have completed at least six consecutive months of service at Lutherwood and who have received a minimum performance rating of Satisfactory on their last evaluation. The funds are made available on a first come first serve basis. Reimbursement may be made for up to six (6) credit hours per semester. A grade of C or better must be earned. Lutherwood offers a group health insurance program for its eligible employees and pays a portion of the cost of an employees coverage under the plan. Emoloyees may also elect to cover their spouses and other eligible dependents under the plan at their own expense. Lutherwood offers a group dental and a group vision insurance program for its eligible employees and pays a portion of the cost of an employees coverage under these plans. You may also elect to cover your spouse and other eligible dependents under these plans at your expense. Lutherwood provides and pays the cost of one times annual salary for eligible employees. Eligible employees may also increase their coverage to two or three times salary, if approved by the carrier, at an additional cost. Group Short-term disability income protection is available to eligible staff. Generally, the cost of this coverage is paid by the employee. Staff completing one year of employment may elect one of three levels of Long Term Disability at the next open enrollment. Lutherwood provides and pays for the cost of the initial coverage level. All employees (whether or not they have completed the trial period) are eligible to receive counseling services at the St. Vincent Stress Center adjacent to the St. Vincent Hospital at 1717 West 86th Street, Suite 130, Indianapolis, Indiana. Supervisors, individual employees, and their immediate family members can schedule up to seven free one hour counseling sessions per treatment episode by phoning the Stress Center at (317) 338-4900 and identifying their association with Lutherwood. Counselors are available to help in coping with such problems as divorce, alcohol, or chemical dependency, legal problems, marital difficulties, illness, sexual problems, family crises, school problems, money management, etc.

Lutherwood also offers a Tax Deferred Annuity, Retirement Plan, Workers Compensation Insurance, Unemployment Compensation Insurance, Credit Union, Employee Recognition Program and free Employee Meals (Lutherwood hand book 2006). Participants A total of fifty employees from Lutherwood Residential Treatment Facility will participate in the study. The participants have various levels of work experience ranging from high school graduates to Master degrees. Measures Participants will complete a 26-item questionnaire (22- closed ended questions and 4- open ended questions) assessing employee satisfactory and employees perception of job performance. The questions have been designed by the investigator to solicit the opinion of the employee on their level of employment satisfaction and what effects it may have on the retention aspects of the facility. There will also be questions related to communication and working relationships. The reliability and validity of the questionnaire is unknown. A copy of the questionnaire is in Appendix A. Procedure The investigator will request employees to participate in the survey and gather appropriate consent forms from the employees being surveyed. The employees will be advised of the process, risks, and benefits of completing the survey. The participants will be advised of their rights if they choose not to participate in the survey, (there will be no further questioning or repercussions.) The consent forms will be distributed, read, and signed before the participants receive the survey. The surveys will be handed to each individual face-to-face and collected back by the investigator. The participants will be given instructions on how to complete the surveys. Participants will be given one week to complete the questionnaire. The questionnaire will be completed in the privacy of the participants own space. The investigator will obtain completed questionnaires personally in a central location that will provide from anonymous retrieval. References ADHA and Hyperkinetic Disorder. 2005, Retrieved August 19, 2007 from http://www.mental-health-matters.com/articles/article.php?artID=917 American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association, 2000. Atkinson, D. R., (2004) Counseling American Minorities. New York, NY: McGraw-Hill. Kane, A. (2004) Helping You Deal With ODD. Retrieved August 20, 2007 from http://addadhdadvances.com/odd.html Kokomo Academy. 2006. Retrieved July 30, 2007 from http://wwwcorrectionalmgmtco.com/kokomo.html. Ladogo Academy. 2006. Retrieved July 30, 2007 from http:www.correctionalmgmtco.com/ladoga.html. Lutheran Child & Family Services of Indiana/Kentucky, INC.2002. Retrieved June 3,2007 from http://www.lutheranfamily.org/lutherwood.html. Lutherwood Residential Treatment Center For Youth Hand Book McWhirter, J. J., (2004). At Risk Youth. Belmont, CA: Thomson Higher Education. Muncie Reception & Diagnostic Center. 2006. Retrieved July 30, 2007 from http://www.correctionalmgmtco.eom.muncie.html. Options Treatment Center. 2007. Retrieved August 2, 2007 from http://www.yfcs.com/facilities/options/index.html Resource Treatment Center. 2006. Retrieved July 30, 2007 from http://www.yfcs.com/facilities/resource/idex/index.html. Rohde, P., Lewinsohn, P. M., Klein, D.N., & Seeley, J.R.(2005). Association of parental depression with psychiatric course from adolescence to young adulthood among formerly depressed individuals. Journal of Abnormal Psychology, 114, 409-420. Sells, S. P., (2002). Parenting Your Out of Control Teenager. New York, NY: McGraw-Hill. Takeuchi, D. T., & Cheug, M. (1998). Coercive and voluntary referrals: How ethnic minority adults get into mental health treatment. Ethnicity and Health, 3, 149-158. Appendix A Please answer and circle your best response the questions listed below. Gender: male or female Position: __________________________________________________ Length of employment: ______________________________________ 1. I have readily access to the information I need to perform my job Strongly Agree Agree Undecided Disagree 2. I have received adequate training for my job Strongly Agree Agree Undecided 3. I am paid accordingly to my skill level Strongly Agree Agree Undecided 4. I feel secure in my current position Disagree Strongly Disagree

Strongly Disagree

Disagree

Strongly Disagree

Strongly Agree Agree Undecided Disagree Strongly Disagree 5. Changes are communicated effectively by the agency Strongly Agree Agree Undecided Disagree 6. There is consistent and fair treatment of employees Strongly Disagree

Strongly Agree Agree Undecided Disagree Strongly Disagree 7. I am provided adequate feedback on my work performance Strongly Agree Agree Undecided Disagree 8. I would recommend others to work for this company Strongly Disagree

Strongly Agree Agree Undecided Disagree Strongly Disagree 9. I would leave my current job tomorrow if a better opportunity was available Strongly Agree Agree Undecided Disagree Strongly Disagree 10. I am satisfied with the Executive Director. If you disagree, please explain why Strongly Agree Agree Undecided Disagree Strongly Disagree ____________________________________________________________ ____________________________________________________________ ____________________________________ ____________________________________________________________ __________________ 11. I am satisfied with my coworkers. If you disagree, please explain why Strongly Agree Agree Undecided Disagree Strongly Disagree ____________________________________________________________ ____________________________________________________________ ____________________________________ ____________________________________________________________ __________________ 12. I am satisfied with my Shift Supervisor. If you disagree, please explain why Strongly Agree Agree Undecided Disagree Strongly Disagree ____________________________________________________________ ____________________________________________________________ ____________________________________ ____________________________________________________________ __________________ 13. I am satisfied with the agency. If you disagree, please explain why Strongly Agree Agree Undecided Disagree Strongly Disagree ____________________________________________________________ ____________________________________________________________ ____________________________________ ____________________________________________________________ __________________ 14. I am satisfied in my current position. If you disagree, please explain why Strongly Agree Agree Undecided Disagree Strongly Disagree ____________________________________________________________ __________________ ____________________________________________________________ ____________________________________________________________ ____________________________________ 15. Management has created an open and comfortable work environment Strongly Agree Agree Undecided Disagree 16. I feel supported by my immediate supervisor Strongly Agree Agree Undecided Disagree 17. My Supervisor recognizes my work efforts Strongly Disagree

Strongly Disagree

Strongly Agree Agree Undecided Disagree Strongly Disagree 18. I am involved in the decisions making regarding my job Strongly Agree Agree Undecided Disagree Strongly Disagree

19. Management recognizes and makes use of my abilities and skills Strongly Agree Agree Undecided Disagree Strongly Disagree

20. There is opportunity for growth within my agency Strongly Agree Agree Undecided Disagree Strongly Disagree

21. My agency supports my growth Strongly Agree Agree Undecided Disagree Strongly Disagree

22. There opportunity to receive professional training outside of Lutherwood?

Strongly Agree

Agree

Undecided

Disagree

Strongly Disagree

23. Do you consider this agency to have high turnovers? If so, what would you suggest to reduce the turn-over rate?

24. Identify the two most important things on your job that satisfy you? ____________________________________________________________ __________________ ____________________________________________________________ __________________ ____________________________________________________________ __________________ 25. Identify the two most important things on your job that dissatisfies you? ____________________________________________________________ __________________ ____________________________________________________________ __________________ ____________________________________________________________ __________________ 26. What would you like to see changed her at Lutherwood? ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ______________________________________________________

Lifestyles of human beings significantly influence their health. People make decisions everyday that will impact them either negatively or positively. Decisions that are made can also have an influence on the environment surrounding the individual. It is society, as a whole, that has the responsibility of mediating its decisions to ensure the health and posterity of mankind. We must take the time and effort to educate ourselves on the behaviors or actions that cause harm to the human race. In todays society, the practice of homosexuality and same-sex marriage among Americans negatively affects both the individual and his surrounding environment; young people need to be educated. Homosexual tendencies can come from a variety of factors. There is no proof; however, of homosexuality being a result of a gene, or DNA alteration. (Satinover) Instead, it is a result of the type of influence during the development stages of life. Homosexual tendencies can be results of a childhood background of effeminate parental roles; the child has absence of a father figure. If the child is treated as if he has a sexual orientation different from his true one, this has also shown to lead to homosexual practices. For example, if a mother wishes to have a female child, and forces that upon her son during his maturation process, this will naturally cause more effeminate characteristics in that child. He will pattern himself after effeminate things in his future. (Aardweg 33-34) Dr. Gerard J.M. Van Den Aardweg, author of The Battle for Normality says this, The improbability of a causative or predisposing sexual gene arises from two facts: (I) there is no pattern of Mendelian inheritance in families of homosexuals, and (II) results of studies with twins are more in line with environmental studies than genetic explanations. Michelle Howell, former committed lesbian, said this, In hindsight, I know that it was a choice I made. It was not in my genes, it was in my mind. Infantilism is a mental disorder that is found in a lot of homosexuals and lesbians. Infantilism is the problem of emotionally remaining teenagers in all areas of behavior. The homosexual or lesbian remains in the frame of mind of a child, continuing to suffer from the obstacles they suffered as an adolescent; obstacles that typical children get past as they enter adulthood. The maturity level is often never fully developed as they enter into adulthood. Many consequences are corollary to this. The individual suffers from self pity, self-consciousness, trouble being accepted, shyness, clinging to others, feelings of rejection, weak, small, inferior, and unloved. (Aardweg 65) Infantilism also affects the homosexuals relationships. The homosexual tends to seek acceptance for himself first. Relationships tend to be more selfish, in an attempt to make the individual feel loved, instead of focusing on loving his or her partner. This self-centeredness leads to the inability to serve and give, the inability to be responsibility for someone else, and ultimately the inability to love unconditionally. The childlike, egotistical mindset deeply hurts the homosexual as he or she tries to go through life. Furthermore, his inability to rationalize his own faults makes him unaware and oblivious, so that he in unable to improve his weaknesses. (Aardweg 65-67) Let us point out that this is not simply a common characteristic found in homosexuals, but rather a mental disorder that has been linked to the practice of homosexuality. The difference is, that without it officially being declared in the medical field as a mental disorder, than these observations are based solely on ones opinion on how homosexuals tend to act. Studies and surveys also show us other negative affects the practice of homosexuality has on an individual. In the year 2000, The Journal of Consulting and Clinical Psychology sent out surveys to over two thousand homosexuals and lesbians. Two years later they conducted studies on over a thousand homosexuals and lesbians. Other surveys came from The Journal of Social Science Research and The Journal of Epidemiology. The theme of self-pity and depression is reoccurring in many of these surveys. Out of the two thousand, seventy five percent said that they had pursued some form of physiological treatment for long-term depress and/or sadness. Twenty five percent had thoughts of suicide either sometimes or often. In two surveys, eighteen percent said they actually attempted suicide at least once. Thirty three percent said they felt depressed. The Journal of Social Science Research says that men with same sex partners are five times more likely to commit suicide. (Daily) Another study shows says that lesbian or bisexual women are significantly more likely to have mental heath problems. (OLeary) Studies show that homosexual relationships are characterized with instability and promiscuity. All surveys show the pattern of the majority of homosexuals being with hundreds of partners in a lifetime. One result of that can be the fact that homosexuals have a high prevalence for mental health problems. In the study done by the Journal of Epidemiology, it was shown that homosexuals who are active sexually have a shorter life expectancy than heterosexuals that are sexually active. (Daily) There was a similarity in high amounts of abuse in homosexual relationships. Fifty percent of lesbian couples admitted to receiving verbal, emotional, or verbal abuse from their partner. In another study, thirty percent said that they had been physically abused, and thirty two percent said they had been raped or sexually attacked. The environment in the home proves to be a factor in the development of homosexuality as one out of every five homosexuals admitted to being involved in incestuous relationships while growing up. (Daily) Other interesting results from the surveys done by the Journal of Consulting and Clinical Psychology; Thirty three percent said they used tobacco on a daily basis. Thirty percent drank alcohol once a week. (Six percent drank daily) Twenty percent admitted to smoking marijuana more than twice a month. Fifty percent said they felt nervous and uncomfortable about accomplishing ordinary activities due to their sexual orientations. Even when a homosexual knows that they carry HIV, thirty six percent of those surveyed said they refused to disclose their disease at the time. (Daily) All of these numbers are primary source facts given to us by homosexuals themselves. There is no argument that homosexuality does not produce a

number of negative effects on the individual practicing it. Most of the consequences are very serious and should not be looked over. I believe this information is not available to most young men who are battling with their own sexuality. It is societys responsibility to be aware of the problems that might harm the posterity of mankind, and we must work together, as a common race, to solve these problems compassionately and respectively. Besides the negative effect of homosexuality on the individual himself, there are also consequences involving society as a whole; the environment surrounding the individual and everyone he has contact with throughout life. The people we choose to be, and the decisions we make, create small but inevitable ripples in the course of history. The concept of the ripple effect is that it actually causes more damage to its surroundings than the perpetrator himself. The biblical principal says it the best, We reap what we sow. (Galatians 6:7-8) The compromises we make today, affect our kids tomorrow. There is no word more reliable than the Bible, so let us first consider the biblical examples of how homosexuality led to the breakdown of society. In Genesis chapters 18 and 19, the Lord has told Abraham He is going to destroy Sodom and Gomorrah, an entire city. Abraham pleads to save the city and asks God that if he can find just ten righteous people, then the city would be spared. As Lot goes back to the city, the sin that this city lives in is revealed. In Chapter 19:5, homosexuality is described and is the cause of an emergency escape by Lot and his family. We know that God was going to destroy the city because of the evil present, but the only sin specifically mentioned in the chapter is sexual immorality. Therefore this perversion led to a destruction of an entire town, which is a very unique and powerful act in the Bible. Romans 1:24-27 says, Therefore God gave them over in the sinful desires of their hearts to sexual impurity for the degrading of their bodies with one another. They exchanged the truth of God for a lie, and worshiped and served created things rather than the Creatorwho is forever praised. Amen. Because of this, God gave them over to shameful lusts. Even their women exchanged natural relations for unnatural ones. In the same way the men also abandoned natural relations with women and were inflamed with lust for one another. Men committed indecent acts with other men, and received in themselves the due penalty for their perversion. There is just no arguing with this scripture that homosexuality can be tolerated. There is no room for interpretation for what is actually wrong. Whether as group of people, or individually, we suffer the consequences when we fall into sin, as we read further in Romans Chapter 1, They have become filled with every kind of wickedness, evil, greed and depravity. They are full of envy, murder, strife, deceit and malice. They are gossips, slanderers, Godhaters, insolent, arrogant and boastful; they invent ways of doing evil; they disobey their parents; they are senseless, faithless, heartless, and ruthless. There is nothing more important than this. All other consequences are still earthly and temporal; the consequence of a life in sin is eternal. (Davies 21) However, such arguments can only convict Christians. From a worldly point of view, society is still harmed by the allowance of homosexuality and samesex marriage. Marriage is an ageless concept that has always been a part of our culture. Sam Schulman says, The essence of marriage is not love, fidelity, financial security or any other characteristic associated with marriage. Marriage venerates and guides the joining of men and women a joining that is the only connection capable of creating life. Without marriage, society would resort to a social order based on polygamy. (Burns 33) Marriage is the basic component of our human life. When marriage dissolves, we dont see freedom or happiness; we see destructive outcomes and disorder. Children need stable families in order to grow up and create stable families of their own. (Burns 27) Legislating same-sex marriage deprives children of a mother or a father. Studies show that fatherless children lead to an increase in poverty, crime, teen pregnancy, welfare dependency drug abuse, and mental/physical health problems. Children are defenseless; it is societys duty to defend the rights of a child. It is immoral to place a child in an environment where it cannot have the full opportunity to develop. There are numerous effects listed earlier based on surveys and studies to prove that bringing up a child in a homosexual environment is counterproductive to its health. Therefore same-sex unions cannot be legalized. Adults are not defenseless and can make rational decisions. It is selfish and morally wrong to think that adults have a right to pursue a lifestyle that will harm future human life. (Burns 27) Homosexualitys effect on a family cannot just be overlooked or ignored. Human reproduction is a huge stumbling block for the homosexuality movement. Although there are methods available to supply homosexuals with children, homosexuality itself gives no means of natural reproduction. Natural reproduction comes only from heterosexual relationships. We cannot possibly legalize something that does not contribute to the population of the human race. (Burns 26) Whether homosexuality is right or not, it cannot produce children, and it is societys obligation, as a majority, to benefit mankind. Human life is much more important than our own selfish desires. We must not uproot unfailing laws that protect many, just to compensate a few. Even a compromise is a failure in upholding our responsibility. That is what I believe is most dangerous about this topic. Accommodation is not a component of compassion; it is a component of weakness. Compromising your beliefs leads to rationalizing what you thought was wrong before. Rationalization leads to desensitization, and desensitization is a long and patient process that leads to the breakdown of morality. Look at the media for example, all it takes is time, and values slowly dissolve. The media is already turning homosexually into comedy, thus desensitizing viewers to the reality and danger of it. Therefore I think it is societys responsibility to begin education that portrays the facts we have about homosexuality to the next generation. Let us share what we have learned and warn the ones who come after us. Americans still have their own human rights, and they can ultimately do whatever they decide, but it is a duty to make them knowledgeable of the dangers, risks, and consequences of pursuing a homosexual life style. Even if it is just a brief discussion during heath class, I think it will greatly influence the number of people choosing to practice homosexuality. I think that if people actually knew the facts, they would be discouraged from such lifestyles. In conclusion, homosexuality is a very harmful lifestyle. There is no way to rationalize that; there is no way to deny that. It has lifelong consequences on both the individual himself, and the environment he is surrounded by. We as humans and we as Christians cannot look over this issue. It is not just an issue concerning homosexuals, but of all mankind. And it is societys job to make sure that the next generation is aware of these facts, so that they can decide for themselves what is right. I close with a final statement from Michelle Howell, Homosexuality is a terrible perversion that can ruin you from the inside out. But God is good, and he will be with you all the way through.