Law & Ethics: Protecting the Community

10 Ethical Principles: Principles 8 thru 10

When we talk about protecting the community, your community can include your coworkers, your agency, the profession, the neighborhood, or any group that includes more than one person. It is your responsibility to protect the community. Do not rely on others to take care of things. Don't allow yourself to fall for the excuse, "everyone does it," when you know it's wrong.

Codes of Ethics

Each state and licensure/certification board has several codes of ethics that protect the community.
III-2 Integrity: Addiction Professionals shall conduct themselves with integrity. Providers aspire to maintain integrity in their professional and personal relationships and activities. Regardless of medium, Providers shall communicate to clients, peers, and the public honestly, accurately, and appropriately

III-3 Discrimination: Addiction Professionals shall not engage in, endorse or condone discrimination against prospective or current clients and their families, students, employees, volunteers, supervisees, or research participants based on their race, ethnicity, age, disability, religion, spirituality, gender, gender identity, sexual orientation, marital or partnership status, language preference, socioeconomic status, immigration status, active duty or veteran status, or any other basis.

III-4 Nondiscriminatory: Addiction Professionals shall provide services that are nondiscriminatory and nonjudgmental. Providers shall not exploit others in their professional relationships. Providers shall maintain appropriate professional and personal boundaries.

III-5 Fraud: Addiction Professionals shall not participate in, condone, or be associated with any form of dishonesty, fraud, or deceit.

III-6 Violation: Addiction Professionals shall not engage in any criminal activity. Addiction Professionals and Service Providers shall be in violation of this Code and subject to appropriate sanctions, up to and including permanent revocation of their NAADAC membership and NCC AP certification, if they:
1. Fail to disclose conviction of any felony.
2. Fail to disclose conviction of any misdemeanor related to their qualifications or functions as an Addiction Professional.
1. Engage in conduct which could lead to conviction of a felony or misdemeanor related to their regulatory bodies.
2. Are expelled from or disciplined by other professional organizations.
3. Have their licenses or certificates suspended or revoked, or are otherwise disciplined by regulatory bodies.
4. Continue to practice addiction counseling while impaired to do so due to physical or mental causes.
5. Continue to practice addiction counseling while impaired abuse of alcohol or other drugs.
6. Continue to identify themselves as a certified or licensed addiction professional after being denied certification or licensure, or allowing their certification or license to lapse.
7. Fail to cooperate with the NAADAC or NCC AP Ethics Committees at any point from the inception of an ethics complaint through the completion of all procedures regarding that complaint.
III-7 Harassment: Addiction Professionals shall not engage in or condone any form of harassment, including sexual harassment.

III-8 Membership: Addiction Professionals intentionally differentiate between current, active memberships and former or inactive memberships with NAADAC and other professional associations.

III-9 Credentials: Addiction Professionals shall claim and present only those educational degrees and specialized certifications that they have earned from the appropriate institutions or organizations. Providers shall not imply Master’s level competence until their Master’s degree is awarded. Providers shall not imply doctoral-level competence until their doctoral title or degree is awarded. The accreditations of a specific institution of higher learning or degree program shall be accurately represented.

III-10 Credentials: Addiction Professionals shall claim and promote only those licenses and certifications that are current and in good standing.

III-17 Scientific: Addiction Professionals shall use techniques, procedures, and modalities that have a scientific and empirical foundation. Providers shall utilize counseling techniques and procedures that are grounded in theory, evidence-based, outcome-driven and/or a research-supported promising practice. Providers shall not use techniques, procedures, or modalities that have substantial evidence suggesting harm, even when these services are requested.

III-25 Multidisciplinary Care: Collaborative multidisciplinary care teams are focused on increasing the client’s functionality and wellness. Addiction Professionals who are members of multidisciplinary care teams shall work with team members to clarify professional and ethical obligations of the team as a whole and its individual members. If ethical concerns develop as a result of a team decision, Providers shall attempt to resolve the concern within the team first. If resolution cannot be reached within theteam, Providers shall pursue and document supervision and/or consultation to address their concerns consistent with client well-being.

III-26 Collegial: Addiction Professionals are aware of the need for collegiality and cooperation in the helping professions. Providers shall act in good faith towards colleagues and other professionals, and shall treat colleagues and other professionals with respect, courtesy, honesty, and fairness.

III-27 Collaborative Care: Addiction Professionals shall develop respectful and collaborative relationships with other professionals who are working with a specific client. Providers shall not offer professional services to a client who is in counseling with another professional, except with the knowledge and documented approval of the other professionals or following termination of services with the other professionals.

III-35 Public Comments NAADAC: Addiction Professionals shall make no public comments disparaging NAADAC or the addictions profession. The term “public comments” shall include, but is not limited to, any and all forms of oral, written, and electronic communication which may be accessible to anyone who is or is not a NAADAC member.

III-36 Public Comments SUDs: Addiction Professionals shall make no public comments disparaging persons who have substance use disorders. The term “public comments” shall include, but is not limited to, all forms of oral, written, and electronic communication which may be accessible to anyone who is not a NAADAC member.

III-38 Development: Addiction Professionals actively participate in local, state and national associations that promote professional development.

III-39 Policy: Addiction Professionals shall support the formulation, development, enactment, and implementation of public policy and legislation concerning the addiction profession and our clients.

III-40 Parity: Addiction Professionals shall work for parity in insurance coverage for substance use disorders as primary medical disorders.

III-41 Impairment: Addiction Professionals shall recognize the effect of impairment on professional performance and shall seek appropriate professional assistance for any personal problems or conflicts that may impair work performance or clinical judgment. Providers shall continuously monitor themselves for signs of impairment physically, psychologically, socially, and emotionally. Providers, with the guidance of supervision or consultation, shall seek appropriate assistance in the event they are professionally impaired. Providers shall abide by statutory mandates specific to professional impairment when addressing one’s own impairment.

III-51 Illegal Practices: When Addiction Professionals become aware of inappropriate, illegal, discriminatory, and/or unethical policies, procedures and practices at their agency, organization, or practice, they shall alert their employers. When there is the potential for harm to clients or limitations on the effectiveness of services provided, Providers shall seek supervision and/or consultation to determine appropriate next steps and further action. Providers and Supervisors shall not harass or terminate an employee or colleague who has acted in a responsible and ethical manner to expose inappropriate employer employee policies, procedures and/ or practices.

III-54 Credit: Addiction Professionals shall give appropriate credit to the authors or creators of all materials used in their course of their work. Providers shall not plagiarize another person’s work.

Four Pillars

Beneficence dictates that we do everything in our power to promote goodness in our communities.
Autonomy is another key element of protecting the community, we need to see the community the same way we see the client.
Nonmaleficence guides us to prevent harm to our communities, to ensure that our actions not only promote goodness but also ensure no harm.
Justice is an obvious choice to help guide our protection of the community. We give the same treatment across the clinical population and we must focus on the community to do so.

Key: Make the Rule

Establish standards of behavior, a set of actions or rules of conduct that are maintained most of the time.
There can be exceptions to the rule but not every time and with every client. Establish the standard first and ensure it works!
Yes, it can “depend” on various circumstances, but it doesn’t always “depend.”

Principle 8: Workplace Standards

The standards you employ at your workplace directly impact your ability to protect the community.
You must provide an appropriate clinical setting, a place that is clean, quiet, safe, and conducive to confidential conversations. Your office decor should not make client's uncomfortable. Furniture should be placed in such a way so that everyone in the room has a clear, unobstructed way to leave the room should they feel the need to do so.
Have a standard of policies and procedures.Yes, we are underpaid and over-worked but you must set the appropriate financial policies in place at the beginning of treatment. Recovery/relapse policy: this is a touchy topic.
Personnel- The staff should support one another, the clients and the profession at large.
Advocacy- What are you doing to improve and further the future of the profession?

Principle 9: Professional Rapport

Relationships in the clinician’s practice involve other clinicians.You have to uphold these professional relationships with colleagues as you would with clients.
Network with your community members in the profession, work together to better the access to care for our clients.
Boundaries and Dual Relationships: When Addiction Professionals are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, they shall clarify role expectations and the parameters of confidentiality with their colleagues (NAADAC, 2016, III-50 Dual Relationship).
Do not duplicate services without notification to the client and other professionals.
Addiction professionals shall work to prevent the practice of addictions counseling by unqualified and unauthorized persons and shall not employ individuals who do not have appropriate and requisite education, training, licensure and/or certification in addictions (NAADAC, 2016, III-28 Qualified).
Addiction Professionals shall offer and provide assistance and consultation as needed to peers, co-workers, and supervisors who are demonstrating professional impairment and intervene to prevent harm to clients. Providers shall abide by statutory mandates specific to reporting the professional impairment of peers, coworkers, and supervisors (NAADAC, 2016, III-42 Impairment).

Principle 10: Societal Obligations

Addiction Professionals shall inform the public of the impact of substance use disorders through active participation in civic affairs and community organizations. Providers shall act to guarantee that all persons, especially the disadvantaged, have access to the opportunities, resources, and services required to treat and manage their disorders. Providers shall educate the public about substance use disorders while working to dispel negative myths, stereotypes, and misconceptions about substance use disorders and the people who have them (NAADAC, 2016, III-32 Advocacy).

Choose a time level
Figure out the hours you can commit and then decide the format.
Choose an access level
Once you choose a time level, choose the desired format
Choose a work type
What types of work are you interested in?
Volunteer/Intern
Try it out first

Pitfalls: Cutting Corners

Administrative

Paperwork- writing the same progress note or treatment plan for all of your clients.
Neglecting to get proper releases of information

Clinical

Getting information that you are not privileged to have and do not have releases of information for.
Billing for a session that did not happen or billing for a 50-minute session when the client only stayed 25 minutes.
Shortening a session because you are hungry or want to beat traffic.

Inter-professional

Manipulating our environment to benefit us.

Supervisory

Not being honest and authentic is supervision.
Addiction Professionals, acting in the role of Supervisor or Consultant, shall take reasonable steps to ensure that they have appropriate resources and competencies when providing supervisory or consultation services. Supervisors or consultants shall provide appropriate referrals to resources when requested or needed (NAADAC, 2016, III-52 Supervision).
Addiction Professionals offering supervisory or consultation services shall have an obligation to review with the consultee/supervisee, in writing and verbally, the rights and responsibilities of both the Supervisory/Consultant and supervisee/consultee. Providers shall inform all parties involved about the purpose of the services to be provided, costs, risks and benefits, and the limits of confidentiality.(NAADAC, 2016, III-53 Supervision).

Profession

Making ethical decisions without considering the impact on the profession or consulting with peers and supervisors.

Practical Applications

The issue of accepting gifts from clients and client's families present a common ethical dilemma. What is your personal policy about gift giving and receiving? What is your agency's policy about accepting and giving gifts? Here are some common responses to those questions:

I accept gifts from clients to avoid hurt feelings.
I accept gifts when clients are graduating.
I accept gifts when it’s something the whole office can enjoy.
I accept gifts only if it’s food.
I accept gifts only if they are handmade.
I accept gifts only if it is culturally relevant to the client and could damage treatment if I deny the gift.

According to Berton (2014), if you are practicing good ethical decision making, your first of three questions should be (p. 222) :

What is the client's intention in giving me this gift to the best of your knowledge? Is your client able to separate the boundaries necessary for a clinical relationship?
What is the potential effect, if any, on the other clients, the agency, and the profession if I accept the gift? Further, ask yourself how the client will respond when you accept the gift? Will the client assume there is a special bond there that was not there previously?
What is the potential effect, if any, on the other clients, the agency, and the profession if I accept the gift? Looking at the bigger picture, who else will be affected by your gift giving and receiving?

Many other persons are affected b our decisions: clients as a whole, colleagues, the agency, our supervisors, and those who work for us. Remember that a gift can signify a lot more meaning to your client than you might intend. Have a policy that is applicable to all your clients.