Ethical and Professional Issues in Addiction Counseling...Intent of this Webinar Series (3-part...
Transcript of Ethical and Professional Issues in Addiction Counseling...Intent of this Webinar Series (3-part...
Ethical and Professional Issues
in Addiction CounselingSection Two:
How and Where to File an Ethics Complaints,
Principles IV-VI, and Cases
Presented by Dr. Mita Johnson
Recorded December 11, 2018
Thomas Durham, PhD
Director of Training
NAADAC, the Association for Addiction Professionals
www.naadac.org
Produced By
NAADAC, the Association for Addiction Professionalswww.naadac.org/webinars
www.naadac.org/webinars
www.naadac.org/ethics-professional-issues-section-two-webinar
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W in Addiction Counseling
NAADAC & Dr. Mita Johnson
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Introduction - Objectives
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Greetings!
Intent of this Webinar Series (3-part series)
Objectives: Participants who attend all 6 hours of this webinar will be able to:1. Delineate the overarching principles and
values foundational to ethical practice.
2. Explore 3 current issues and concerns related to new technologies and emerging practices.
3. Discuss 3 tools useful for risk management.
4. Outline 3 ways NAADAC and NCC AP can be helpful to anyone providing addiction-related services.
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Content of Each Webinar Segment
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Section I:
• Definitions, Principles I - III, Cases
Section II:
• How to file an ethics complaint? Where to file complaints?
• Principles IV – VI, Cases
Section III:
• NAADAC’s Ethical Decision-Making Model
• Principles VII – IX, Cases
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Ethics Committee
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The objectives of NAADAC’s & NCC AP’s
Ethics Committees are to:
define and endorse ethical conduct by
Providers at the highest professional level;
educate Providers concerning ethical,
evidence-based and scientifically-
supported standards of practice;
protect the public/client(s) against harmful
conduct by Providers; and
assist NAADAC/NCC AP in achieving its
objectives as reflected in their
Mission/Vision statements and Bylaws.
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What warrants filing a grievance?
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• Any situation where a Provider has
violated a NAADAC/NCC AP Code of
Ethics Principle
• Any situation that violates a local, state or
federal law - including insurance fraud
• Any situation that violates a standard of
practice, placing the client at risk for harm
or in fact harming the client
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NAADAC: how & where to file an ethics complaint
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• Code of Ethics Violation: Instructions and
Complaint Form can be found at:
https://www.naadac.org/assets/2416/naadac-
nccap-ethics-complaint-form-122016.pdf
• Complainant: person filing a complaints
against another person.
• Respondent: the person whom the complaint
has been lodged against.
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NAADAC: what information you need to file complaint
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• As Complainant, your complete contact
information
• Name and contact information regarding
Respondent
• Complaint, including ethical principles and
sections that you believe have been
violated
• Documentation/evidence supporting the
allegations against Respondent
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Before filing complaint with NAADAC, please consider the following -
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Complaints against a Respondent’s
credentials need to be filed with the
licensing board in the state where the
Respondent is certified and licensed first.
NAADAC will take the State’s findings of
fact and final determinations into
consideration when determining NAADAC’s
recourse against a person’s membership
and NCC AP’s recourse against a person’s
national certifications. You would send the
state’s findings to NAADAC with your
complaint.
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Before filing a complaint with NAADAC, please consider the following -
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• NAADAC cannot revoke a Provider’s state
certification or license or restrict a Provider from
practicing. We cannot obtain a monetary award for
the Complainant or require that a
Provider/Respondent deliver a specific action that
the Complainant is requesting.
• As a membership organization, NAADAC can create
a stipulation(s) whereby the Provider keeps their
certification/membership or expel the member from
the association with notifications, and restrict or
revoke their NCAC I/II, MAC or other NAADAC
certification.
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Before filing complaint with NAADAC, please consider the following -
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• Complaints against an agency receiving
federal block grant funding must be filed
with one or more of the following:
• SAMHSA’s Single State Agency (SSA)
for Substance Abuse Services
• Directory link for SSA:
https://www.samhsa.gov/sites/default/fi
les/sites/default/files/ssa_directory_8-
20-2018.pdf
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Before filing complaint with NAADAC, please consider the following -
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• Complaints against an agency receiving
federal Community Mental Health Services
block grant funding must be filed with one
or more of the following:
• SAMHSA’s State Mental Health
Authority
• Directory link for SMH Authority:
https://www.samhsa.gov/sites/default/fi
les/grants/mhbg_state_mental_health_
commissioners_06182018-508c.pdf
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Before filing complaint with NAADAC, please consider the following -
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• Check your state legislative laws and
administrative rules specific to addiction
counselors/counseling practice regarding
prohibited activities. If the Respondent has
violated a legislative law or administrative
rule/board rule – you will file a grievance with
your state regulatory board first prior to filing
grievance with NAADAC. You would send their
findings to NAADAC with your complaint.
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NAADAC: types of complaints Committee cannot accept
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• Complaints against a person or organization that is not a member of NAADAC and/or certified by NCC AP.
• Complaints against business or administrative policies and procedures. This is not in our jurisdiction.
• Complaints regarding billing and finances. We do not have the authority or power to make an organization/person refund money to anyone. This is a civil matter and the Complainant may be able to file a civil case.
• Anonymous complaints.
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What happens when a complaint/grievance is filed with NAADAC?
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1. A search is made to determine if the Respondent is a
member of NAADAC or certified by NCC AP. If the person is
not a member or certified by NCC AP, the Respondent is
notified that we have no jurisdiction over the Respondent
with suggestions of alternative agencies to file complaint.
2. The Complaint is read by the NAADAC and NCC AP Ethics
Committee Chairs and Executive Director of NAADAC.
3. A determination is made as to whether the complaint falls
within NAADAC’s/NCC AP’s jurisdiction.
4. Complaints that do not fall under our jurisdiction are sent
back to the Complainant with suggestions for alternative
actions.
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What happens when a complaint/grievance is filed with NAADAC?
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5. Complaints that do fall under our jurisdiction, but that
need to be investigated by the state first – are sent back
with request to file with the state and submit findings to
NAADAC.
6. Incomplete complaints are sent back with request for
additional information.
7. Once NAADAC has all the information it needs to proceed,
the Respondent is notified of the Complaint and given an
opportunity to provide a response to the Complaint. The
complaint and response are read by the NAADAC and NCC
AP Committee members.
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What happens when a complaint/grievance is found to be valid?
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Potential outcomes of grievance filed with NAADAC include, but are not limited to:
• Dismissal of case due to lack of malpractice
• Stipulations include but are not limited to:
• Request for specific education/training/workshop, i.e., ethics class
• Request for supervised experience
• Time-limited suspension of credential or membership
• Revocation of membership or certification
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Typical Grievances Read by Ethics Committee
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• Boundary violations, i.e., personal versus professional
• Confidentiality and/or privacy breaches
• Lack of correct or adequate documentation
• Failure to keep records secured
• Inappropriate relationship with client or others connected to client
• Dual relationship questions
• Provision of inadequate treatment
• Failure to use evidence-based practices
• Inadequate clinical supervision
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e-THERAPY, e-SUPERVISION and SOCIAL MEDIA.
WORKING IN A CULTURALLY-DIVERSE
WORLD
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INTERPRETATION
PRINCIPLES IV - VI
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• Culture – what is it?
• Cultural diversity
• Necessary components of ethical multicultural practice
• DSM-5 Cultural Formulation Interview developed by
APA
• Cultural sensitivity vs. cultural competency
• Cultural humility
• Personal beliefs vs. credibility vs.
advocacy
• Needs-driven services
• Assessment, Validity, Reliability
• Cultural Influences
• Diagnosing, Results, Security
• Forensic Evaluations
• Assessment, Validity, Content Validity, Reliability
• Cultural Influences, Cultural Context
• Diagnosing, Results, Security
• Forensic Evaluations
New technologies, such as telehealth, help improve healthcare
services. For technology to succeed in doing so, it must work for
the people it is meant to help; it must aid not only clients, but also
the professionals providing their care. Telehealth helps ensure that
clients who are veterans get the right care in the right place at the
right time. It aims to make the home the preferred place of care
whenever possible. SAMHSA.
• e-therapy; distance counseling; TAC: technology-assisted care
• synchronous delivery and asynchronous delivery
• text messaging; mobile devices; apps; electronic health records
• telephone-based services; email-based services; chat-based
services; video-based services; social network-based services;
self-directed tools
• Competency
• Technology Informed Consent
• Verification, Secured vs. Non-Secured, Access
• State and Federal Laws Governing Use of
Technology
• Boundaries, Records, Links
• Use of Social Media; Friends
• increasing access to care
• reducing travel time and costs of parking, etc.
• improving satisfaction with SUD/ABD/MH systems
• enabling continuity of care when client or provider relocates
• reducing delays in initiating services
• bringing together diverse group members for support,
psychoeducation
• reconceptualizing delivery of care – more in line with medical
telehealth
• reducing stigma against clients struggling with SUD/ABD/MH
disorders
• help consumer learn and maintain coping skills
• help consumer in recovery to maintain his or her sobriety
• locate 12-step meeting or other mutual support group
• prompt consumer to check on possible medication interactions
• deliver videos that motivate consumers at home
• provide information, screening, counseling & preventive recommendations
• enable clinical conversation to be recorded for later viewing
• allow consumers to track behaviors, diet, exercise, sleep, abstinence
• engage consumer in mind-challenging games or tests
• how specific technology works
• common technology terms
• ways technology can enhance practice
• common ethical challenges related to use of technology
• privacy, confidentiality & informed consent issues associated with TAC
• security risks that clients/providers may encounter & steps to minimize
risks
• emoticons/acronyms clients may use & boundary concerns surrounding
use
• policies on scope of practice, coordination care, security, informed
consent, mandatory reporting, emergencies, electronic records, privacy
violations
• access the internet for information; use technology with ease
• communicate with clients & peers using technology
• provide basic troubleshooting
• interact with others effectively using technology
• minimize privacy, confidentiality & security risks to clients
• establish & maintain relationships, using technology
• have effective writing skills – communication in context of professional
relationships
• build referral relationships in the community, including emergency
referrals
• willingness to learn & use technology to support practice/deliver services
• interest in & curiosity about adoption of new practice tools & techniques
• willingness to work through technology interruptions & glitches
• recognition of the importance of clients & providers working to understand
what the other means, including the use of emoticons & other symbols
• credentials provider obtained to practice distance counseling/technology
• physical location of provider’s practice & contact information
• physical location(s) of the client
• description of the technologies that may be used for or during sessions
• proof of client’s identity and proof for remainder of sessions
• time zone differences
• risks & benefits of engaging distance counseling, technology, social media
• inability to guarantee confidentiality or privacy when using technology
• policy & procedures to initiate in event of technology failure & alternatives
• anticipated response time if using asynchronous delivery
• emergency procedures to be initiated by client, when Provider is
unavailable
• duty to warn & mandatory reporting requirements of Provider
• cultural and/or language differences that may affect utilization of
technology
• payment options, including procedures in event of insurance denial
• arrangements when client is traveling to another state or jurisdiction
• emergency procedures Provider will initiate in event client is not safe
• recording and taping policies and procedures
• anticipated response time if using asynchronous delivery
• emergency procedures to be initiated by client, when provider is
unavailable
• duty to warn & mandatory reporting requirements of provider
• cultural and/or language differences that may affect utilization of
technology
• payment options, including procedures in event of insurance denial
• arrangements when client is traveling to another state or jurisdiction
• emergency procedures provider will initiate in event client is not safe
• recording and taping policies and procedures
• specific boundaries established by provider regarding appropriate use
and/or application of technology & the limitations of its use within the
professional counseling relationship including the frequency & time frame
within which provider will respond to emails, texts, voice messages
• electronic links & physical addresses of the appropriate licensing &
certification boards responsible for protecting the public
• documentation required & where documentation will be housed
• social media policy: provider does not engage in use social media
w/clients
• social networks: Facebook, Instagram, Reddit, Tumblr, Google+, Meetup,
YouTube, Twitter, Vine, Pinterest, Flickr, LinkedIn, ClassMates, etc.
• mandatory disclosure and informed consent process
• professional pages versus personal pages; friending
• benefits, limitations, boundaries; policies and procedures
• Electronic health records (EHRs): benefits and concerns
• Access, data collection, clouds, laptop security, password protection
www.naadac.org/ethics-professional-issues-section-two-webinar
Cost to Watch:
Free
CE Hours
Available:
2 CEs
CE Certificate for
NAADAC
Members:
Free
CE Certificate for
Non-members:
$25
To obtain a CE Certificate for the time you spent watching this webinar:
1. Watch and listen to this entire webinar.
2. Pass the online CE quiz, which is posted at
www.naadac.org/ethics-professional-issues-section-two-webinar
3. If applicable, submit payment for CE certificate or join NAADAC.
4. A CE certificate will be emailed to you within 21 days of submitting
the quiz.
CE Certificate
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