Sexual misconduct by addiction counselors isn’t something treatment programs want to talk about. But it’s something they should be formally reporting to the clinician's professional credentialing authority, when there is an allegation involving a counselor's conduct with a patient. However, sources tell Addiction Professional, credentialing organizations are informed of these damaging incidents only one-third of the time, or less.
What many addiction treatment facilities do instead is hope to prevent any harms to their reputation by firing the counselor or, more often, letting him or her resign so they aren’t exposed to wrongful termination claims. This constitutes a violation of patients’ rights, according to counselor membership and credentialing bodies.
It’s also costly, because while sexual misconduct represents a fraction of the number of claims filed against addiction treatment programs, the cost of claims involving sexual misconduct runs high—sometimes more than $1 million. As long as sexual misconduct is allowed to proliferate, it will cost treatment programs substantially, both in insurance premiums and in patient settlements.
In any given year, member credentialing boards of the International Certification and Reciprocity Consortium (IC&RC) receive 300 to 500 sexual misconduct complaints, says IC&RC executive director Mary Jo Mather. “This is pitifully low,” she says. “I believe the figure should be triple that.”
To illustrate the types of incidents that have occurred in treatment facilities, here are some of the cases that recently have been handled by Sean Conaboy, a sales executive with NSM Insurance Group in Philadelphia:
A treatment facility client with programs in three states found that three of its male staff members all had sexual relations with a female patient who, it turned out, was HIV-positive. One of the men became infected. “All three guys have been fired, but so what?” says Conaboy. “This will be millions of dollars in legal fees and costs.” All three young men had worked the third shift in a residential program housing female patients. They claimed they were seduced.
Misconduct that takes place between a counselor and a patient after the counselor is fired doesn’t get the treatment provider off the hook. In one of Conaboy's recent cases, the misconduct occurred toward the end of treatment and into early recovery. Even though the counselor was warned about his behavior and the treatment program tried to provide supervision and training, he violated the program’s well-defined policies and procedures by seeing the patient after he was fired. The patient’s attorney is suing both the counselor and the treatment program.
An 18-year-old woman returned home from high-end treatment, and three weeks later discovered she had become pregnant after having sex with another patient. “Her parents probably paid $100,000 for her treatment, and what did they get? A girl who was not sober and was pregnant by a celebrity,” says Conaboy.
Two female patients in an extended-care drug and alcohol treatment program both claim to have been sexually assaulted by a male patient, and didn’t file a police report at the time, but later filed a claim saying the facility failed to protect them and failed to conduct adequate screening of everyone they admitted to treatment. The facility had to pay nearly $500,000 to each woman to settle a lawsuit.
Importance of reporting
Reporting ethical violations is key—and may help facilities in a lawsuit as well. Typically, the treatment agency wants to get rid of the counselor, quietly.
“They don’t want to be charged with unlawful firing,” says Frances Patterson, who serves on the ethics committee of NAADAC, the Association for Addiction Professionals. “I’ve seen this over and over again: The director of the agency says, ‘If you resign, we’ll give you a letter of recommendation.’” The counselor then moves on to the next agency, and all that’s happened is the problem has been relocated. The problem is that no one is ever reported, says Patterson. NAADAC's code of ethics warns counselors to avoid dual relationships, and never to have a sexual relationship with a patient—even a former patient.
“The sad thing is that people don’t want to report,” says Patterson. “They don’t want the headache.” She says some counselors and supervisors have told her they were warned at their workplace that if they reported a sexual misconduct violation, they would be fired themselves.
“My response to that is, ‘Go ahead and fire me,” says Patterson, because then the employee would have grounds for a lawsuit. She does concede that this isn’t an easy position to be in—sometimes counselors are made so uncomfortable that they quit. “The people in power don’t want this reported,” Patterson says.
Kenneth Pope, PhD, who for many years chaired the American Psychological Association’s (APA's) ethics chapter, similarly found that only 10% of cases of sexual misconduct involving psychologists are ever reported. (Pope resigned from the APA in 2008 because he felt ethical standards were being loosened.)
Revocations and suspensions
IC&RC member boards, which oversee the process of awarding professional credentials to counselors, are required to have a code of ethics for every counseling professional credential they offer. The boards have ethics committees that receive and investigate complaints.
“If it’s a ‘he said, she said’ issue, the counselor is notified, and writes back what he thinks happened,” says Mather. Often an IC&RC ethics board will bring everyone together for a hearing. The result can be that the complaint is dismissed, or that the counselor loses his credential.