The Bahay Pagbabago Drug Reformatio Center in the Province of Bulacan: A Qualitative Analysis

Introduction

More than a year have passed after the implementation of the OPLAN Tokhang and the establishment

of different community-based rehabilitation center in the country had been on the increase and there had

been a fair share of graduates of such drug rehabilitation centers. The core rationale in establishing Bahay

Pagbabago is due to the limited number of drug rehabilitation center in the country. The idea came to the

minds of the police because most of drug surrenderers have no means to support themselves inside an

established government and privately owned drug rehabilitation center which often collects a sum of money

in payment for its services. Therefore, the effectiveness of the strategies by the government to decrease the

use of illegal drugs should be evaluated.

As a community intervention program of the government they launched the OPLAN Sagip which

provide guidelines or protocol to be followed by law enforcement agencies, Anti-Drug Abuse Council of

the LGU’s and cause-oriented NGO’s in handling drug personalities who voluntarily surrendered. Drug

surrenderees will be the target client of the community-based treatment center which Is known as the Bahay

Pagbabago Drug Reformation Center.

Currently, the Bahay Pagbabago Drug Reformation Center is a major drug rehabilitation modality in

the the Region 3 supervised by the Philippine National Police not the same as the drug rehabilitation center

managed by the Department of Health. The rehabilitation facilities are in response to the challenge posed

by thousands of surrenderers who had volunteered to undergo reform to be free from illegal drug use (The

Manila times, October 2016). The Bahay Pagbabago was established in October 2016. However, even

before the administration of President Duterte there was the same concept existing in the province of

Bataan, the idea of the programme originate there wherein there was already a center which commit drug

user in an institution.

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 The client in the Bahay Pagbabago will need to stay in the Center until there is a new batch that will

replace them in the reformation center. There is no consistent number of days or months that the reformist

will stay in the center. There is also no basis which will release depending on their progress inside the center

or if they have been successfully reform. After completion of the program and staying in the center reformist

will receive a certificate of completion.

As the treatment and approach in the Bahay Pagbabago is not the same with the drug rehabilitation

center managed by the DOH. The purpose of this study is to evaluate the program implementation,

environment, personnel and service provider and the impact of the program in the family and

community.The challenge is whether the Bahay Pagbabago Reformation Center is a positive solution to the

drug menace in the Philippines. This study therefore aims to identify problem areas in the implementation

of Bahay Pagbabago Reformation Center and recommend sound solutions to improve the present conditions

inside the centers by collecting data from stakeholders which includes the reformist, graduates, personnel

inside the Bahay Pagbabago, family member and member of the community.

Although many studies are already conducted regarding drug rehabilitation center in the Philippines,

the researcher believed it is the first study that will be conducted regarding Bahay Pagbabago Drug

Reformation Center a “Community-based Intervention Program” which is presently supervised by the

Philippine National Police in coordination with the Local Government Unit. Studies and literature

mentioned above deals with different common methods to treat the use of illegal drugs, not involving the

community. As a program or institution which do not have any effect or positive outcome to the

reformation of the graduates will make such program ineffective or useless.

Research Objective:

This study evaluated selected Bahay Pagbabago Drug Reformation Centers in the province Bulacan

in terms of its program administration such as (1) Identification, (2) admission and assessment; (3)

Programs inside the Bahay Pagbabago; and (4) Aftercare Program?

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Research Design

This study utilized the qualitative program evaluation. According to Rossi et al. (2003), a program

evaluation, which can be interchanged with evaluation research, is a social science activity involving

collecting, analyzing, interpreting and communicating information about the processes and effectiveness of

social programs. Evaluations are done for various reasons such as aiding in the decision as to whether the

program should be continued, improved, expanded or stopped, and guiding the program management and

administration as they improve on the effectiveness of the program.

Program Execution refers on the process of properly identifying the clients of Bahay Pagbabago.

Admission and assessment of those who will enter the program. As well as the programs offered inside the

reformation center and the provisions for aftercare or follow-up of clients.

Evaluation parameters were set based on the program rationale and research questions in the study. To

identify the actual problems or realities for each parameters, the researcher utilized of triangulation as an

approach in the collection of research data which includes (a) unstructured interview in order to have an

understanding regarding the program that will be evaluated; (b) field-investigation/ ocular inspection will

also be utilized for the program which was presently active to actually observe and study the implementation

of the program; and (c) documentary analysis on the reports and related documents were also gathered to

determine the objective, purpose and scope of the program. These findings were analyzed alongside the

program rationale and basic principles of drug reformation. Further, as these findings were compared to

what is intended, a qualitative judgment for each of the parameter as well as the entirety of the program

was conducted in the course of the study.

Purposive sampling was in the investigation as it is the recommended sampling scheme for most

qualitative researches. Purposive sampling is a non-probability sample that is selected based on the

characteristics of a population and the objective of the study.

This study involved stakeholders of the Bahay Pagbabago. The sampling method used is particularly

used in the context of evaluation research and policy analysis, this strategy involves identifying who the

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major stakeholders are who are involved in designing, giving, receiving, or administering the program or

service being evaluated, and who might otherwise affected by it (Palys, T., 2008). The reason for using the

purposive sampling method is to ensure that stakeholders are made part of the study, hence a holistic

approach in gathering data is realized.

Research Instruments

Data in the study is a mixture of primary data coming from interview and observation while secondary

data emanates from police records and records of the reformation center. Interview is a qualitative method

of analysis, in which a confidential and secure conversation or interview between an interviewer and a

respondent takes place in order to gather data or information about the specific topic or subject.

A digital recording device was used in conducting the interview and handwritten notes was also used

by the researcher in order to highlight important statements that was expressed by the participants. In

transcribing the interview, the researcher inputted the data from the computer and printed copies of the

transcript for analysis. In addition, the verbatim transcripts were also inspected and verified. For the

protection of the rights of the participants, and to avoid the fear that information that they provide will be

used against them, confidentiality agreement was prepared and signed by the researcher and the participant.

Participation are voluntary and will not involve coercion in anyway.

An observation checklist with the evaluation parameters are also developed in the study to gather the

needed data from the areas covered by the study. Documentary analysis was used in the records collected

from the police offices which confirm the evaluation parameters of the study.

Reliability of the Research Tools

In qualitative studies, the reliability of the data is measured by consistency and honesty in reflecting

the real sentiments, views and experiences of the participants (Holliday, 2012). Audit trailing was used to

establish reliability of the research tools. Audit trail is a transparent description of the research steps taken

from the start of a research project to the development and reporting of findings. These are records that are

kept regarding what was done in an investigation (Creswell, 2012).

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Evaluation Parameters

The evaluation parameters as earlier discussed are composed of four criteria namely: (1) program

execution; (2) Bahay Pagbabago environment; (3) personnel inside the Bahay Pagbabago; and (4) impact

of the program.

Table 1. Evaluation Criteria of Bahay Pagbabago Reformation Center

DIMENSION AND
EVALUATION CRITERIA
PARAMETERS
PROGRAM EXECUTION
Identification, admission and  Identification of clients is based on a pre- determined list based
assessment on reliable information.
 Collaboration with community members and organizations in
identification and preliminary screening of drug users.
 Discussion with drugs users and families.
 Preliminary screening and basic needs assessment.
 Referral of people who are believed to have a substance abuse
problem to health centers.
Programs inside the Bahay  Provision of support to drug users who are not drug dependent.
Pagbabago  Referral of drug users to DOH accredited physicians in case of
severe drug dependents.
 Liaising with NGOs in the community for logistical and
financial support.
 Provision and availment for psycho-social counselling for drug
surrenderers.
 Presence and participation to the following programs (a)
Livelihood and skills development (b) sports and recreation (c)
spiritual formation activities (d) Literacy program (e) programs
that enhanced the social-civic kindness of drug surrender
 Therapeutic community services are practiced and made
available.
Aftercare Program  Provision for aftercare services.
 Drug test are administered in a pre-determined period of time to
determine whether client is still using illegal substances.

Data Analysis

In analyzing the data the table below was used in evaluating each criteria for each parameter. Table 2. Data
Analysis of Each Criteria

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 Symbol Analysis Assessment
E provision or condition is
made the actual practices must meet all the evaluation
extensively criteria that was given and proving a condition
which is beyond what is needed
S provision or condition is moderately if the condition is sufficiently provided according
extensive to what is needed

L provision or condition is very limited if the shortcomings of the practices are not of
great salience and there is shortcomings according
to what is needed
M provision or condition is missing lack of the condition and is needed
O provision or condition is not desirable would be given if the condition does not apply or
or does not apply not needed by the program

The researcher used the data gathered through interview; field-investigations and documents acquired from

each center as basis for the analysis.

The participants in the study are the stakeholders from six identified municipalities in the province of

Bulacan. Three (3) of which has been identified as having best practices and the other three (3) which are

identified as to have fair implementation of the program based from the data provided by the police and

reports attached thereto. The selection of municipalities was based on the accomplishment reports furnished

by the police offices to the provincial office and then submitted to the regional and national police office,

hence bias in selection is avoided.

The stakeholders that will be included are: (1) police officer assigned in Bahay Pagbabago or head of

the Police Community Relation Office; (2) a graduate of the Bahay Pagbabago; (3) a reformist of the center

presently undergoing programs inside the center; and (4) a family member or nearest of kin or guardian of

a reformist or graduate of the center. In the absence of a family member of the participant, the Barangay

official or Punong Barangay is considered as family member on his behalf.

Results and Discussions

Identification, Admission and Assessment

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 Identification of clients is necessary to determine whether the persons admitted in the program are

qualified based on their needs and that there cases fit the programs and activities of the Bahay Pagbabago.

Admission requires proper identification of prospective clients, such process includes the taking of personal

data or information for reference purposes. The list of identified clients came from the Barangay Anti-

Drug Abuse Council established in each barangay to render assistance to the law enforcement agency in

the eradication and clearing operations of illegal drugs (Sec. DDB Boad Regulation No. 3 s2016). The

BADAC submits the watch list to the local police unit for validation. Those names included in the drug

watch list will be now the subject of the OPLAN

Table 3. Results of the evaluation of the identification, admission and assessment

Evaluation Criteria Practice of Selected Bahay Pagbabago Assessment
in Bulacan Province

 Identification of clients is Provision or condition

based on a pre-determined list  Identificationn of client is based from is made extensively
based on reliable information. ‘BADAC List” as validated by the
PNP and the PDEA.
 Collaboration with community  There is collaboration with
members and organizations in community members and
Provision or condition
identification and preliminary organization in the identification
is made extensively
screening of drug users. (e.g  Profiling of drug reformist and
profiling, interview) Medical Check-up
 Orientation in the Bahay  There is orientation explaining the Provision or condition
Pagbabago concept and the rules and regulation is moderately
inside the Bahay Pagbabago. extensive
 Discussion with drugs users  Discussion with family members
Provision or condition
and families. happened during the operation of the
is moderately
OPLAN Tokhang and in the
extensive
Barangay.
 Preliminary screening and  No preliminary screening and basic
Provision or condition
basic needs assessment. need assessment
is missing but needed
 Referral of people who are  There is referral by the family Provision or condition is
believed to have a substance member to the Bahay Pagbabago limited
abuse problem in the Bahay
Pagbabago
OPLAN Tokhang is a practical and realistic means of accelerating the drive against illegal drugs in

affected barangays, this is the primary method of enlistment to the Bahay Pagbabago. This concept involves

the conduct of house to house visitations to persuade suspected illegal drug personalities to stop their illegal

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drug activities (CMC NO. 2016-16). Police officer together with the members of the BADAC visits each

house and convince drug personalities to surrender and undergo reformation at the Bahay Pagbabago. The

identification of clients may also come from the watch list by PNP and PDEA who voluntarily surrenders

to the authorities.

However, there are some cases wherein a person surrendered voluntarily even they are not included

in the watch list. Persons who even previously used drugs are also included as long as they have history of

taking illegal drugs. This means that the means of identification and admission is flexible and open to those

who seek professional help. Besides, due to the intensified campaign against illegal drugs by the President

and with the growing number of victims of extra- judicial killings of drug personalities, it is of no surprise

that the ordinary drug user will be convinced to surrender to the police.

In the admission process, the participation is voluntary. A document (affidavit of undertaking) is signed

for those who will undergo reformation; the affidavit states the rules and regulations inside the reformation

center and that each of the client is supposed to follow the rules inside the Bahay Pagbabago. The failure

to comply with the conditions and requirements of the Bahay Pagbabago can lead to the filing of

appropriate charges in court. Section 55 of Republic Act 9165 or the Comprehensive Dangerous Drugs Act

provide that when a drug user surrenders to the authorities he must undergo rehabilitation program at an

accredited rehabilitation center of the Department of Health, for six (6) months. Failure to do so would lead

to the filing of criminal case against the drug user.

A member of the BADAC mentioned that during the initial phase of the implementation of the

program, families and drug personalities were perplexed and adamant with the program of Bahay

Pagbabago. In an interview, he mentioned that:

“Noon ay nahirapan kami na magkumbinsi na makapasok sa Bahay Pagbabago pero etong later na
(paused) marami na gustong pumasok. Mula ngayon hanggang December may naka schedule na. (At first
we find it hard to convince them but later on majority of them wants to enter the program. There is already
a schedule from this month until December of who will enter the Bahay Pagbabago.)”

When asked whether all of the drug surrenderee’s were willing to undergo reformation, in an interview:

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 “Hindi hindi, hindi lahat. Pero pag talagang malala na, na papraning na, yung mismong asawa,
magulang na nagdadala dito samin. Kasi pag ka ganun na willing ang magulang walang problema. (No,
no, not all. But when there is paranoia, the spouse or parents voluntarily bring them to us.)”
The nature of the work of the participants and their availability affects their intention to undergo

reformation. Most of them are working to support their family. Hence, this is a major obstacle in the

admission to the program and eventual recruitment of the client. In an interview with a barangay official,

he added:

“Ang ikinatatangi lang ng iba kaya ayaw nila, dahil yung trabaho, hindi sila pwedeng mawala ng
one-month dahil karamihan sa trabaho pag umalis ka ng one-month wala ka ng babalikan. (Some refuse
to undergo reformation due to the fact that they have work and they can’t just leave for one month as it may
be a reason for losing their job)”

Referral by the family members to the reformation center is also a usual method of recruiting the

participants. As to the gender, most of the reformation center admit only male surenderer’s except in

Municipality D as they have separate room for female reformist.

In the assessment phase, there is an interview conducted by the PNP for profiling (taking of personal

information) and medical check-up conducted by a health practitioner for screening. The Bahay Pagbabago

only accept drug users who are mild or low risk drug user. The determining factors to accept the client lies

in the preliminary screening and interview. If in the interview, a drug surrenderee who is a problematic

drug user is referred to a DOH accredited drug rehabilitation center.

Discussion with family members regarding the program happens during the OPLAN Tokhang or

during the encounter with the police when they knock and asks the drug user to surrender. There is also a

brief dialogue in the Barangay with the drug surenderee together with the police and BADAC members.

Orientation about the rules and regulations inside the Bahay Pagbabago happens in Day 1 of the program.

In an interview with a police officer, she narrated:

“Kasama po namin sila (referring to the drug user), kinakausap na po namin yung pamilya tungkol
po dun sa gagawin pong thirty days na reformation kasi mawawalay,so kailangan ma-condition lalo na
yung may mga pamilya, asawa sila lang yung sumusuporta. So pinapaliwanag po namin sa kanila kung
para saan po yung reformation kasi kumbaga de-listing, din po kasi yan para malinis na po yung pangalan
nila. xxx kagaya po nung binaba po ng PDEA na listahan, isa po sa mga parameters dun para po kayo ay
ma-clear ay mag undergo ng reformation program. So kapag po pumasok na mabigayan po namin ng
certificate, napaliwanag po namin sa kanila na at least mas magiging panatag sila kasi hindi na sila
magpupunta dun para katukin uli, hindi na sila mangangamba baka i-operate sila at least meron na sila,
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meron na silang pinanghahawakan. So napapaliwang po ng maayos sa pamilya yun xxx.(They are part
[referring to the drug user], we talked to the family regarding the thirty days reformation as the drug user
will be separated with their families. They need to be prepared especially those who are married and have
their own family and serve as the breadwinner. We explained to them the purpose of reformation, as it also
serve as de-listing of their names. Xxx the list issued by the PDEA, one of the parameters therein to clear
your name is to undergo reformation program. So when they are already inside the Bahay Pagbabago and
there is already a certificate, we explained that at least they will be at peace s they will not be the subject
of the knock and plead campaign, they will not be afraid they will be the next subject for operation at least
they have their certificate as proof of reformation. We clearly explained that to the family and they
understand.)”
In this parameter most of the criteria were met except preliminary screening and basic needs

assessment for client who will enter the Bahay Pagbabago. This is also based from the collated information

from the stakeholders, document analysis and field observation.

According to the Center for Substance Abuse Treatment, screening involves asking questions carefully

designed to determine whether a more thorough evaluation for a particular problem or disorder is warranted

as many screening instruments require little or no special training to administer.

In addition, according to CSAT (2017), screening is a process for evaluating the possible presence of

a particular problem. On the other side, assessment is a process for defining the nature of that problem,

determining a diagnosis, and developing specific treatment recommendations for addressing the problem

or diagnosis.

According to the UNODC (2010), good assessment is essential to the continuing care of the patient

and that the primary purpose of assessment is to carry out a functional analysis and determine the best type

of response. Assessment is an ongoing process and does not stop at the first interview. A rehabilitation

worker, duly accredited by the DOH, conducts the assessment (UNODC, 2010).

In a study in Nyanza province, one of the causes of relapse cases was a result of poor assessment of

addicts prior to their admission in the rehabilitation centers (cited in the study of Sereta BN & Amimo FA,

2016).

Another study by Ferreira (2015) emphasize the importance of proper screening and assessment, the

study deals with drug addict treatment motivations and it was found that health professionals must assess

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these stages at the beginning of treatment because, when planning care according to the patient's

idiosyncrasies, they will expand the possibilities of success in rehabilitation.

Successful treatment begins with a comprehensive biopsychosocial assessment and diagnosis.

Treatment needs are determined using comprehensive and multidimensional assessment procedures,

typically in the form of structured clinical interviews and standardized assessments. (Hawkins et al., 2012)

Based from the previous study, screening and assessment are essential factors in effective treatment of

drug use. The absence of proper screening and assessment inside the Bahay Pagbabago may result in

admitting severe drug users that may lead to ineffective treatment. Needs assessment results should be

integrated as a part of an organization’s on-going commitment to quality services and outcomes.

Programs inside the Bahay Pagbabago

As provided in the Guidance for Community-Based Treatment and Care Sevices for People Affected

by Drug Use and Dependence in the Philippines (2010), program for low risk for drug abuse dependence

includes: a.) individual and family programs (e.g. orientation and briefing, seminars, brief intervention,

family counseling, individual counseling); b.) Community Care Interventions (e.g. skills training,

livelihood opportunities, job placement); c.)Health Psycho-education (e.g drug awareness lecture) and d.)

Psychological/Social/Spiritual Support Services (e.g. recollection, retreat) and that the minimum duration

of the program should be one (1) month.

Table 6. Results of the evaluation of the Programs inside the Bahay Pagbabago
Evaluation Criteria Practice of Selected Bahay Assessment
Pagbabago in Bulacan Province
 Provision of support to drug users  Provision of support to drug Provision or condition
who are not drug dependent user is present is limited

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  Referral of drug users to DOH  There is no referral of drug
accredited physicians in case of users to DOH accredited Provision or condition
severe drug dependents physicians in case of severe is missing but needed
drug dependents
 Liaising with NGOs in the  Liaising with government or
Provision or condition
community for logistical and non-governmental organization
is limited
financial support is present
 Provision and availment for psycho-  No provision for psycho-social
social counselling for drug counselling for drug Provision or condition
surrenderees surrenderees is missing but needed

 Presence and participation to the  Livelihood and skills

Provision or condition
following programs development programs are
is moderately
(a) Livelihood and skills development provided by TESDA and other
extensive
(b) sports and recreation (c) spiritual volunteer
formation activities (d) Literacy  Basketball is the usual activity Provision or condition
program (e) programs that enhanced for sports and recreation is limited
the social-civic kindness of drug  Different religious group visits
surrender Provision or condition
the center at least 2 hours
is made extensively
everyday
 No literacy program is being
provided Provision or condition
is missing but needed

 No socio-civic kindness activity

Provision or condition
is missing but needed

 Therapeutic community services are  Therapeutic community

Provision or condition
practiced and made available. services are practiced and made
is limited
available.
To determine the programs being implemented in the Bahay Pagbabago, documents such as the

Operations Manual, Program of Instruction, Daily Activities of the reformist were collected to each Bahay

Pagbabago depending upon if any of the mentioned documents are available and can be accessed by the

researcher. As well as an in-depth interview to validate the information in the documents. Lastly, a field

inspection was also conducted by the researcher.

The Bahay Pagbabago in Bulacan has a duration of 30 days except in Municipality C which is the

only reformation center which has a duration of 90 days for completion. The programs offered consist of

the livelihood and skills development provided by Technical Education and Skills Development

Authority (TESDA) and others volunteers and to prepare them for employment.

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 For their spiritual formation activity, different faith based groups are visiting the reformist twice a

week for spiritual guidance and religious activities. Physical activities consist of everyday morning

exercise and basketball games made as part of their leisure activities usually held on weekends. It is

noteworthy to say that there is no literacy program in the Bahay Pagbabago among the six municipalities.

Socio-civic activity is limited only to tree planting and community-service such as general cleaning in

designated places in the community.

The usual daily routine of the reformist start at 5 o’clock in the morning and ends at 9 o’clock in the

evening. From 6: 00- 12: 00, the common activities are formation/head count, exercise in the morning,

polishing the area, spiritual activity provided by the religious group, skills and livelihood activities. After

their lunch, the reformist have their ‘siesta’ from 1: 00- 3: 00 PM. From 3: 00- 5: 00 farming or gardening

are conducted. Finally physical activity such as basketball from 5: 00- 6: 00 and dinner is at 7: 00 PM

formation/accounting.

Financial support comes from the Local Government Unit such as the Municipality and the Barangay

for the payment of the rent, food and electric bill of the reformation center. The financial resources of each

Bahay Pagbabago depends on the budget allocated by the Local Government Unit. There are instances

wherein if there is a shortage fund, the reformists would shoulder the expenses thru equitable contribution.

Service providers or the staff of the Bahay Pagbabago experienced difficulty in the implementation the

program without strong coordination with the LGU, in an interview one of the staff said:

“Actually sana yung coordination between the PNP and LGU’s mas lalo pa sanang maging mas
maganda. Kasi kung walang tulong ng LGU’s at ang kapulisan lamang po ang tutulong, ang gagawa, hindi
po namin kayang iprovide lahat ng pangangailangan dun. Unang-una yung financial support na dapat
talaga eh katuwang natin yung LGU’s dahil sila po ang meron budget regarding dyan. So, sana po yung
bawat station or bawat bayan ng Bulacan is magkaroon po sila ng tamang budget,tamang coordination
para po mas mapaganda yung ginagawa,lalong-lalo na po sa loob ng Bahay Pagbabago. (I hope that
improved relationship and coordination between the PNP and LGU’s should happen. The PNP does not
have enough budget so without the assistance of the LGU, we cannot provide all the needs in the Bahay
Pagbabago. First of all, the financial support that the LGU should be a priority in the budget. So, I hope
that in every municipality or city will have sufficient funds, coordination for the enhancement of the
programs in the Bahay Pagbabago)”

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 There is no referral of drug users to DOH accredited physicians in case of severe drug dependents, in

an interview to a question in determining the steps taken if such case occur, he narrates:

“Inaano lang natin sila sa loob, yung parang kininoconfined pero dito pa din sila, isolate sila , tapos
inobserbahan ng mga officer. (We just confine and isolate them here then there is an observation by the
officer)”
Graduation ceremony is attended by the Chief of Police and Local Chief Executive; service providers;

family of the reformist; and the new incoming reformist. A ‘Certificate of Completion’ is being issued

signed by respective local head of the PNP and LGU. A ‘Certificate of Appreciation’ is also given by

religious groups and other volunteers of the reformation.

Therapeutic community is present in the Bahay Pagbabago. Therapeutic community is defined as

having a recovery orientation, focusing on the whole person and overall lifestyle changes, not simply

abstinence from drug use. (Vanderplasschen et al., 2013; De Leon, 2012).

The programs inside the Bahay Pagbabago is limited as there are programs that are not currently

offered or implemented in the Bahay Pagbabago such as literacy or educational program which is a

necessary asset for a full life and the assurance of a sustainable livelihood (UNODC, Guidance for

Community-Based Treatment and Care Sevices for People Affected by Drug Use and Dependence in the

Philippines). This is also justified by the fact that the budget given is often delayed if not available for use,

hence, the clients are compelled to contribute to defray the costs of the operations. There is also no referral

of drug users to DOH accredited physicians in case of severe drug dependents affected by the absence of

proper assessment in the admission process.

Research conducted by Doris MacKenzie et. al (2012) asserts that rehabilitation programs that have

shown to be effective include the following vocational education; academic education; drug treatment in

the community (cited in the study of Miceli, 2009). Another study by Ntembi (2010) noted that treatment

of drug abusers also encompasses vocational training to help acquire skills, which make them self-reliant.

He also added that rehabilitation typically includes assessment of individual‘s vocational needs,

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counselling, skills training, and job placement. In connection with the study by Chie (2016) wherein four

activities were identified by patients and rehab staff as favorite treatment components: spiritual

studies, vocational workshops, counseling), and recreational activities. Spiritual studies, either religious-

based or civic-focused teachings, were viewed as essential toward helping patients resolve personal issues

and bring about internal changes. Vocational skill components were beneficial toward preparing patients to

enter the workforce after treatment completion. Group counseling sessions were able to provide patients

with the opportunity to share their problems and resolve it as a team, while individual counseling with

professionals help patients resolve personal issues that are confidential in nature. Recreational activities

were also a favorite, as it did not require special skills and helped improve patients’ physical health.

The presence of counselling according to the Wake Forrest University provides a safe space for patients

to openly talk about their struggles with addiction, to guiding family members through the recovery process,

to addressing plans to avoid relapse, counselors play an important role in addiction recovery. In the study

Jhanjee (2014), substance misusing clients, any form of psychological treatment leads to better treatment

outcomes compared with no psychological treatment, but there is no general consensus that one form of

psychological treatment is better than another. Psychosocial interventions treatment includes cognitive-

behavioral therapy (CBT) (including relapse prevention (RP), contingency management (CM),

motivational enhancement/motivational interviewing (MI) and brief interventions (BIs) for alcohol and

tobacco.

According the UNODC (2010) acquiring occupational and vocational skills builds self-worth and self-

esteem and can lead to higher levels of satisfaction, provide a sense of security, and reduce the risk of

relapse.

As to the spiritual formation activities, it was proven that in the study by Khodayarifard & Fatemi

(2013) the enhancement of family members social competencies based on a focus on spirituality and

cognitive behavior techniques may facilitate the process of modification of thinking patterns of clients. De

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Ridder (2010) suggested that without a combination of spiritual, relational and transformational processes,

effective treatment is not possible.

As to the psychological outcome of physical activity to the reformist the participation is consistently

associated with positive mood and affect; experimental trials support the effect of moderate exercise on

psychological well-being; exercise is related to positive changes in self-esteem and related physical self-

perceptions. In the same study he noted that there is also a meta-analytic findings show a large effect size

from studies that have used exercise as a treatment for clinically defined depression. It is that physical

activity could not be a panacea but that it could have a possible role such as improving physical health,

providing a diversion from drugs, providing an alternative social network and possibly helping prevent

relapse. However, evidence for the use of exercise in drug rehabilitation programs is very hard to find. In

contrast, physical activity has the ability to improve mood, as long as they are not too intense and

competitive, which can in turn worsen negative affect (Salmon, 2001). In a study by More et al. (2017) it

was found that exercise help to alleviate a number of the factors that contribute to SUD development and

that act as barriers to healthy recovery (e.g., a lack of social support, poor mental health, high stress, and

boredom).

Effective interventions depend on a coordinated response between criminal justice agencies, drug

abuse treatment providers, mental health and physical health care organizations, and social service agencies

(Chandler, 2010).

In the study by Vanderplassche (2013) he defined therapeutic communities for addictions are drug-

free environments in which people with addictive problems live together in an organized and structured

way to promote change toward recovery and reinsertion in society. TCs can promote change regarding

various outcome categories. In a study by Johnson, K. (2008) which assess the impact of drug abuse

treatment showed substantial positive change in use of illegal drugs in a TC Program with fidelity.

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 The program of Bahay Pagbabago has a duration of 30 days only which may become more effective

if the duration be sufficiently long to produce stable behavioral changes (NIDA Principles of Drug Abuse

Treatment for Criminal Justice Populations, 2012). According Johnson et al. (2008), studies have

consistently shown the length of time a drug user stays in a treatment program is one of the most important

predictors of successful treatment outcomes.

The Bahay Pagbabago offered programs which does not respond to individual needs of client can make

the program ineffective. Based on the previous study vocational, educational, counseling or psycho-social

intervention should be included in the programs offered inside the Bahay Pagbabago as the aforementioned

programs produce positive outcome as to the abstinence in taking illegal drugs. The physical activity such

as exercise really have a positive psychological effect into the reformist however, intense and competitive

exercise may lead to negative outcome.

Aftercare Programs of the Bahay Pagbabago

Aftercare which comprises a broad range of community-based supports designed to maintain the

benefits that have been achieved when a structured treatment has been completed. Community Support,

Aftercare and Reintegration shall focus on relapse reduction and reintegration into the community may

which consists of the following core services: Medical/Dental Services; Psychological Services and Social

Services which include random Drug Testing (Adm, Order No. 2017-0018, DOH). It is one of the most

important actions any recovering addict can take to increase their odds of successful sobriety (Siringi, 2003

cited the study of Sereta, et. Al, 2016). In this aspect, the researcher gathered the data through interview

of the stakeholders and field observation in the reformation center. The provisions for aftercare or follow-

up of clients offers the opportunity to reinforce treatment interventions and may reduce the number, length

and severity of a relapse (UNODC,2010). Aftercare in the Bahay Pagbabago, includes: house visitation;

monitoring and providing and helping the graduates in searching for employment.

Table 7. Results of the Aftercare Service Evaluation of the Bahay Pagbabago

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 Evaluation Criteria Practice of Selected Bahay Pagbabago Assessment
in Bulacan Province
 Provision for aftercare  House visitation for each graduate is Provision or condition is
services not widely practiced limited
 Employment assistance thru hiring
some of the graduates in the
reformation center or referring them to
other agencies
 Monthly reporting in the reformation
center, police station or in their
respective barangay
 Drug test are administered  No random drug testing have been
in a pre-determined period conducted
Provision or condition is
of time to determine
missing but needed
whether client is still using
illegal substances.

The conduct of house visitation after the client has completed the program as an after care activity is

not widely implemented but there are still some practices Bahay Pagbabago who have such visitations. In

an interview with a barangay chairman regarding house visitation, he confirmed:

“Oo nagpupunta din sila dito, nagpapasama sila sa bahay, dadalawin nila, titingnan nila kalagayan
kung okay lang. (Yes, they visit here, together with our company, they will visit them (referring to the drug
user) just to check if they were fine).”
While monitoring of drug personalities is the most widely activity implemented for aftercare programs.

One of the stakeholder explains how monitoring is being conducted:

“Yung sa monitoring kasi, halimbawa etong tao na to eh graduate sya ng barangay graduate in the
Bahay Pagbabago) xxx. Ngayon kung ilan ang graduate duon ng Bahay Pagbabago, meron pong naka
assign na intel operative kami dun so tatanungin yung mga kapitbahay, yung pamilya, (illustrating an
actual statement of an operative) anong napansin nyo meron bang kakaiba silang ginagawa na hindi ulit
kaaya-aya? (paused) at the same time syempre yung mga nahuhuli namin na halimbawa sa operation sa
anti-illegal drugs syempre magbibigay yan ng mga kasamahan nila kung sino pa yung active na
gumagamit. So dun pa lang sa mga taong kagaya din nila kung totoo o seryoso yung pagpasok nila sa
Bahay Pagbabago. (Monitoring of graduates is conducted this way, for example, this person is a graduate
(graduate in the Bahay Pagbabago) in that barangay xxx. Depending on the number of the graduates there
are intelligence operatives assigned therein who will conduct query to the neighborhood, family and the
like [illustrating an actual statement of an operative] Did you notice something unusual to him [referring
to the graduate]? At the same time those who were arrested in the operation for illegal drugs also provides
information as to the person who still use drugs. In that aforementioned circumstances, we can determine
whether a person who is a graduate of Bahay Pagbabago is serious in the reformation program.)”

Reformist can also be monitored thru reporting in the barangay, police station or reformation center

on a monthly basis after their release in the community. The usual activity involves signing an attendance

18
sheet twice a month usually conducted during weekends. However, lenient monitoring was found by the

stakeholder as weakness of the program they even suggested that:

“...yung pangalawa dapat eh monitor (paused) sana, maaring may nagmomonitor sana pero kung
maari mas higpitan pa dapat para kung may gustong bumalik eh macontrol na. (Second, I hope that the
monoting be more strict so that those who wish to return to drugs ca be controlled.)”
Another manner on how the reformist can be monitored is by assisting the graduates who do not have

occupation upon his/her release to the community to be employed with the partners of the LGU. The

researcher encountered during the field investigation that some graduates are presently working in the

police station as “runner” or simply an errand boy. In some cases, the reformation center employs the

graduates as cook and maintenance staff in the Bahay Pagbabago. In another municipality some graduates

are employed as maintenance in an agency of the government. The aforementioned occupation have been

occupied by the graduates through the assistance and guidance of the LGU in partnership with the local

police.

Random drug test was never conducted in the Bahay Pagbabago as they lack resources. Hence, relapse

of drug users cannot be determined.

A service provider or staff of the Bahay Pagbabago mentioned that they are planning to coordinate

with religious groups in the monitoring of clients. This partnership with religious group shall include close

coordination with the family of the reformist. But she clarifies that they are currently in the planning stage

and the actual execution is not yet clear:“.…

may bagong programa ang Catholic dito na isasama nila sa rehabilitation ang family. So kakausapin
nila ang family every Sunday na dumadalaw sa kanila. So hindi matatapos sa rehabilitation center lang sa
reformation center lang, baba pa sila sa community. xxx. Initial pa lang, sila palang yung unang batch.
Tapos kapag naayos na namin bababa kami sa community para tuloy-tuloy ang rehabilitation.(… there’s
is a new program of the Catholic groups wherein they will include in the rehabilitation the family of the
reformist. So they will talk to the family every Sunday during their visits. So that rehabilitation in the
reformation center, it will be extended in the community. We are still in the initial stage of implementing it,
they [referring to the present batch of the reformist] will be the first batch. Then, upon polishing here, we
will go down to the community for the continuation of the rehabilitation) “

In this parameter, aftercare services was limited. Although, house visitation, monitoring and assistance

to the employment of the graduates are provided, they are not widely practiced. In addition, aftercare

19
services as to the medical/dental services and psychological services to prevent relapse are lacking. In

addition, random drug testing was never a practiced in the Bahay Pagbabago.

Aftercare service is a key component of substance-abuse treatment which involved strengthening the

individual's place in the community as a productive worker, family member, and community member cited

in the study of Kelly et al. (2010). These services when available are critical phase for ultimate success for

treatment. Former drug abusers often face severe problems of adoption when moving from the protected

and well-structured environment of therapeutic community, back to normal life (Ntembi, 2010). In addition,

in the study of Vanderplasschen et al. (2013), participation in aftercare, post treatment employment, and

older age were found to be the most common predictors of abstinence and absence of re-arrest

The monitoring being conducted by the PNP will not deter the graduates in using illegal drugs again

as monitoring serves as an eye only for checking if there’s a relapse on the part of the graduates. According

to the UNODC (2017), Developing Community Drug Rehabilitation and Workplace Prevention

Programme:Aftercare Services For Drug-Dependent Persons, monitoring and collecting information about

clients after they leave a program is not aftercare but the focus should be providing support and guidance

in relapse prevention, whole person recovery, and developing new skills.

House visitation conducted by the PNP reflects as good way of engaging and determining the status of

the graduates. It also provides them with the particular needs of the graduates in relation to their reformation

in order to improve their lives. Kouimtsidis et aI., (2007) stated that family members plays arole in the

recovery process of the addict. The report of Buckley (2009) in Ireland he noted that many of those

receiving treatment for problem drug use are early school leavers, with low educational attainment and a

history of unemployment hence, providing Community Employment places to be made available for drug

users in rehabilitationas well as basic education and training — such as the pre-Community Employment

stabilisation initiative — are now envisaged, aimed at ensuring that those with the greatest skill and

competence deficiencies have an opportunity to progress to other forms of training and education.In another

study in Tobago and Trinidad by it was concluded that structured aftercare would help clients maintain

20
accountability, continue the education process on addiction, provide a supportive network and integrate the

family and other support systems into the recovery process (Callender, 2010). In providing comprehensive

service, according to Center for Substance and Abuse Treatment (2008)treatment providers should be

prepared to help clients access a broad array of services, including life skills development, English as a

second language, parenting, nutrition, and employment assistance.

An aftercare program should also be individualized, therefore a need assessment should be conducted

to determine the specific needs of the graduates upon their release to the community. To response with the

needs assessment it should be coordinated with community organizations, primary health services including

NGOs and Social welfare agencies which serves as a component of a community-based treatment program.

The minimum duration for community support, aftercare and reintegration shall be six months and

maybe extend depending upon the assessment of the community health team (UNODC, Guidance for

Community-Based Treatment and Care Sevices for People Affected by Drug Use and Dependence in the

Philippines, 2010). In Georgia, there is a six-month, highly structured; substance abuse aftercare services

program that targets offenders who have completed a primary, intensive substance abuse treatment program

which consist of cognitive-behavioral process groups, crisis interventions, group activities, and treatment

follow-up for program graduates (Substance Abuse Aftercare Services Program).

Based from the above mentioned study aftercare practice in the Bahay Pagbabago an individual

aftercare service based on assessment should be considred. Although, duration of 6 months is the mandate

as an aftercare this may be extended Family should also be considered in planning aftercare service as well

as the community. Aftercare services which provide skills and training for possible employment should

also be added as program for aftercare. Most importantly, there should be structured, monitored and

integrative aftercare program for enhancement and further development of the Bahay Pagbabago.

Conclusion

The program of execution the parameters of identification, assessment and admission all of the criteria

was present except basic needs and assessment; programs in the Bahay Pagbabago is only limited in to

21
livelihood and skills development, spiritual formation, sports and recreation essential factor is the limited

financial support from the LGU. The aftercare services was also found limited only to monitoring after

release made thru the use of intelligence operatives, reporting in the barangay, police stations or reformation

center and random house visitations.

Recommendations

Screening and assessment should be strictly followed before admitting a reformist to be performed by

a specialist in the field of drug screening including but not limited to psychologist, medical doctor and the

like. An individualized treatment plan should be designed for each reformist in view of their needs and

best interest which is made during the initial stage of the program. Livelihood and skills program for each

reformist should be aligned with their career or preferred job opportunities. The intervention of Psychologist

is also needed. In addition, creative, art or craft making activities should be included in the programs to be

implemented iniside the Bahay Pagbabago. Policy makers and other stakeholders should formulate ways

of funding the existing Bahay Pagbabago reformation center, this may include legislation by the local

municipal council by utilizing their internal revenue allotment or may solicit from philanthropist.

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