Presented With The Complaints Of Depression Psychology Essay

Presented With The Complaints Of Depression Psychology Essay The purpose of this case study is to describe the case of a patient known as Ellen Farber. Ms. Farber, an insurance company executive, arrived at a psychiatric emergency room at a university hospital with numerous complaints in regard to her overall well-being. It is apparent that Ms. Farber has been affected by her symptoms to a large degree. This case study will discuss the complaints provided by Ms. Farber and will provide a detailed discussion of how her symptoms fit the criteria provided in the DSM-IV-TR for several disorders such as Major Depressive Disorder, Single Episode; Eating Disorder Not Otherwise Specified; and Impulse-Control Disorder Not Otherwise Specified. This paper will also discuss differential diagnoses as well as co-occurring disorders that may be present. The final portion of this paper will discuss a possible treatment plan as well as an indication of the patients prognosis based on known information about her diagnosis. Ellen Farber is a 35 year old woman who presented with complaints of depression, the thought of driving her car off of a cliff, and numerous other symptoms. Upon closer evaluation of Ms. Farbers symptoms it appears that she is suffering from a Major Depressive Episode. The symptoms that she has exhibited that allow for this conclusion are a lack of energy for the past six months; a lack of pleasure for the past six months; increasingly persistent depressed mood for the past six months; oversleeping in amounts of 15-20 hours per day; overeating to the extent that she has gained 20 pounds over the past few months; and thoughts of suicide with a specific plan (Barlow Durand, 2012, p. 206). According to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000), the presence of a single manic depressive episode in the absence of another disorder, such as schizophrenia, indicates that Ms. Farber can be diagnosed with Major Depressive Disorder, Single Episode. It is also clear that Ms. Farber has never experienced a prior Major Depressive Episode indicating even further that Major Depressive Disorder, Single Episode is the proper diagnosis for her (DSM-IV-TR, 2000, p. 375). It is essential to point out that Ms. Farber is also a candidate for other diagnoses because she has engaged in binge eating and impulsive spending. Ms. Farber has reported that she has engaged in eating binges since she was an adolescent. During these binges she reports that she eats anything that she can find. Although she has engaged in intermittent binge eating since adolescence she has done so without using compensatory methods to rid her body of the excess calories. According to the DSM-IV-TR (2000), Ms. Farber should be diagnosed with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) because she does not engage in the compensatory behaviors that are typically characteristic of Bulimia Nervosa (p. 595). Fin ally, Ms. Farber has engaged in shopping sprees that she refers to as buying binges. This excessive and impulsive spending has resulted in a large amount of debt, about $250,000, that has arisen from illegal practices such as unauthorized use of her employers credit cards and over drafting bank accounts to open new accounts, a process she calls check kiting. Since the money was used on impulsive purchases and cannot be accounted for by another disorder, such as substance dependence or a paraphilia, it appears likely that Ms. Farber is also a candidate for a diagnosis of Impulse-Control Disorder Not Otherwise Specified (DSM-IV-TR, 2000, p. 677). According to the DSM-IV-TR (2000), the following diagnoses are relevant for Ellen Farber: Axis I: Major Depressive Disorder, Single Episode Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) Impulse-Control Disorder Not Otherwise Specified Axis II: Borderline Personality Disorder Axis III: Moderately Overweight Axis IV: Unemployed, financial difficulties Axis V: GAF = 35 (current) On Axis II, Ellen received a diagnosis of Borderline Personality Disorder for several reasons. First, she has reported that she has experienced lifelong feelings of emptiness, chronic feelings of loneliness, chronic feelings of sadness, and chronic feelings of isolation. In order to satisfy her feelings of emptiness she has engaged in weekly buying binges which established her current level of debt. Ellen has also engaged in daily episodes of binge eating without compensatory behaviors. She has also experienced chronic uncertainty with whom she wants to be friends and about what she wants to do in life. We also know that she has been in numerous brief and intense relationships with both men and women. In these relationships, Ellen exhibits a quick temper that has frequently led to arguments and physical fights. Based on a comparison of Ellens symptoms and the diagnostic criteria for Borderline Personality Disorder provided in the DSM-IV-TR it is clear that Ellen suffers from Borderli ne Personality Disorder (DSM-IV-TR, 2000, p. 710). Ellen has not presented with any other medical conditions other than the fact that she is moderately overweight. Since this is the only condition of concern it was listed on Axis III. Axis IV includes relevant information about psychosocial and environmental problems that may be affecting Ellen. Since Ellen is unemployed and is experiencing a large amount of debt as a result of her spending binges this information is listed under Axis IV (DSM-IV-TR, 2000, p. 33). On Axis V I have included a GAF score of 35. After evaluating the information provided in the DSM-IV-TR it seemed apparent that Ellen fell within the 40-31 range on the GAF scale. She fell into this range as a result of her suicidal thoughts with a specific plan and because she is currently unemployed but unable to work as a result of her depression. Within the scale it appeared that Ellens level of functioning was not severe enough to receive a GAF score of 31 but her func tioning was not well enough to receive a GAF score of 40. Based on this scale, it seems that Ellen fits in the middle of the 40-31 scale so I assigned a GAF score of 35 (DSM-IV-TR, 2000, p. 34). According to the DSM-IV-TR (2000), there are several common differential diagnoses present for Major Depressive Disorder, Single Episode. These disorders include Bipolar I Disorder; Bipolar II Disorder; Mood Disorder Due To a General Medical Condition; Substance-Induced Mood Disorder; Dysthymic Disorder; and Schizoaffective Disorder (DSM-IV-TR, 2000, p. 373). In the process of diagnosing Ellen, I made a differential diagnosis between Dysthymic Disorder and Major Depressive Disorder, Single Episode. The primary way that this differential diagnosis was made was comparing the length of time that Ellen reported experiencing her symptoms and comparing them to the length provided in the DSM-IV-TR. For Dysthymic Disorder, a period of at least two years must be met for depressed mood (Barlow Durand, 2012, p. 209). Symptoms for Major Depressive Disorder, Single Episode are only required to be present for a period longer than two weeks (Barlow Durand, 2012, p. 206). From the information that is known about Ellen, it only appears that Ellens symptoms have differed from her normal level of functioning for six months. Since Ellen did not meet the minimum two year requirement for depressed mood it seemed apparent that her symptoms only met the criteria for Major Depressive Disorder, Single Episode. Eating Disorder Not Otherwise Specified also presented with a differential diagnosis, Bulimia Nervosa. This was easily distinguished because Ellen did not engage in compensatory behaviors in order to control her caloric intake, and a diagnosis of Bulimia Nervosa requires that a person engage in inappropriate compensatory methods to prevent weight gain (DSM-IV-TR, 2000, p. 589). It is not uncommon for other mental disorders to co-occur with Major Depressive Disorder, Single Episode. These common mental disorders include Substance-Related Disorders, Panic Disorder, Obsessive-Compulsive Disorder, Anorexia Nervosa, Bulimia Nervosa, and Borderline Personality Disorder. Axis II presents the personality disorders that Ellen has presented with and Borderline Personality Disorder is listed. Ellen has presented with chronic feelings of loneliness, emptiness, sadness, and isolation. She has also experienced chronic uncertainty about what she wants to do in life and with whom she wants to be friends. She has engaged in numerous intense relationships with both men and women that have often resulted in arguments and physical fights as a result of Ellens quick temper. In order to cope with her chronic symptoms she has engaged in weekly buying binges and daily episodes of binge-eating. Based on this information, as stated previously, Ellen meets the criteria for Borderline Personality Disorder (DSM-IV-TR, 2000, p. 710). There are no conditions listed in the DSM-IV-TR that co-occur with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) or Impulse-Control Disorder Not Otherwise Specified. The treatment of Ms. Farber is complicated by her thought of driving her car off a cliff. This indicates that she possesses suicidal desire, capability, and intent. As a result, she should be asked to agree to, or sign, a no-suicide contract. This contract is essentially a promise that she will not attempt suicide without contacting the mental health professional overseeing her case first. If she declines to agree to the terms, or if there is doubt about her sincerity, hospitalization may be required (Barlow Durand, 2012, p. 251). Considering that Ms. Farber has presented with several co-occurring conditions, treatment for her Major Depressive Disorder would be most effective if she undergoes combined treatment. The first aspect of her treatment should be a medication based treatment, particularly treatment with a selective-serotonin reuptake inhibitor (SSRI). This medication functions by blocking the presynaptic reuptake of serotonin causing a temporary increase in the levels of se rotonin at the receptor site. All antidepressant therapies provide some form of benefit to about fifty percent of the patients who receive them (Barlow Durand, 2012, p. 236). In combination with the prescription for SSRIs, I would also recommend cognitive-behavioral therapy. A cognitive-behavioral approach, such as Lynn Rehms self-control therapy, could assist Ellen in gaining control over her moods and daily activities while incorporating cognitive therapy to assist her in identifying and correcting errors of thought, shifting her thought pattern from a depressive thinking pattern to a more realistic thinking pattern (Barlow Durand, 2012, p. 240). Ms. Farber should also undergo treatment for her diagnosis of Eating Disorder Not Otherwise Specified (Binge-Eating Disorder). The most appropriate treatment for Ms. Farber would be a technique that involves therapist led treatment. It seems appropriate that she should undergo guided self-help therapy in which she would meet with a ther apist periodically to review a self-help manual. This approach would be the most effective for her because she presented with several diagnoses (Barlow Durand, 2012, p. 375). The prognosis for Ms. Farber appears to be relatively positive in regards to the alleviation of her Major Depressive Episode; however, there are some risks within the first two years following her diagnosis of Major Depressive Disorder, Single Episode that may alter her prognosis level to fair. Approximately 67%, or two-thirds, of patients experiencing a Major Depressive Episode may experience complete remission of their symptoms. One-third, or 33% of individuals suffering from a Major Depressive Episode may only experience partial remission of their symptoms or may not experience any alleviation of their symptoms at all. At least 60% of individuals with Major Depressive Disorder, Single Episode will experience a second episode and 5%-10% will subsequently develop a manic episode, meeting the criteria for Bipolar I Disorder (DSM-IV-TR, 2000, p. 372). In the first year following an episode there is a 20% risk of reoccurrence. In the second year the risk of reoccurrence increases as hi gh as 40% which would qualify Ms. Farber for a diagnosis of Major Depressive Disorder, Recurrent (Barlow Durand, 2012, p. 208). By undergoing combined treatment for her depression her chances for remission may increase slightly over receiving medicinal treatment alone (Barlow Durand, 2012, p. 243). At this point it is impossible to determine the exact course of Ms. Farbers symptoms. At best we can expect a more positive prognosis with treatment than without any treatment at all. Ellen Farber presented with several co-occurring conditions and psychosocial and environmental problems that have potentially affected the onset and severity of her symptoms. The purpose of this paper was to discuss Ms. Farbers symptoms, provide diagnoses based on the DSM-IV-TR, and discuss the appropriate means of treatment for her conditions. Ms. Farber has been affected immensely by her symptoms and requires appropriate treatment immediately in order to prevent her condition from worsening. In the end, her prognosis ranges between fair and relatively positive based on the available knowledge about her diagnosis. It appears that if Ms. Farber receives the appropriate treatment she is at a greater likelihood for remission of her symptoms and continuing treatment may reduce the risk of a reoccurrence of her symptoms. Only time can definitively show how Ms. Farber will be affected by the course of her co-occurring disorders.

Hamlet †What Makes Polonius Indispensable? :: GCSE English Literature Coursework

Hamlet – What Makes Polonius Indispensable?      Ã‚  Ã‚   Polonius, father to Laertes and Ophelia in the Shakespearean tragedy Hamlet, is vitally important to this play. Without his involvement there would be something seriously lacking. Let us dwell on the lord chamberlain in this essay.    In â€Å"Tragic Alphabet† Lawrence Danson explains Polonius’ use of â€Å"lie-detector† acting:    For the lie-detector use of acting is one we see much of in Hamlet, and though it shares certain characteristics with Hamlet’s use of acting, it is decisively not the same. Polonius is the great master of it – of using, that is, the indirection or downright falseness of acting to discover a truth. Polonius was in his time an amateur actor himself; appropriately, he played Caesar and was killed in the capitol. But we now see Polonius either as a theater critic (and it is a flat sort of criticism he practices, multiplying rigid categories while demanding that he be kept entertained), or as a director – of Laertes, Reynaldo, Ophelia, Gertrude. To each he recommends the use of seeming: in the case of Laertes it is to be nothing short of a life-style, but with the others it is specifically a means for getting at a hidden truth. (83)    In the Introduction to Twentieth Century Interpretations of Hamlet, David Bevington presents Polonius as similar to Hamlet in various ways:    Polonius, his [Hamlet’s] seeming opposite in so many ways, is, like Hamlet, an inveterate punster. To whom else but Polonius should Hamlet direct the taunt of â€Å"Words, words, words†? The aged counselor recalls that in his youth he â€Å"suffered much extremity for love, very near this,† and he has been an actor at the university. Polonius too has advice for the players: â€Å"Seneca cannot be too heavy, nor Plautus too light.† When Hamlet jibes at â€Å"so capital a calf† enacting Julius Caesar, killed in the Capitol, he reinforces the parallel to his own playacting and anticipates the slaying of Polonius behind the arras. (4)    Polonius’ entry into the play occurs at the social get-together of the royal court. Claudius has already been crowned; Queen Gertrude is there; Hamlet is present in the black clothes of mourning. When Laertes approaches Claudius to give his farewell before returning to school, the king asks Polonius: â€Å"Have you your father's leave? What says Polonius?† And the father dutifully answers:   

A Cup of Hot Tea Essay

A cup Of Hot tea Tea is a kind of drink. We get It from leaves. Now-a-days it Is popular drink in the world. where grows: Tea grows well in the hilly places where rain water can not stand at all. It grows in Bangladesh, India, China and Japan. In Bangladesh it grows well in the hilly areas Sylhet and Chittagong. How grown: Tree plants grow seeds. Seeds are shown in March; seedlings are planted In rows five feet apart. They are regularly prunced and allowed to grow only four or five feet high. How gathered: When tree lants are four years of age, leaves are plucked three or four times a year. The leaves are first dried in the sun and roested in fire. Thus the leaves are ready for use and sale. How prepared: At firest water Is boiled in a pot. Tea leaves are put Into boiling water. After three or four minutes it Is poured into cups through a sieve. The suger and milk is mixed with it. Thus it becomes a good drink. usefulness: Tea is a useful drink to us. Refreshes body and mind. Gives us energy to work. It also helps us o keep awake. Taking tea three times a day Is healthy for healt While gossiping with our friends and relatives we can not heardly think without a cup of hot tea. It brings a new mood of gossiping And In our country it is an important crop also. Demerites: Tea is not always good for healt. Too much of it is bad for health. It kills our hunger. The Importance of tea In our national economy Is very great. It Conjunslon: brings a good deal of foreign money every year. So we should take care of better production of tea.

Debate About K to 12 Essay

Debate About K – 12 JOEL: Good morning/Good afternoon as the case maybe! The Department of Education is currently facing the issue about —DepEd Order No. 32, series of 2012 (otherwise known as the implementing rules and regulations of Republic Act No. 10157 or the Kindergarten Education Act); and DepEd Order No. 31, series of 2012 (policy guidelines on the implementation of Grades 1 to 10 of the K to 12 Basic Education Curriculum). These curricula are bombarded with a lot of doubt and questions, not being part of the Department concerned with the implementation of these programs. The Department of Education’s planned shift to K+12 seeks to enhance the current curriculum and allow high school graduates to specialize and be equipped with skills to enter industry, a vocation or engage in entrepreneurial activity. Though reforms have been discussed since the Unesco Mission survey in 1949, it is only now that definite action on K+12 is being taken to move our education system up to international standards. But this does not end here. The move to K+12 is a gradual process that will need the time and commitment of all stakeholders, especially parents and teachers, because this kind of reform is not focused on one area alone but involves cohesive action from all sectors to address the needs of their communities. According to some studies and researchers, 10 years of studying is not enough for us to be that ready. That equipped to face all the challenges in life. We are living in this ever – changing world, the reason why we need to be always ready, to be always at our best to face those changes, for us to be fully armed in the time of battle – the battle of the brain, the real battle of life. But is there really a need to add 2 more years just to make us ready and that knowledgeable enough? Is an additional of 2 more years in education really satisfies the need of Filipino people? We are aware that many Filipino suffered and still suffering from hunger, malnutrition, maltreatment, unemployment and many more. Many are suffering from being uneducated and maybe it is true K – 12 is a great help. But the question is can we afford it? There are many out – of – school youth today because of poverty. Because their parents had no means of living, those who are called  as â€Å"isang kahig, isang tuka†. The money they have is just enough for the food and it is too tough for them to go to school and spend their 10 years of life in studying. Because for them what matter most is that they have food to eat. So they choose to work rather than studying. In fact 10 years of studying is really spending a lot of money and another 2 years, more money again. Also, students find it boring and feel like studying is a never ending journey. Additional years in education system will really require more budgets not just from the government but from the parents as well. Aside from that, students will need additional classrooms, school supplies, program and more qualified teachers as well. CHAWEE: We’ve heard the argument on the effectiveness of K+12 if the students don’t even have tables to work on, or can’t even get to school because of poor infrastructure. These are programs that the private sector, through civil society, is actively working on with the help of the government. Local government units have a large role in making sure that the educational needs of their communities are met. The Synergia Foundation has been effective in working with LGUs to improve their communities. ESPLENIA: Are we ready for E-Learning? Maybe yes, or maybe no, but if we don’t prepare for it now we will never be. The technology and the infrastructure have been introduced to the public schools through Gilas, a public-private sector initiative that has been at the forefront of providing computers and Internet connectivity to public schools nationwide. Through Gilas many teachers and students have been trained on the use of technology for learning. An eLearning program called Genyo has proven an effective tool for public school teachers and students. The software is currently being used in private schools and has been donated to public schools through Gilas and the initiative of private foundations. Manuel â€Å"Boy† Mejorada says: November 12, 2010 at 9:57 am JOEL: I must add that the K-12 revised curriculum isn’t the cure-all solution for our educational woes. Huge investments need to be made on strengthening the education infrastructure — classrooms, textbooks, learning aids, teacher  training — at all levels. Adding the two years will not repair the defect if the foundations of a child’s education are weak in the first place. The problem about the present curriculum in squeezing 12 years of basic education into just 10 is that students are overloaded with subjects. Without even having to go inside a classroom, the ordinary observer can already see this from the oversized bags that students have to lug everyday, filled with books and other learning materials One consequence is that the ordinary school day leaves our kids exhausted, with little time for play and socializing at school. This leads to the exclusion of learning social skills which is an essential part of growing up. The main objection of parents against the K-12 is more economic than anything else. Parents fear the extra years will result in more expenses to be shouldered. They miss the point about the proposed curriculum leading to improved learning for their children. Dean Jorge Bocobo says: ESPLENIA: I also realized that indeed â€Å"TEACHING IS NOT FILLING UP THE PAIL, IT IS ABOUT LIGHTING THE FIRE.† Blatantly true indeed—we should not see out students to be blank sheets, who are incapable of thinking for themselves. My teaching career was and is a continuing humbling experience. Our students are geniuses in their own rights, and as educators we should be able to tap on these hidden gifts of theirs. Which brings me to the point of my discussion, will this philosophy that teaching is not merely filling up the pail, rather it is lighting up the fire be heightened or diminished by what is now called the K to 12 program of the Philippine Educational System? CHAWEE: Another point to consider is that children of this generation, this NEW generation, more specifically, get easily bored. They have shorter attention span and will most likely display their boredom and discontent more obviously. So will they be able to bear and cope with the additional years in school? I am also concerned on the preparedness in general with regards to the implementation of this program. Although the program was based on foreign research and was seen to be successful in different  countries, but are we certain that this curriculum will be adaptable to the Filipino learners, and are the teachers ready to adapt yet again another curriculum—believing that this could be the solution to our deteriorating educational system. JOEL: believing that this could be the solution to our deteriorating educational system. Are the teachers well-informed about the program? Do they have enough training, seminar-workshops and the likes? Have there been researches on the effects of the K-12 program in the Philippine classroom setting? Many critics are still bothered that K-12 might be more disastrous than helpful if the transition is not velvety. As sighted by one of the professors from the University of the Philippines-Diliman, integrating K-12 to the educational system is like overhauling the whole system and it obviously require generous time to bring about. Ironically, DepEd keeps reassuring that the time is ample and they will do it gradually. Then if it is true, why was it that most if not all of the kindergarten teachers who underwent the 2-day training for the new kindergarten curriculum have lots of uncertainties in understanding it? In essence, the teachers are the ones who will transmit the program to the students but if they are less capable and less qualified then it may turn ineffectual and waste of time. CHAWEE: Amor Cielo says: My take on the K+12, although the purpose or the intention of the proponents of this additional school year in the Philippine educational system is perfectly everyone parents dream for their kids – to give them the quality of education at par with the global standards, I feel that it is not ideal in our current educational set-up. I deem that before we must be able to successfully attain the global standards that we are aiming for, the government should first look at the current logistics involving the educational system. The following should be first address which has long been a problem ever since. Two of my maids from Mindoro experienced the following: * Classroom shortage – my maid can attest that in Mindoro there are classes held under the tree. * Book Shortage – in their school those who are in lower section has a ratio of 1:7 usage. *  PC usage – only those in the first section has a chance to use the computers. * Teachers’ low salary –Teaching is regarded as a noble profession; they should given proper respect and just compensation / benefits due to them. * Teacher to student ratio – 45 to 50 students or more in one classroom. * Lack of basic facilities needed to provide good learning environment – clean comfort rooms, laboratories, libraries, gymnasium, drinking fountain for potable water, clinic). JOEL: another important thing to consider is that: * Parents have to shell out more money (for transportation and food) for the education of their children. * The government does not have the money to pay for two more years of free education, since it does not even have the money too fully support today’s ten years. DepEd must first solve the lack of classrooms, furniture and equipment, qualified teachers, and error-free textbooks. * We can do in ten years what everyone else in the world takes 12 years to do. Why do we have to follow what the rest of the world is doing? Filipinos right now are accepted in prestigious graduate schools in the world, even with only ten years of basic education. * As far as the curriculum is concerned, DepEd should fix the current subjects instead of adding new ones. The problem is the content, not the length, of basic education. As an editorial put it, we need to have better education, not more education. * A high school diploma will not get anybody anywhere, because business firms will not hire fresh high school graduates. * While students are stuck in Grades 11 and 12, colleges and universities will have no freshmen for two years. This will spell financial disaster for many private Higher Education Institutions (HEIs). * The drop-out rate will increase because of the two extra years. More fundamentally adding two more school years would only exacerbate the situation. * While public education is free, a political youth group estimates that a student would still need an average of P20,000 per school year to cover transportation, food, school supplies and other schooling expenses. * Also, based on the latest Family Income and Expenditure Survey, families prioritize spending for food and other basic needs over their children’s school needs. Two more years for basic education would inevitably translate to higher dropout rate. * Former Education secretary Mona Valisno stated in a separated study  that DepEd needs at least P100 billion to fully address the shortage of 93,599 classrooms and 134,400 seats and P63 million for textbooks and scholarships ESPLENIA: Objectively, the program is good. But the important thing is what does the public say. Hindrances and opposing minds are there. additional years means additional expenses Thus, an extra effort of explaining is needed as our DepEd secretary brother Luistro Armin explained, let us not look at it as expenses but rather more of an investment. traditionally poor families have their children worked right after high school.On the brighter side, k-12 envisions that graduates of senior high school are equipped with skills to get better job opportunities even if they would not pursue college which means a better income for the family.K-12 is not a perfect program though through years of implementation DepEd were open for criticisms and suggestions. Since, one of its biggest problems is the resources. Lack of classrooms, teachers, textbooks and other materials yet budget in education increases still it is not enough but, arising the spirit of unity. This is not just Deped program or b rother Luistro’s but instead it is a Filipino program for the Filipinos. Positively, if the people see that it is viable, help from LGUs and private sectors will pour in. JOEL: History speaks itself that we had gone through BRIDGE, BEC, SEC and many changes in our curriculum. Hope this would be the last; we are unique and adaptable to any kind environment. We Filipinos are survivors. As they say, â€Å"bahala na†¦Ã¢â‚¬  let’s just cross the bridge when we get there. Prepared by: Joel A. Raz In conclusion, let me say that the K to 12 program does not only affect DepEd teachers and personnel—it affects EVERYBODY. But as we all know, we are â€Å"prisoners† and we cannot question the authorities; we have become victims of the circumstances. However, I realized that regardless of whatever program is being implemented by the government, or DepEd, or CHED for that matter, what matters is the dedication of the teachers. How are we willing to go farther and further and give it all we’ve got, even if there’s nothing  left of us to give? It is not a question of how good is the program; it is a question of how are the teachers willing to answer the call of fidelity to the noblest profession.