The Theory Underpinning One Intervention With A Dually Diagnosed Client Nursing Essay

The Theory Underpinning One Intervention With A Dually Diagnosed Client Nursing Essay Dual diagnosis has been described as one of the most significant problems facing the health services (Phillips et al 2010). The term was first used in America in the 1980s and in its most basic elements describes someone who has a combination of a mental illness and substance misuse problem. Dually diagnosed patients are often frequent users of emergency services and of in-patient care (Bartels et al 1993). There is also a much higher rate of offending and imprisonment amongst this group (Yesavage and Zarcone 1983 cited in Menezes et al (1996). Yesvage and Zarcone cited in Menezes (1996) believe that alcohol and drug misuse interact with the symptoms of psychotic illness to produce a more severe acute illness. Due to the complication of treatment approach recovery is often slower than a psychotic episode uncomplicated by substance abuse. This places a great burden on resources and staff (Drake et al 1993), which is corroborated by the London survey (Menezes et al 1996) discovering on average that this group of patients spends almost twice as much time in hospital than those without a substance misuse problem. Clients with the most severe psychiatric disorders tend to have the highest rates of co-occurring substance use disorders (Drake 2007). It has been well documented that the co-existence of severe mental health and substance misuse problems are common (Regier et al 1990; Krausz et al 1996; Menezes et al 1996 cited in Graham 2003). Prevalence figures vary across studies however the latest study by Weldon and Ritchie (2010) estimate the lifetime prevalence rate of substance abuse amongst persons with severe mental illness at 50%, which is 4.6 times higher than that of the general population (Blanchard et al 2000). One of the challenges of mental health providers is how best to meet the needs of this group of clients (Graham 2003). The most recent government guidance is one of integrated treatment whereby the treatment for drug and alcohol problems are provided primarily within mental health services, integrating this with the treatment of mental health problems (DoH 2002). This is to be provided by one team and involves a flexible combination of treatments targeting the specific needs of those diagnosed with co-morbid severe mental illness and substance misuse (Horsfall 2009). Researchers and clinicians have developed a number of interventions that combine, or integrate mental health and substance abuse interventions (Drake et al 2007). An example of one element of integrated treatment is Cognitive- Behavioural Integrated Treatment (Graham and Carnwath 2004). C-bit incorporates an integrated approach with personalised formulation to deliver improved treatment outcomes to dual diagnosis patients. The focus of this essay will be on the use of C-bit (Graham and Carnwath 2004) and its application with a client who has been has been diagnosed with schizophrenia and alcohol problems. For the purpose of this essay and confidentiality his name has been changed to David. C-bit can be split into 4 distinct phases, Engagement and Building motivation, Negotiating some behaviour change, Early relapse prevention Relapse management. The essay will concentrate on negotiating behavioural change and what this entails. The author will then compare its effectiveness with an alternative approach. An introduction to C-Bit Hermine Graham (2004) describes C-bit as a psychological multi-purpose tool designed specifically for people with both a mental illness and a problematic substance misuse. It was developed from CBT which had a strong evidence base for mental health (Grant et al 2004) and substance use problems (Conrod and Stewart 2005). The evidence base of CBIT in dual diagnosis remains poor as studies have tended to focus on engagement and building motivation as appose to the maintenance of change that CBIT encompasses (Callaghan and Jones 2010). However early studies would suggest that the skilful use of analysis, disputing cognitions and homework assignments improve the skills required to promote abstinence including self-efficacy in finding, establishing and maintaining appropriate support networks (Rassool 2002). CBIT follows the cognitive model and treatment approach (Graham 1998, 2003). A clients beliefs about substance misuse are often linked to their own experience of mental health problems. David would often say in therapy that the side effects of his anti-psychotic medication made him feel over sedated and this had a knock on effect in social situations. He found that alcohol improved this and allowed him to integrate better in social situations. By continuing to use alcohol it was maintaining a negative maintenance cycle. Graham (2004) identifies three key aims of CBIT with dual diagnosis patients. The first concentrates on client and therapist identifying and challenging unrealistic beliefs about substance misuse and substituting them with alternatives that aim to break negative maintenance cycles. The second facilitates an understanding of the link between substance misuse and mental health problems and thirdly CBIT aims to give the client the ability to self-manage substance misuse and recognise the early signs of relapse. Although there are 4 distinct steps in treatment approach the flexibility of the treatment means a client does not need to progress through them all. The harm reduction philosophy that underpins the intervention (Heather et al 1993) puts more emphasis on a client setting more realistic goals and achieving these. Although flexibility is a key asset of CBIT it would be wrong to assume there was no structure to therapy sessions. In later sessions especially, before commencing a sess ion client and therapist must set an agenda to discuss which ensures key areas are discussed (Graham 2004). In practice, teams trained in the use of CBIT tend to use the general principle of the approach rather than the distinct components or techniques (Graham et al 2006). The author believes this shows the flexibility of the therapy and therapists and clients find what proves useful to them . Graham et al (2006) also discovered that when trained members of the team used various assets of CBIT, engagement increased, alcohol intake was reduced and a reduction in alcohol-related beliefs. The study however noticed similar findings when the client had been seen by teams that had not yet received CBIT training suggesting that CBIT alone was not responsible for the change in behaviour and belief. However, qualitative information recorded from the teams staff suggested that treatment integration increased over the course of the study, and that CBIT was a useful tool for integrating planning substance misuse treatment. Qualitative information from the team managers suggested that CBIT training i mproved the ability of teams to address substance use by themselves, rather than avoiding substance issues referring clients to specialists. Achievable Goal setting Following treatment phase one the client will be able to identify some of the negative effects of substance misuse. David could recognise the negative effect that alcohol use had on his ability to find any form of employment and how he had no real supportive social network besides drinking companions. Graham (2004) highlights that in treatment phase two it is probably too early for a client to consider complete abstinence. David was beginning to make links with the amount he drank and the negative effects he was having. Due to this he negotiated with the therapist that he would reduce his alcohol input by stopping all spirits but remaining on his strong lager. This follows the harm reduction philosophy that there are several levels in which change can occur that would reduce the negative impact it causes to the client. David identified his long-term goal as eventually getting some form of employment. Following treatment phase one David was able to see the impact excessive impact alco hol was having on his ability to make appointments on time (if at all), and how this would have a negative effect on any chance of employment. Graham (2004) suggests that for a client to get to this long-term goal a series of short term harm reducing steps need to be identified by the client in therapy that will in-turn have a positive impact upon his life. David had already agreed to stop drinking spirits but further steps included reducing contact with fellow drinkers, attending all appointments on time, getting his body back into a work routine. These steps would move David closer to the eventual long term goal and give him the belief that this was achievable. The therapist found that the use of the recovery star was a useful tool with aiding the client identify and plan how to achieve these goals. The recovery star helps both client and therapist measure change and visually see progress made. At times when David struggled to achieve goals it provided an opportunity for discussio n on how to change the approach. David found the tool useful in between sessions where he could refer back to past successes to give him the confidence to continue. On reflective sessions what proved important for David was to identify and discuss possible obstacles that he may experience in trying to achieve his goals and to recognise that if things do not go as planned it should not be automatically assumed to be a failure. Simmons and Griffith (2009) believe that there is never a failure but an opportunity to learn and do things differently. Behavioural Experiments By treatment phase two of CBIT the client will have identified an unhelpful thought, the nature of which will be maintaining a negative maintenance cycle. David had begun to plan harm reduction goals to reduce the negative aspects of his substance misuse however there was clearly some situations he was avoiding, and some underlying maladaptive thoughts there were perpetuating his problems. To address this the therapist and David discussed and designed a Behavioural Experiment. Beck (1995) believes that BEs strengthen an intellectual belief by helping the client test out alternative beliefs and thoughts in practice in order to gain evidence to discover the validity of a belief . Beck (1979) believed through altering behaviour a cognitive change occurs. BEs are significant as a means of explicitly targeting belief change through experience and as such offer prime opportunities for sustained therapeutic change (Padesky 2004). David held the belief that if he did not drink alcohol he wou ld appear boring and no-one would have any time for him. For this reason when David was going to be in the company of anyone he would drink excessively, therefore getting intoxicated became a safety behaviour. By allowing a client to see what will happen if they drop safety behaviour and then testing out what actually happens in that situation proves to be a powerful challenge to unhelpful assumptions (Whitfield and Davidson 2007). Sloan and Telch (2002) support this view adding that experiments target safety behaviours result in significantly greater changes than exposure alone. Safety behaviour may seem helpful and protective to a client but can lead to maintenance cycles of maladaptive processes perpetuating the initial belief. If a threat is not disconfirmed the maladaptive cognition continues (Salkovskis 1991, Sloan and Telch 2000, Clark 1989, Salkovski et al 1998). The notion of experimentation, derived from scientific principles, can be applied to the patients experience of t he therapeutic process and it is this active experience which can be so meaningful; the validity of a new cognition being generally more memorable when followed through from conceptualisation to active experience (Westbrook 2007). Once the evidence contradicts the initial belief it allows the client and therapist to explore the validity of new more adaptive beliefs (Westbrook et al 2007). David and the therapist designed an experiment in which he would limit his alcohol approach and would then engage in general conversation in his local pub. Initial experiments gave David the confidence to build on further experiment supporting the work of Bennett-levy (2004) who believe early experiments increase confidence and independence BEs can be active, where the patient takes the lead role in either real or simulated situations to test the validity of thoughts, or observational, where data is gathered. Lewin and Kolb propose a learning cycle in which it suggests that for learning and retenti on to be enhanced the client must build upon knowledge and understanding gained through the experiment which in turn forms a foundation for the next step of the experiment. (Lewin 1946; Kolb 1984). The five key aspects of this learning cycle, Experience, Observation, Reflection, Planning and then further experiment underpins BE work. Establishing supportive social networks In the field of substance misuse social factors are seen as important in the onset, aetiology and maintenance of substance misuse (Graham 2004). David recognised that as his alcohol intake increased the friends he associated with were also using alcohol regularly. This supports the work of Drake (2004) who identified that clients with both severe mental health problems and substance misuse problems would have social networks of solely fellow substance users. David felt increasingly isolated from anyone outside of this network as his behaviour would draw attention towards himself. Trumbetta et al (1999) suggest that for anyone to make changes in substance misuse they need to reduce contact with such peers. Healthier networks need to be formed which provide positive support where there is excessive substance misuse is not the norm (Drake 1993a). David identified his sister as someone who was willing to and who he would like as a supportive person away from mental health services. In cr isis David could contact his sister who could give him some level of support. Graham (2004) emphasises the importance of working closely with family members as they often know very little about dual diagnosis problems. David was only close with his sister. The rest of his family had isolated him due to his substance misuse. Ideally psycho-education information is often given in the group setting as family members may benefit from the experience and support of fellow members (Graham 2004). Davids sister became a key figure in Davids recovery and was encouraged to attend sessions on psycoeducation so she could best understand the problems associated with dual diagnosis clients and how best she could support David. Limitations of its use Prochaska and DiClemente (1992) recognised certain barriers to treatment for dual diagnosis patients in regards to therapeutic engagement, treatment continuance and goal setting. In the case of CBIT it makes assumptions of a certain level of coping skills and ability to facilitate cognitive change. Symptoms of schizophrenia can inhibit a clients impetus to change behaviour (Horsfall et al 2009). Negative symptoms which have a negative effect on motivation and energy affects individuals internal drive to initiate the complex behavioural routines needed for abstinence (Ballack and DiClemente 1999). An integrated treatment approach incorporating CBIT does not make dramatic changes in the short term, it is a long term therapy. Evidence based studies are always plagued by attrition rates as clients relapse or do not return to the study. This may suggest that CBIT may suffer from the same poor treatment compliance/attendance. For clients who complete a full programme of treatment 10-20 per cent achieves a stable remission of their substance use problems per year (Graham 2004). This seems a low figure for the intensive input required on the part of the therapist and client. Bellack and Gearon (1998) believe the therapist must become tolerant of this client group dropping in and out of therapy and abstaining then relapsing. Davids attendance was at times sporadic but the therapist never criticised him for this but used it as a platform for discussing problems experienced through the week. Drake et al (2001) suggests the importance of assertive outreach teams in retaining clients within programmes. Hellerstein et al (1995) cited in Philips et al (2010) highlight that without this input dropout rates may be high, especially amongst those identified as having difficulties participating in treatment. Alternative approaches The evidence base for dual diagnosis is still in its infancy. Those studies completed have limited generalisation due to methodological issues such as heterogeneous samples, equivocal descriptions of treatment components and high attrition rates (Weldon and Richie 2010). Horsfall et al (2009) recognises that due to a lack of longitudinal studies long term outcomes have yet to be determined. It also proves difficult to compare C-Bit with alternative interventions as C-Bit is not used in a vacuum it is often used in conjunction with other therapies such as pharmaceuticals of motivational interviewing. Kemp et al (2007) found a significant improvement in substance use in dual diagnosis patients when CBT and MI principle were combined. For the purpose of this essay the author will briefly look at one main alternative approach to dual diagnosis, that of motivational interviewing. Motivational interviewing Treasure (2004) describes MI as a patient centred counselling approach that facilitates the patient in resolve and explore ambivalence about behaviour change. The theory of MI centres on the cycle of change and its six components, precontemplation, contemplation, decision, action, maintenance of change and relapse. Miller and Rollnick (1994) describes motivation as something that one does as appose to something that one has. Empathy is vital in the therapeutic relationship and the use of MI. If the client believes the therapist has no appreciation of their experience they are likely to dis-engage or not fully commit to therapy. Rassool (2002) believes active listening also has an important role in MI. Reflecting back to the client their thoughts, fears, hopes and doubts give a feeling of genuineness, trust and empathy. In MI it is important not to offer advice , give judgement or attempt to question. The reason for behavioural change should be acknowledged and stated by the client. M I proves an effective therapy in dual diagnosis if delivered effectively. The therapist needs to avoid confrontation as this will lead to client denial, the role of the therapist as expert proves counter-productive and structured answer formats will inhibit the client in recognising the effects of their substance misuse. Motivational styles that guide a client in discovering alternative ways of thinking about their problems results in positive change (Miller and Rollnick 1991). By combining elements of style and technique MI has proven successful in dual diagnosis patients and has a developing evidence base. It proves difficult to contrast MI with CBIT as both complement each other so well and have similar approaches. Both are based on a collaborative relationship with clients, both incorporate a non-judgemental approach and both are approaches are built on empathy, warmth, trust and positive regard (Rogers, 1991). Both approaches also incorporate socratic questioning techniques encouraging the client to discover alternative meanings of their experience (Padesky and Greenberger 1995). One of the key differences is when it is best to use either technique. Those following a transtheoretical model of change may use MI when the client remains undecided about change in the precontemplation and contemplation stage whereas CBIT can be adopted when the client is more committed to change (Treasure 2004). This would support the work of Drake et al (2001) who after studying the work of a number of researchers believe that to enhance attendance and utilisation of treatment motivation interventions a re important. Conclusion The research on the impact of CBIT as a therapeutic intervention is still in its infancy. Some anecdotal evidence would suggest it provides the skills necessary to promote abstinence (Rassool 2002). Qualitative information gained from Grahams (2006) study suggests CBIT proved a useful tool for integrating and planning substance misuse. Due to the complex nature of dual diagnosis it seems unlikely that a single intervention will have the desired effect of meeting all the clients needs. Kemp (2007) supports this finding an improvement in substance misuse when MI and CBIT were combined. Due to this there has been a shift towards the integration of interventions delivered by mainstream mental health services (DOH 2002, 2006;Rassool 2002; Ziedonis et al. 2005). Some of the strongest treatment effects have come from combining a number of approaches (Barrowclough et al 2001; Bellacket et al. 2006).

Gender Inequality in Education Essay

Gender Inequality is the unjust behaviour or insights of people on the basis of gender. In regards to education, we can then say, gender inequality in education is the discrimination of individuals based on gender in schools. When talking about this gender inequality it is quite obvious that the ones being discriminated are the females. Education is a fundamental right, which should not be restricted to a certain gender, every human being, male or female has a right to education. No matter the form of inequality it is bad for an economy and well-being. The impact is more severe if when it is viewed from the perspective of gender and even more detrimental when the resources allocated are unfair against women. A society that its hierarchal organisation have a habit of placing men in choice making positions and women demoted to economic work that seeks limited work and does not give them the satisfactory resources of means of support is a society that is put in danger. (Ijaiya & I.O.Bal ogun) This issue of gender inequality in education is far more prominent in less developed countries, plus Nigeria where quite a number of readings have shown that under the backings of religion and tradition the men discriminate against women hence divesting them access to skills and education for useful activities. (Ijaiya & I.O.Balogun) In general education is well-defined as a long life progression through which a person’s progress is smoothed so that he can be beneficial to his society and to himself. From this definition, my concern here is the western education because it the most important form of education in the world which is more prominent and its achievement, regardless of what level one has attained is seen to be very significant to the development of an economy, since it allows people accomplish new tasks and to assess and adjust to new jobs. Gender inequality in education affects a lot of things in countries, it affects economic growth as it brings down the level of human resources because when some of the population that could have  contributed to somethings are not educated, they do not amount to much in the society. There has been a lot of concerns with women when it comes to education and it is not a new thing. History of Gender Inequality in Education For some time now, there has been a change in gender success all through education; in the late 1980’s underachievement by girls was common; girls were less likely than boys to gain one or more A-levels and also not likely to go on to advanced education. In the 1990’s there was a quick reversal; girls started doing better than boys. In the year 2006 10% more females were gaining more A-levels than males. This gender diversion has been viewed from a social perspective. (Gender and Educational Attainment, 2014) In the 1990’s gender discrimination was still evident in the society though women were attaining greater success throughout work and education. The Education Reform Act of 1998 (important piece of education in Wales, Northern Island and England) which brought coursework helped girls as they tend to be generally more organised and care about the how their work looks than the males. Feminists consider that the purpose of education ought to be to benefit and advantage disadvantaged women. In a feminists view this is not wrong as what that is what they seek. The 1998 Education Reform Act indicates clearly that women are to be given more chance to attain education. Some girls were interviewed in the 1970’s and others were interviewed in the 1990’s, it was found that main concern had changed, it had changed from marriage and love in the 1970’s to careers and jobs in 1990’s. From this it is quite obvious there has been an increase in career ambitions. Two things could have influenced this, contemporary socialisation from media and parents or achievement from course works. (Gender and Educational Attainment, 2014) A conceptual Issue Wellbeing and Gender Inequality, according to the World Bank a key determinant of wellbeing in a country is the presence of a stable economy and its growth. Inequality is frequently referred to as lack of equivalence. One of the concerns of gender inequality when it comes to education is that it could pointer to a whole great deal of violence against women, which might make it hard for them to talk about issues of power. If this  inequality is such that leads women into having little access to education as well as limited skills for dynamic employment, it will have an effect on them when it comes to poverty of the present and also of that of the next generation. An illiterate woman with restricted access to income cannot take care of her children in regard to nutrition and health; and a woman with so much work and has no regular access to income might use their daughter’s labour for survival which might end up depriving them of a chance to gain education. (Sheehan, 2012) Effects It is also observed that gender inequality in education may weaken development goals. It may avert increase in child mortality and fertility and the increase of education on the next generation. There is absolutely no doubt that education has a main impact on economic growth, as the more educated people in a society, the better the economy of that society. Studies have conventionally used years spent in schooling as a variable to measure education. There is a strong proof that quality of education is more essential than the quantity of education. Gender inequality in education influences education indirectly, through dissimilar ways such as by dropping the fertility rate, growing life span of population and social unity. Gender inequality has a negative impact on the outcome of education, which will also have a negative impact on the economy’s growth. These can happen in so many ways. Girls who are schooling in a school where there is high inequality might end up believing the re will inequality in the society, which might hinder their opportunity for success in life. These would lead to decrease in their performance in school. Gender inequality does not only manifest itself in education but also in other areas, like, politics, education etc. (Sheehan, 2012) While numbers of children not in school has dropped, and number of girls not in school has declined from 58% to 54% in 2010, in some countries there has been limited progress in children getting into schools, many which are girls, and girls from poor households continue being one of the groups at jeopardy of never attending school. In 2006 in Pakistan, 60% of children not in school were girls while only 12% of poor Hausa girls in Nigeria went to school. The odds of getting to school are not in favour of girls from poor households. Girls’ enrolment in Yemen is vividly much lesser than boys and the same case goes for Pakistan when  attendance is the case analysed. (Engendering Empowerment: Education and Equality , 2010) It is seen also that gender is not regarded as a serious issue compared to poverty, some officials in the South African Education Department said: Gender is not a primary issue to them because they deal more with poverty, whether one is male or female poverty is still poverty, they get to deal with hunger and that does not discriminate. From what they can see, gender is not an issue. Poverty is an issue also but to think it is more important that gender inequality in education is totally wrong, from what I have said earlier, the more educated people the lesser the chances of poverty, so, a way to tackle poverty is to tackle gender inequality in education first. Another South African is worried that focusing on gender will distract from the poorest needs, saying that there is a risk involved with having too much emphasis on gender issues, saying that it is an issue that would be taken well in resourced areas rather than areas with the majority being the poor. (Engendering Empowerment: Education and Equality , 2010) In conclusion, what this paper is saying is, Gender Inequality in Education is an ongoing issue that is declining but not going away anytime soon. It is a problem that comes with its own problems, meaning it affects economic growth and development. A way to decrease the number of inequality is to educate people especially those in the rural areas that the girl child’s education is just as important as the male’s child. Every individual male or female should not be discriminated on the basis of anything talk less of education, education is key. Say NO to Gender equality in Education. Works Cited Engendering Empowerment: Education and Equality . (2010). United Nations Girls’ Education Initiative , (pp. 15-25). Dakar. Gender and Educational Attainment. (2014). Retrieved from History Learning Site: http://www.historylearningsite.co.uk/gender_education_attainment.htm Ijaiya, T. G., & I.O.Balogun. (n.d.). Estimating the Impact of Gender Inequality in Education on the well-being of women in Nigeria. Kolhapur: Serials Publications. Sheehan, K. (2012). Does Gender Inequality in Education Affect Educational Outcomes? Connecticut.

Cohesion and Discipline of the Party in Government

Parties matter in part because they influence the actions of elected officials. But scholars also note that lawmakers from the same party may not vote together. Party cohesion has varied over time – sometimes party members stick together on many key votes, at other times they are no more likely to vote with fellow party members than with the opposition. Parties have various means at their disposal to encourage members to cooperate in achieving a party program. Sometimes these tools are sufficiently compelling that individual members may back the party program at the expense of their constituents' interest.However the case is quite different in European Parliamentary systems of government where party cohesion is essential for the implementing of government policies that the party in power wishes to impose. Although party cohesion in American government has risen because of intraparty heterogeneity and the realignment of the South (Hetherington and Larson), the party discipline and unity is not nearly as cohesive as those found in Parliamentary systems. This is in large part due to the fact that the tools of the party leaders in each system are different.In Parliamentary systems, because the risk of not voting in terms of party could lead to the collapse of the present regime and government system, party leaders tend to have more effective tools at their disposal to use in encouraging party cohesion/discipline. Party discipline or cohesion  is the ability of a  political party  to get its members to support the policies of their party leadership. Party discipline is essential for all systems of  government  that allow parties to hold  political power  because it determines the degree to which the governmental organization will be affected by the political processes.Party cohesion is closely related to party discipline (Aldrich). Distinctly, however, it is essentially â€Å"coordinated† behavior reflecting the interacting incentives of individual legislators, whereas party discipline is the outcome of a strategic game played within political parties, in which legislators who are party members respond to rewards and punishments determined by some internal party decision-making regime. In political systems other than American presidential democratic system, straying from the party lines can result in the fine and/or expulsion of members such as in the  People's Republic of China (Aldrich).Party discipline tends to be extremely strong in  Parliamentary systems such as in  European countries in which a vote by the legislature against their party is understood to cause the governmental â€Å"collapse† of the present regime (Huber). In these situations, it is extremely rare for a member to vote against the wishes of their party. Party leaders in such governments often have the authority to expel members of the party who violate the party line.Weak party discipline is usually more frequent in congressional s ystems  such as the  United States Congress where power within in the party is more democratic than the authoritarian system seen in parliamentary governments, with leaders dictating order to the members to follow suit. In these American legislatures, it is routine for members to cross party lines on a given vote, typically following the interests of their region (constituents) or following other members of a borderline group within their party.In America the risk is not that high, with party disagreement just results in the upsetting of the party elites without true damaging costs except for the withdrawal of their support. Party cohesion and party discipline are very distinctive under parliamentary government, where a lack of cohesion and/or indiscipline among parliamentarians belonging to government parties may jeopardize the very existence of the government. Certainly from the perspective of making and breaking governments, levels of party discipline are very high in Europea n parliamentary democracies.There are very few examples indeed of parties that have been â€Å"half-in, half-out† of government, in the sense that legislators from the same government party have voted in different ways on key legislative motions of confidence and/or investiture. In this sense parties do go into and come out of government in a unified manner. In the American democracy, this just isn’t the case. Politicians have more allegiance to their regions and constituents than to their party. Because of the way the nomination system works. Party nominations no longer rest in the hands of party elites but in those of the public.Thus it’s better for one’s political career to appeal to the public and not to party. According to other scholars enhance this opinion by adding â€Å"the main influence of party discipline is not on the votes on specific roll calls but on the choice ideologically of the party† (McCarty, Poole and Rosenthal). This suggest s that members will vote in line with their ideals rather than their leadership. To come to this conclusion they observed changing patterns of roll call voting among party-switchers and inferred that legislators appear o coordinate on roll calls because they change policy preferences to reflect those of their parties. Thus the question becomes, why do members of political parties even bother to behave in cohesive manners? Political scientists and elites have attributed this behavior to a trinity of solutions. Electoral incentives for legislators that arise from the value of a party label, strategic incentives within the legislature that reward legislators who behave in a coordinated fashion, and the ability of party leaders to implement a system of rewards and punishments are all attributed reasons (Hix and Simon).Political scientists argue that electoral incentives might generate emergent party cohesion. By creating a type or brand that politicos can blanket themselves under in ord er for voters to infer information about candidates in elections. Recognized legislators join political parties to signal policy positions to voters, doing this so long as it increases their chances of election or re-election. Voters make inferences about candidates’ policy preferences only by observing their party membership.Identifying candidates with their party and ignoring what candidates might actually say about their own policy preferences. Candidates in these models do have underlying policy preferences and thus prefer to join parties comprising like-minded colleagues (Krehbiel). This is because the party policy positions that are part of the brand with which each member is associated are influenced by the positions of all party members.In this system it benefits a candidate to vote along party lines in order to be associated with a specific regime policies, outcomes, and therefore successes. Party membership involves costs that arise from this incentive. There are co sts arising from associating with a party label indicating a unique policy position that differs from the ideal point of the member – and of being associated with a party that will actually implement this position if it is in a position to do so(Snyder and Ting).Since the primary focus of this type of work is on the electoral phase of the political game, and despite occasional references to â€Å"party discipline†, this approach involves no explicit model of intraparty politics– except for the assumption that the party policy platform is chosen by either a dictatorial leader or simple majority voting by party members (Snyder and Ting). In addition, this incentive assumes that politicians are allowed to join, and to remain within, any party they choose. The only â€Å"filter† on party entry in such odels is party policy itself which, combined with the deadweight costs of party membership, discourages legislators with very divergent policy positions from jo ining the party (Snyder and Ting 2002: 95) This means that the underlying process being modeled is a type of sorting or the partitioning of voters between parties, but the logical engine of this model could also be applied to explain the sorting of politicians between parties on the assumptions that party positions are some function of the positions of party members and that politicians want to affiliate to the party with the closest position.While this large body of work gives us useful intuitions about electoral incentives for legislators to affiliate to parties, the main lesson is that electoral incentives may well make a party label a valuable commodity. Thus, if a party’s decision-making regime can intensely threaten to withdraw the party label from party legislators if they fail to abide by party decisions about legislative behavior, then this will make those decisions easier to enforce.On this perspective, party discipline is about legislators responding to explicit or implicit threats by party leaders to impose electoral costs by withdrawing the party label, by casting votes in otherwise costly compliance with party policy. The resources party leaders in both parliamentary and US federal government and parliamentary government context can deploy to structure the incentives of legislatures in a way that ensures party discipline include control over electorally valuable party labels (party identity) and control over sought-after perquisites in the legislature.However, this incentive structure has an important new dimension under parliamentary government, arising from the fact that the legislature typically functions as a recruitment pool for the executive, and political ambition of its members are at the forefront. In Parliamentary governmental system, party leaders have the tools at their disposal to make or break candidates if they dissent, because the stakes are so high. If government parties cannot maintain firm party discipline, then they can not retain a secure hold upon office.When legislative parties do move into government, control over the allocation of important government jobs, whether these are cabinet or junior ministries or other key patronage appointments, typically rests in the hands of a very small number of senior party politicians, who can and do use these offices to reward loyal party members and who can and do punish mavericks by denying them the rewards of office. However, in American politics party leaders do not have the authority to simply dismiss a candidate.They may only throw their endorsement or support candidates with funds and become â€Å"king makers†. It is unrealistic to think that Nancy Pelosi can tell a conservative democrat to go away. She can allow withhold resources (money and her name recognition support). But this won’t be enough if the candidates’ constituents carry him through to victory. Legislative incentives also coexist which derives from improved expectatio ns in relation to a range of legislative payoffs that accrue to legislators who belong to larger rather than smaller cartels or coalitions of legislators.A large part of the relevant literature has been concerned with the role of party in the US Congress, and how the main concern of those elected is to pass legislature and having a single legislative party commands a majority position. The main legislative resource is the ability to capture a majority coalition of legislators. This is achieved by controlling the allocation between legislators of agenda setting legislative offices, such as committee chairs.On this argument, the power to make such allocations is delegated by party members to the party hierarchy, which can use this power to enhance party discipline, which in turn feeds back to enhance the value of the party label in the electoral game. This is important because the legislature is the main political arena in which legislators seek to fulfill their objectives, policy and otherwise. US parties impose discipline on their members by manipulating scarce agenda-control resources is in contrast an alternative influential argument, ( Krehbiel (1993, 1998).This holds that what looks like legislative party discipline is an essentially emergent phenomenon. US legislators choose which party to affiliate to on the basis of their intrinsic policy preferences – in effect joining a party of like-minded individuals and then quite voluntarily behaving in the same way as these on the floor of the House without the need for any â€Å"externally† imposed party effect. Legislators are voting the same way because they like the same policies, or because they are responding to the same non-policy incentive structure put in place by the party hierarchy.There are two roll calls put in place to ensure this outcome (Snyder and Groseclose). On one hand there are â€Å"lop sided† roll calls. In which first, legislators will treat these as a forgone conclusi on and, second, that party leaders will see them as offering no rationale for the (by assumption costly) deployment of party discipline. On the other hand there are â€Å"close† roll calls, for which coordinated legislator behavior makes the difference between winning and losing. There is strong evidence suggesting that the â€Å"party effect† is much higher for close than for lop-sided roll calls.They infer from this that US parties can and do influence the behavior of their legislative members when this makes a real difference, and do not attempt to do so when it does not. Cohesion seems to be closest when the party leadership has publicly identified as a priority, and find much more of a party effect on these than on issues that are not party priorities. Party cohesion in parliamentary government is important to the proper function of government because it essentially in lamest terms â€Å"makes or breaks government†.Under the constitutional regime of parliam entary government, that is pervasive in Europe, almost certainly the most important role for the legislature arises from the fact that the executive gains and retains office as long as it maintains the confidence of the legislature. This requirement is constitutionally manifested in the parliamentary vote of confidence/no confidence in the government (Huber 1996; Lijphart 1992, 1999). The executive under parliamentary government, furthermore, the â€Å"cabinet† of ministers bound together under the constitutionally embedded rule of collective cabinet responsibility.The stability and effectiveness of the government thus depends upon the ability of government parties to maintain disciplined behavior by party legislators. Effective party discipline means that a government is not defeated – either on votes of confidence/no confidence or on key pieces of legislation – because some legislators who belong to government parties vote against the government. Thus, while t he vote of no confidence is the constitutional foundation of parliamentary government, the behavioral foundation can be seen as party discipline.If the government parties maintain firm discipline on the part of their legislators, and if they control sufficient legislative support to take office in the first place, then they can maintain themselves in office, with firm control over the entire political process and facing few legislative impediments to the implementation of their policy and other objectives. Conversely, if government parties cannot maintain firm party discipline, then they cannot retain a secure hold upon office. The key point in all of his concerns the huge incentive in a parliamentary government system for senior party politicians – who themselves will often be members of the government – to maintain firm discipline over the members of their party. What is so striking about incentives for party cohesion and discipline under parliamentary government, as opposed to presidential government, is that these incentives cast the role of party leaders in a completely new light. â€Å"Party leaders† tend to play explicit and implicit roles. Party leaders tend to be seen as managers who essentially offer coordination and enforcement services to party members.As agents of their party, such party leaders have incentives to shirk. Imposing party discipline, by whatever means, is thus the fulfillment of obligation The reason such models of party discipline can look bizarre and unrealistic in the context of parliamentary government is that an â€Å"agency/expensive-discipline† model of party leadership (Cox McCubbins) seems implausible in a constitutional environment where party leaders are senior politicians who are the key players in a series of interlocking at the essence of the political process.Not only do party leaders make the really key decisions – about making and breaking governments, elections, but they also enjoy the benefits of office when this is achieved – whether these are perquisites such as the hefty check, the government jet, or the ministerial Mercedes, or opportunities to shift policy outputs in preferred directions as a result of controlling vetoes and agendas. In a nutshell, maintaining tight party discipline is highly incentive compatible for party leaders under parliamentary democracy.Indeed it is difficult to think of reasons why party leaders in a parliamentary government system would not want to maintain tight party discipline. Except in the matter of a voting on a highly divisive, sensitive, and cross-cutting issue, such as gay marriage or stem cell research for which it is against party interests to be identified with a single unambiguous position – then a legislative â€Å"free vote† can be declared on the matter and legislators can be allowed to vote with their â€Å"consciences†. But the orderly ability to switch free votes on and off is an i ndicator of firm party control over the behavior of party legislators (Aldrich).Parties are institutions in their own right. They are endogenous institutions, but parliamentary governmental parties are more deeply embedded into the constitutional rules of the political game of parliamentary government than a mere behavioral coalition of legislators. They are â€Å"political clubs† with their own set of rules to abide by. They are guided by their own system of rewards and punishment. In parliamentary government, membership of the party is completely dependent on the party label and the incentive of legislatives to be associated with the party brand or label. Cohesion and coordinated voting produce this benefit.In which individual members have an incentive to take part in coordinated behavior if they can get away with doing so. As mentioned before, if members choose not to act in this fashion, they can be exiled from the party and thereby denied access to the party label. Actin g in accordance to party can result in the placement of one’s name on the party ballot. Parties have the right to endorse particular candidates as official party candidates. Under the list-Proportional Representation electoral systems that are very common in parliamentary democracies, parties absolutely control access to and candidate placement on the party list.Therefore, parties in parliamentary democracies directly control access to the party label on the ballot. If denied this, a putative candidate must be admitted to and endorsed by another party, or must form a new party, or must run as an independent. In addition, access to legislative perquisites, whether these are physical office accommodation, speaking time on the floor of the house (perhaps to impress constituents at the next election), or paid positions with access to considerable resources, such as committee chairs.There are thus plenty of opportunities for party hierarchs to reward and punish individual legislat ive party members as they go about their daily lives. No doubt in the U. S. A. the movement towards the establishment of a disciplined and responsible party system is largely confined to the academic world. In the presidential system in US government rewards and punishment do indeed exist but not on the same level as in the parliamentary government (Cox and McCubbins). Party elites cannot simply cast away political hopefuls directly due to the constitution and the format of the political system.Power is not solely in the hands of elites, but the major American parties, national and state, are not based on mass memberships. â€Å"Only here and there in the United States are attempts made to fix a large-scale party membership on a regular dues-paying basis and thus to correspond to the European parliamentary scale (Jackson Moselle). † Party cohesion is absent even among the party workers and all the discipline that exists among party organizers before elections ceases to exist after elections. The problem stems from American attitudes about party.Most Americans identify themselves with a particular party but do not feel that they are obliged thereby to work actively for that party’s nominees (Laver). Anyone can legally qualify himself as a party member just by going through some registration procedure. Unlike the parliamentary system where you must pledge party allegiance before even having one’s name considered on the ballot. No state demands work on behalf of a party’s candidates or contributions to its campaign funds as prerequisites for becoming a legal party member (Giannetti and Laver).Structure of the American party has impact on party cohesion. The party structure in America consists of â€Å"a hierarchy of permanent party committees from precinct to national committee†. The National Committee which stands at the apex is made up of one man and one woman from each of the states picked by some kind of machinery within its State organization. The seemingly hierarchical structure does not produce party cohesion for power is decentralized and each unit is independent and needs not approval form the others.For example, the Chairman of the County Committee does not depend for his post on the State Committee and the latter hardly depends for its tenure or powers on the National Committee. To add to decentralization of power is the absence of uniformity in structure. The most striking feature in the party organization in the U. S. A. is that it is regulated by State laws while in all other democracies party structure is determined by the party itself. Diversity in State laws regarding party organizations naturally does not give scope for political discipline for the parties in America.In addition, primaries took the power of selection away from a band of leaders and activists and placed in by law in the hands of the voters. Unlike in Parliamentary systems where the local party organization selects the cand idates, the national party organization is finally obeyed. V. O. Key express the view that â€Å"by the adoption of the direct primary the organization was stripped of its most important function, that of nomination†. Every political party has two divisions, the organizational and legislative, and party discipline is as essential in the latter as in the former.If party cohesion is judged on the basis of the roll-call vote and the frequency with which members of a party differ among themselves, the index of cohesion in U. S. A. may be said to be very low. â€Å"The relatively low cohesion among Republican and among Democratic Congressmen† is mainly due to the non- parliamentary system of Government. The Congressman in U. S. A. need have no fear that division in the ranks of the party will lead to the dissolution of the legislature unlike in the Parliamentary system. So the significant feature with the roll-call vote in the American Congress is the absence of party cohes ion.Each of the two parties is divided into several factions and the factions in the two parties join or oppose one another irrespective of party labels, depending on the issue put for voting (Krehbiel). The decentralized structure of the parties makes a member depend for his success in elections more on his constituency than on his party. However, party cohesion in American government is not nonexistent, even though it is not as strong as those under the parliamentary democracies system. Each party selects a floor leader, whips and a Caucus Chairman creating a somewhat centralized structure that in practice increase party cohesion.Commonly, the party groups cohere more tightly on some party dividing issues than on others. For example 4,658 members of the House in 11 selected modern sessions only 181 or less than 41 per cent voted with the opposing party more often than with their own. The proportion was slightly higher in the Senate. Out of 847 senators in 9 sessions, 63 percent se cured their parties on a majority of the votes. (Jackson and Moselle)† For there is a tendency for most Republicans to be in voting opposition to most Democrats on controversial issues, showing strong party discipline.Indeed, American party cohesion is on the up rise. Realignment of the South played a role as the South has consistently voted conservatively since the Nixon years (Hetherington and Larson). Another key piece is the ideological differences among the two major parties (Democrats and Republicans) are greater today than they have been in years pass. Scholars have noted that the more ideologically extreme, the higher the cohesion. As parties have more interparty heterogeneity, each party has developed more intraparty homogeneity, which has given rise to roll-call voting (Hetherington and Larson).Strong party leaders also play a role in this phenomenon. Members in each party endow their respective party leaders with powers to advance the policy agenda. Ideological unit y in the 1970s with House Democrats, cause them to place the Rules Committee under the control of party leaders. Thus giving the house Democratic Caucus more power to oust wayward committee chairs who stood in the progress of the party’s initiatives. Demonstrating, American parties have been adjusting to their weak party model, and adapting in a way to influence party cohesive as exhibited so strongly in the American government.It is the clear consensus that Parliamentary government is indeed stronger in party discipline and cohesiveness than its American presidential system counterparts. The main reason for this phenomenon rests in the power of the political elites in each party system and the tools the system provides for their disposal-party label, patronage, etc.. In American politics, elites can only indirectly influence party-line voting as granted to the present political system. However, in parliamentary government, elites directly have the authority to dismiss or ele vate the position of their members, thus encouraging party cohesion.Bibliography Aldrich, John H. 1995. Why Parties? The Origin and Transformation of Political Parties in America. Chicago: University of Chicago Press. Cox,Gary, and Mathew McCubbins 1993. Legislative Leviathan. Berkeley: University of California Press. Cox, Gary, and Mathew McCubbins. 2005. Setting the Agenda: Responsible Party Government in the US House of Representatives. Cambridge: Cambridge University Press, forthcoming. Gallagher, Michael, Michael Laver and Peter Mair. 2005. Representative Government in Modern Giannetti, Daniela and Michael Laver. 2005. Policy positions and jobs in the government.European Journal of Political Research. 44: 1-30. Hetherington and Larson. Parties, Politics, and Public Policy in America. 11th edition. 2009 Hix, Simon. 2001. Legislative behaviour and party competition in the European Parliament: an application of Nominate to the EU. Journal of Common Market Studies 39:4 (November 20 01), 663-688 Huber, John. 1996. Rationalizing parliament: legislative institutions and party politics in France. Cambridge: Cambridge University Press. Jackson, Matthew O. and Boaz Moselle. 2002. Coalition and Party Formation in a Legislative Voting Game Journal of Economic Theory, Vol. 103, No. 1, pp 49-87.Kollman, Ken, John Miller and Scott Page. 1992. Adaptive parties in spatial elections. American Krehbiel, Keith. 1993. â€Å"Where’s the Party? † British Journal of Political Science 23 (1): 235–6 Political Science Review. 86 (December) 929-937. Laver, Michael. 2005. Policy and the dynamics of political competition. American Political Science Review, forthcoming. Snyder, James M. , Jr. , and Tim Groseclose. 2001. â€Å"Estimating Party Influence on Roll Call Voting: Regression Coefficients versus Classification Success † American Political Science Review. Vol. 95, No. 3, 689-698 V. O. Key:  Politics, Parties and Pressure Groups. p. 12.

Defining a Hero in Shakespeares Macbeth - 1308 Words

When one typically defines a tragic hero, he or she may claim that it is a hero of high class that possesses unprecedented courage and exceedingly strength; thus, a hero who also suffers a calamity of their own downfall and ultimate death through their tragic flaw. Their downfall not only causes infliction on oneself, but also inflicts the society. This can be seen and heavily stressed through William Shakespeare’s tragedy, Macbeth. In his play, the reader comes across Macbeth, a noble and honorable hero, who ranks highly among his peers. Nonetheless, as the play unfolds, it clearly depicts how power can corrupt even the most honorable. The noble Macbeth usurps his higher sovereignty, King Duncan of Scotland, in order to obtain the throne. However, in doing so, he annihilates anyone and everyone who seeks to stop him. As a result of his fallacious ambition, Macbeth is murdered by Macduff, one of the plethoras of victims of Macbeth’s cruelty. Even if a tragic hero spira ls down to his downfall; can his actions and destruction be interpreted as a monster? When thinking about the qualities of a monster, the reader can agree that they are evil, have no remorse, do not have any guilt, nor respected among the society. However, after analyzing this Shakespeare’s tragedy, it shows Macbeth to be a true tragic hero, rather than a monster. Shakespeare demonstrates this through Macbeth’s high worth and social standing, dormant flaw being ignited, and internal conflict of guilt. TheseShow MoreRelatedWilliam Shakespeare s Macbeth And The Human Condition1292 Words   |  6 PagesWilliam Shakespeare’s plays have been analysed and studied for hundreds of years. They are an iconic aspect of human history and are considered by many, even today, to be timeless classics. But how is it that stories written centuries ago continue to maintain so much relevance in modern society? 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