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Applying Our Ethical Principles I

August 8, 2009
by Dr. Anne
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When we hear about what another counselor did and make a judgment based on our emotional reaction, there is a tendency to say that the counselor did something unethical. Often if we look at it carefully, we find that we object to the behavior on the basis of our own standards of conduct or morals. Taken to the next step, when compared to the NAADAC Code of Ethics there might not be a principle that describes the behavior. An attorney recently said that Codes of Ethics and laws are written because someone did something that caused problems and an ethical standard or law was written to hopefully prevent another person doing the same thing. When an ethical complaint is sent to NAADAC, the counselor’s behavior is evaluated by the Code of Ethics. Beginning with this post, each principle from the NAADAC Code of Ethics will be reviewed. A situation will be described for the reader's consideration. Please read the scenario and decide whether or not the cited principle applies.

Principle 1: Non Discrimination. I shall affirm diversity among colleagues or clients regardless of age, gender, sexual orientation, ethnic/racial background, religious/spiritual beliefs, marital status, political beliefs or mental/physical disability.

This statement includes many of the characteristics exhibited by clients and co-workers. Under this standard, do we also include freedom of choice? Do we honor the right to participate or not participate in an activity? A situation which made some of us think about this principle was a supervisor’s requirement for all counselors in an agency to participate in a therapy group led by her. Two counselors refused to participate because they thought an in house therapy group for counselors was a breach of boundaries. If a counselor who worked in this agency consulted you, how would you approach the problem?

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I didn't like the idea of the in house therapy session and would support the counselors opposing the idea. I've attended training where participants discussed issues but these were voluntary. As for NA/AA and other support groups these should be suggested as resources and never forced on clients. If client is a Baptist or Buddahist suggesting they find support in their faith is not unethical. Therapists (those not working in faith based centers) need to be neutral letting the clients find what works for them. 12-step groups, religion or any other outside entity have no place in a skilled therapists toolbox excepts as a resource for after therapy.

I believe that no agency should require in-house therapy unless the therapy is conducted individually by an outside therapist and if it's disclosed upon hiring. I think my inner thoughts are better left in my doctor's office.

Hi Anne. I've always been curious about how Principle 1 applies for professionals working at faith-based agencies. Can they be said to "affirm diversity" of "religious/spiritual beliefs"? This basic question has been a hugely sensitive issue for policymakers working with the Access to Recovery program in particular, and it was the #1 reason that SAMHSA's scheduled reauthorization got delayed indefinitely by Congress last year.

(A similar question is whether, by encouraging AA/NA attendance, addiction professionals are "promoting" a Higher Power-based religious/spiritual system at the expense of an atheistic or agnostic one. That's the case made by AA/NA detractors like Save Our Selves [http://www.sossobriety.org].)

I echo Daniel's concerns, and would take it a step further and say that court-ordered participation in AA/NA (though I think that these approaches can be very helpful) or any other faith-based treatment program, such as those offered by Salvation Army or, here in Denver, Victory Outreach, could well result in a lawsuit based upon violation of a client's civil liberties. Even more concerning is that these programs are often SO faith-oriented that prayer is the sole means of treatment.

As to the case presented, it represents a prohibited dual relationship that would violate not only the NAADAC Code but the Mental Health Statutes in most states.

We were forced in a work group under guise of a 'supervison' group and co-workers getting along. Even though we were told it was optional to speak, it really was not as you were confronted and questioned about even intimate details. It had vouyerstic qualities to this group. It was extremely uncomfortable and many considered it unethical and a violation. The person running it had no prior experience running such a group. There were many political dynamics involved as well because of this group. There is so much to write and not enough time or pages to address this ethics question.

Dr. Anne

Anne S. Hatcher, EdD, CAC III, NCAC II, is Co-Director of the Center for Addiction Studies at...