Critical Incidents: Ethical Issues in the Prevention and Treatment of Addiction

About the Authors

William L. White is a Senior Research consultant at Chestnut Health Systems/Lighthouse Institute. He has a Master’s degree in Addiction Studies and more than 30 years of experience in the addictions field as a clinical director, administrator, researcher and well- traveled trainer and consultant. He has provided ethics-related training throughout the United States. He has authored more than 70 articles and monographs, and seven books, including Slaying the Dragon- The History of Addiction Treatment and Recovery in America.

Renee M. Popvits is the founder of the Chicago-based law firm of Popvits and Robinson. She has represented a wide variety of substance abuse and mental health service agencies related to such issues as corporate transactions, regulatory and corporate compliance, confidentiality, licensure, reimbursement, contract, tax exemption, managed care, human resource, electronic records/ HIPAA compliance, and public policy matters. She has lectured extensively and published articles on many of these issues.

Learning Objectives

After completing this course you’ll be able to:

1. List the five purposes for Codes of Professional Practice.
2. Define informed consent and the most common source of liability.
3. List the three components of professional competence according to Haas and Malouf.
4. List several guidelines for hiring a recovering person for a staff position.
5. Discuss the now-famous Tarasoff decision of 1976.

Course Contents

1. Introduction
Ethics for a New Century
Ethical Issues in the Addictions Field: Special Concerns
The Composition of the Field
The History and Transience of the Field
The Industrialization of the Field
The Changing Context of Addiction
Rethinking Our Assumptions about Personal and Professional Ethics
Systemic Approaches to Professional Practice Issues
How to use this Book
A Review of Ethical Values
A Note on the Relationship Between Ethics and Law
A Note on Legal Annotations
2. The Code of Professional Practice
What is a Code of Professional Practice (CPP)?
What purposes are such code designed to achieve?
Are all employees of the organization bound by the standards set fourth in the code?
Why is there a need for a CPP?
Our agency is considering implementing a Corporate Compliance Program, how does this relate to the CPP?
How can we integrate the CPP and a Corporate Compliance Program?
Why should we implement a compliance program and integrate the CPP?
How is the CPP developed?
How long does it take to develop a CPP?
How is the CPP updated?
An Introduction to the Critical Incidents
A model for Ethical Decision-making
3. Conduct Related to the Practice of Business
Macro-Planning
Stewardship of Resources
Planning
Lobbying
Misrepresentations of Information
Exploitation of Clients
Utilization of Staff Time for Political Lobbying
Advocacy: Interest of Field Versus Agency Self-Interest
Fundraising
Use of Professional Fundraisers
Staff/Board Support
Solicitation of Funds from Clients/Families
Marketing
Misrepresentation of Scope or Intensity of Services
Misrepresentation or Misallocation of Costs
Exaggeration of Treatment Success
Exploitation of Family Members
Financial Management
Fee Structure and Billing
Referrals
Dual Relationships
Conflict of Interests
Management of Facilities, Property and Supplies
Sale of Non-Profit
Merger Mania
Due Diligence Discovery
Fraud & Abuse
E-mailing Price Information
Telecommuting
Staff/Managerial/Executive Compensation
4. Personal Conduct
Use of Alcohol/Drugs
Relapse
Moral and Legal Standards
Financial Investments
Discrimination
Personal and Agency Reputation
Personal Replenishment
5. Professional Conduct
Self-development
Personal Appearance
Recognition of Limitations
Representation of Credentials

Use of Agency Resources

Secondary Employment
Publishing
Respect for Proprietary Products
6. Conduct in Client/Family Relationships
Definition of Client
Informed Consent
Labeling: The Ethics of Diagnosis
Right to Treatment
Refusal to Treat
Refusal to Treat
Respect
Respect for Personal/Religious Beliefs
Honesty
Right of Privacy
Empowerment Versus Paternalism
Cultivating Dependency Versus Autonomy
Restrictiveness of Treatment Environment
Stewardship of Client Resources
Experimental Counseling Techniques
Special Treatment Procedures
Freedom from Exploitation
Self-Disclosure
Countertransference
Dual Relationships
Casual Encounters
Therapeutic Bias
Social Relationships
Mutual Aid Relationships
Financial Transactions and Gifts
Physical Touch
Verbal Intimacy
Sexual Relationships
Verbal/Physical Abuse
Assisted Suicide
Documentation
Referral
Responsibility to Terminate
Responsibility to Refer
7

Conduct to Professional Peer Relationships

Internal Professional Relationships
    Management of Human Resources
Staff Hiring
Nepotism
Patronage
Issues in Authority Relationships
Confidentiality
Mandatory Training
Right to Privacy
Socializing Outside of Work
Role Stressors
Obedience and Conscientious Refusal
Sexual Harassment
Abuse of Power
Impaired Co-worker
Team Relationships
Managing Conflict
Professional or Ethical Misconduct/ Whistle Blowing
Staff Termination
External Professional Relationships
Value of External Relationships
Multiple Service Involvement
Commenting on the Competence of Other Professionals
Allegations of Unethical Conduct
8 Conduct Related to Public Safety
Child Abuse Reporting
Duty to Warn
HIV/AIDS Duty to Report
Physical/Sexual Abuse
Duty to Warn (Threat of Physical Violence)
Allegations of Misconduct
AIDS and Risks to Third Parties
Threats to Public Safety
9 Professional Standards Related to Special Roles
Prevention
Personal Conduct
Role as Change Agent
Relationship Boundaries
Confidentiality and Limits of Competence
Alliances
Iatrogenic Effects
Honesty
Social Action/Civil Disobedience
Freedom of Access Versus Harmful Use of Information
Restriction of Speech
Intrusive or Abuse Interventions
Early Intervention: Employee Assistance Programs (EAP) and Student Assistance Programs (SAP)
Integrity of Organizational Structure
Independence and Objectivity of Professional Judgment
Definition of Client/ Conflicts of Loyalty
Environmental Stressors
Early Intervention: Student Assistance Programs (SAP)
Confidentiality
Disposition of Contraband
Outreach
Confidentiality/ Duty to Disclose
Worker Vulnerability
Relationship Boundaries
Compensation
Training
Use of Agency Resources for Personal Gain
Self-disclosure
Relationship Boundaries
Marketing of Seminars
Professional Impairment
Use of Clients in Training
Consultation
Confidentiality
Support of Toxic Organizational Conditions
Research
Sponsorship of Research
Research with Human Subjects
Confidentiality, Security, and Disposition of Data
Scientific Role Versus Clinical Role
Honesty in Reporting Findings
Responsibility for Use of New Knowledge

Comments:

"Very good book! Personally helpful." - M.B., LISW, OH

"I was expecting the text to be very boring but it was very interesting and I learned a great deal from it." -J.B., Counselor, MH

"I really enjoyed the book. Very useful case studies." - R.E., LCSW, OR

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