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

About 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 4 causes of ethical breaches.
  2. Define beneficence, stewardship, nonmaleficence, and restitution.
  3. List the five purposes for Codes of Professional Practice.
  4. Define informed consent and the most common source of liability.
  5. List several exceptions to confidentiality that would permit disclosure.
  6. Discuss how work therapy can be therapeutic or exploitative
  7. List several items to be included in a sexual harassment policy.
  8. Describe how tapes and transcripts should be secured and disposed of with confidentiality maintained.

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

Customer 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