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Information about EthicsPresentation

Published on March 10, 2008

Author: Renzo


“Ethics!”:  “Ethics!” DHS Regional MISA Cross Divisional Training Starved Rock State Park Utica, Illinois May 31, 2006 Slide2:  Bill Johnson, Executive Director IAODAPCA 401 East Sangamon Avenue Springfield, IL 62702 (217) 698-8110 (217) 698-8234 (FAX) E-mail: IAODAPCA@aolcom Web Page: Illinois Certification Board (dba IAODAPCA):  Illinois Certification Board (dba IAODAPCA) JESSICA HAYES, ASSISTANT DIRECTOR DEBBIE TROTT, SENIOR OPERATIONS ASSISTANT DIANNE GUTIERREZ, OPERATIONS Russ, Friedewald, OPERATIONS Robyn McCarty, Administrative Assistant Laura Copp, Receptionist/Secretary IAOAPCA Credentials:  IAOAPCA Credentials CADC CRADC CSADC CMADC MISA I II RDDP CARS CPCGC CADP CSADP CCJP (Drug Courts) NCRS (IAEC) CAAP Program Objectives:  Program Objectives Explore history of credentialing in the USA Discuss professionals and AA Discuss the issue of multiple relationships Discuss the “Ethics of Affiliation” Discuss the Nature of verbal communication Explore some ethical dilemmas We will Question-Discuss-Interact “Increase awareness of ethical issues” THE TEST What is Ethics?:  What is Ethics? Ethics the study of standards of conduct and moral judgment; moral philosophy the system or code of morals of a particular person, religion, group, profession, etc. a code of values which guides our choices and actions and determines the purpose and course of our lives (Michael Josephson) Slide7:  Filing a complaint against an IAODAPCA professional (217) 698-8110 Web page: E-mail: IDPR LICENSED PROFESSIONAL Complaint Intake Unit: (312) 814-6910 “Common” complaints against IDPR Professionals 1. Unlicensed practice of various professions 2. Theft 3. Forgery 4. Unlawful use of weapons 5. Diversion of controlled substances (For illegal use) Anonymous complaints are accepted and investigated with the same amount of consideration as any other complaints. Updates on the status of the investigation are periodically sent. Illinois Child abuse Hot Line 1-800-252-2873 1-800-358-5117 (TTY) Criteria: The alleged victim is under the age of 18 ELDER ABUSE 1-800-252-8966 (Voice and TTY) 8:00 AM – 5:00 PM Monday through Friday 1-800-279-0400 (All other times) Slide8:  Why are you here? What do you hope to learn today? Where do you work? THE GREATES THREAT TO OUR FIELD :  THE GREATES THREAT TO OUR FIELD “The greatest threat to our field comes not from changing drug trends, external regulation, or changing methods and levels of reimbursement, but from our own failure to define our work and ourselves. Ideological splits, competition, and a marked propensity for organizational isolation make it unlikely that the whole field will come together to fully back a single set of ethical standards and values. There is however, a movement within local programs to more clearly define ethical standards and processes of ethical decision-making.” William White and Renee M. Popovits Critical Incidents, Second Edition AODA Credentialing :  AODA Credentialing AA - 1930’S (Founding principles published in 1938) We admitted we were powerless over alcohol We got honest with ourselves We got honest with another person in confidence We made amends for harms done to other We worked with other alcoholics without demand for prestige of money We prayed to God to help us to do these things as best we could AA Pamphlet:  AA Pamphlet What it said referencing traditions What it suggested Slide12:  Minnesota Model Pioneer House ( Given two books at admission AA Big Book & 12 x 12) Hazelden 1949 Willmar State Hospital (MN) 1954 created a means to credential recovering alcoholics to work in the field acceptance of the recovering alcoholics as a legitimate member of an alcoholism treatment team clarifying boundaries between the status as AA member and responsibilities as a counselor Ethics of Multiple Relationships:  Ethics of Multiple Relationships Accept a gift worth less that $10 Go out to eat with a client after group Attend the same 12 meeting as a current client Refuse to give a client a ride in your vehicle Lend a client cigarettes or a small amount of money. (Less than $10) Serve as a clients 12-step sponsor Keep quiet about a clients relapse to other treatment team members Disclose one client’s progress to another client Decline to write a job recommendation or letter for a client Avoid attending the same religious or social activity as a client Hire a client to baby-sit your children Talk about a client’s therapy issues to colleagues outside the treatment team MRS SAC:  MRS SAC Jennifer Kenney Hollander, Ph.D 7 states out of 30 applicants chosen AZ, IL, Maine, Maryland (DC), MT, NC, WY Results of the study showed that two variables contributed to participants viewing items as ethically problematic. Non-recovering individuals obtained a lower total score on the MRS SAC and individuals currently receiving supervision obtained a lower total score. This indicated non-recovering individuals and individuals receiving supervision found more multiple relationship behaviors to be ethically problematic than recovering individuals and individuals not receiving supervision. Thus recovering status and current supervision contributed to individuals views regarding multiple relationships. Highest degree obtained, experience prior to licensure (Cert), and supervision prior to licensure/cert were not associated with lower total test scores on the MRS SAC, indicating these factors did not contribute to beliefs regarding multiple relationship behavior. MR-INCIDENT:  MR-INCIDENT You go to buy a new vehicle, when you arrive at the dealer you’re met by a former client. The client is happy to see you and offers to sell you the car of your choice at cost? What might you need to consider How does this differ that an encounter you might have with a checker at the grocery store? What standard should govern financial transactions with clients? ???????:  ??????? A client you saw briefly in counseling discontinued therapy and some months later committed suicide. The parents contact you with a request that you share any information that could help them to understand why their son killed himself. They are in great pain and are each experiencing guilt over real and imagined sins of commission and omission in their respective relationship with their son. How would you respond? Is sharing information about the deceased client to his parents a breach of confidentiality? Could similar information be shared with legal authorities investigating his death? Does the moral imperative to not share confidential disclosed information continue even after the death of a client? Clients?:  Clients? Who are our clients? How and when does one achieve the status of client Once attained, when if ever, does one lose the status of client? Does a client stay a client for ever? What does your code of ethics say about a “Client”? What do you say about who is your client? What does your code of ethics say about having an intimate relationship with a client/ex-client? 42 CFR 2.12:  42 CFR 2.12 Patient definition as defined by federal confidentiality law. Consistently used across all the states. … “any individual who has applied for or been given a diagnosis for treatment for alcohol or drug abuse at a federally assisted program and includes any individual who, after arrest on a criminal charge, is identified as an alcohol or drug abuser in order to determine that individuals eligibility to participate in a program.” MR – Incident:  MR – Incident Sharee, a withdrawn adolescent who has been slowly emerging from her shell, enters your office and offers you a gift she’s purchased. The gift is a silk flower in a small glass vase. Sharee says this is her way to say thanks for “hanging in with her” What’s your response? Any situation where refusal of the gift would be clinically or ethically inappropriate? What kind of protocol should guide our decision regarding acceptance or refusal of gifts from clients? What to consider?:  What to consider? Value of the gift? Purpose of the gift? Circumstances under which the gift was given? What is the position and sensitivity to influence of the person receiving the gift? What are accepted business practices in the area? What is the company policy? What is the law? Ethics of Affiliation:  Ethics of Affiliation Alcohol, Tobacco, Pharmaceutical (ATP) industries Mission Compatibility vs. Mission Conflict Who consumes AT Products Where AT products can be purchased Quality Control Product labeling Product potency Unit dose of product Event/daily dose When use occurs Perception/Promotion products Illicit markets Product taxation ATP – related injuries and fatalities ATP – related social costs Paraphernalia Heavy use Alcoholism Bill White & Elizabeth Tolnai Prevention First – Ethics of Affiliation Slide22:  Nature of Verbal Communications “You’re very attractive Using profanity with or directed at client “We’ve become very close since we started seeing each other” “You’re very special to me.” “There are times I forget you’re a client.” “Talking with the client about sexual issues.” Answering client questions about your personal life “I like you.” “I’m going through a difficult divorce myself right now.” Increasing the frequency and duration of client interviews Nature of verbal communications continued::  Nature of verbal communications continued: Asking questions about the client’s personal life not related to presenting problem (s) Calling by his/her first name Using the client’s time to discuss counselor’s interests/hobbies “I’ll always be there for you.” Using terms of endearment with a client, e.g., Honey, Sweetheart, etc. Calling the client at home Meeting the client outside the office “I love you.” Slide24:  The Boundaries of Physical Touch Frontal Hugs (face to face full body) Holding a client on your lap Kissing a client on the cheek Asking client for a massage Touching a clients knee Side Hug (One arm around client) Touching clients face as if wiping away a tear or touching cheek Brief holding of hand Massaging a clients face Massaging a clients neck/shoulders Kissing a former client on the lips Sexual intercourse with a clients relative Boundaries of Physical Touch continued::  Boundaries of Physical Touch continued: Patting clients arm or shoulder Sustained holding of clients hand Asking client to remove articles of clothing Asking client for any type of touch “Ethics Check” Questions:  “Ethics Check” Questions Is It Legal? It is Balanced? How will I feel About Myself? Blanchard and Peale “The Power of Ethical Management”, 1988 Making Ethical Choices :  Making Ethical Choices The Bell The Book The Candle Michael Josephson The Josephson Institute for Ethics ASK FOR HELP & ACT :  ASK FOR HELP & ACT 1. A – Identify Alternatives 2. C - Project Consequences 3. T - Tell your story (Consider your Defense.) Michael Josephson The Josephson Institute for Ethics ETHICS: What’s the Big Deal?:  ETHICS: What’s the Big Deal? Career Survival Media Coverage Community view of AODA Treatment In-House Dissension Personal Stress It’s the “Right Thing to Do” 1 B:  1 B Counselor resigned from position with agency and married a client of the agency the next week. Client had been discharged. CADC alleged that she wasn’t the clients counselor. CADC was member of the treatment team when client was receiving services. What’s your agency policy on this? What’s your professional affiliations policy on this? 2 B:  2 B CADC admitted to borrowing money from a client who he transported in a van for treatment agency. This was against agency policy and complaint was filed by clinical supervisor. Is there ever an opportunity when a professional counselor should accept gifts and or borrow money from a client of their agency? What’s your agency policy on this issue? 3 B:  3 B Counselor was alleged to have: Touched inappropriately (hugged) Sold client car Used alcohol with the client Developed dual relationship with the client Burden of proof is placed on the complainant. 4 B:  4 B Ben, a staff member who conducts remedial education classes for impaired driving offenders at your agency, was arrested Saturday night for impaired driving. He was not on duty There was no agency car involved in the incident To the best of our knowledge Ben has not history or alcohol or other drug related problems and did not self-identify as recovering when hired. 5 B:  5 B You see two staff members take charts home because the Medicaid audit is tomorrow and it has to be done or the agency will lose money. They tell you they have two weeks of charting to catch up on. You don’t tell anyone. 6 B:  6 B You witness one of your poor patients who is on probation take $20 from your wallet. Your patient begs you not to tell because he will go to jail. He gives you the money back and says no harm done. You agree with him. 7 B:  7 B Your patient who you discharged 1 year ago wins the $200 million lotto and because you were instrumental in his recovery he mails you a check for $5000, and says thanks. He gives no return address and has moved from the address the agency had. 8 B:  8 B Joanie a therapist at CABH did therapy for 30 minutes on Ms. Sick. With her charting the total time she billed for was 45 minutes! Legal? Ethical? 9 B:  9 B CADC alleged to have taken medication from clients RX Admitted guilt Cooperated with investigation Volunteered information Recovering vs. non-recovering person? Should the consequences be different? What would be appropriate? 10 B:  10 B Ralph a mental health worker at Mile Square has a friend who needs therapy. He recommends that his friend comes to the Square to receive therapy. Ralph’s friend later has a party and invites Ralph. Ralph goes to the party. Ethical, legal, unethical, Illegal.? Which part is what? 11 B:  11 B Mary, an employee of a program is invited to a party by a casual acquaintance. After she arrives she finds that illicit drugs are being used openly and one of the clients in the agency are there. 12 B:  12 B DUI provider bartered office support services in lieu of payment for counseling. DUI Provider hired husband of recipient of services to remodel kitchen. Is there ever a case where this could be acceptable? Who could be affected by this activity and how? TEST:  TEST I lied there is a test! And it starts right now.

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