Substance abuse counsellors work closely with adolescents and adults struggling with serious problems related to alcoholism and drug addiction. Advising emotionally distraught and suffering clients demands a high level of skill and professionalism.
Health care professionals follow a code of ethics that identifies expected behavioural norms, rules, boundaries, standards and shared ethical principles. A code of conduct for substance abuse counsellors offers guidance on how to handle tricky situations and appropriately support clients from intake to recovery.
What is NAADAC Code of Ethics?
NAADAC, the Association for Addiction Professionals is a well-known organization representing more than 10,000 specialists in the field of addiction prevention, treatment and recovery. As part of the organization’s mission to provide quality addiction resources, NAADAC provides substance abuse counsellors with standards of practice in the form of an overarching code of ethics. The NAADAC Code of Ethics is certified by the National Certification Commission for Addiction Professionals.
Officially known as the NAADAC/NCC AP Code of Ethics, the document provides detailed information on proper ethical conduct within the field of addiction treatment. The code is composed of 10 fundamental principles that guide ethical practice and decision-making in the areas of counselling-client relationships, professional obligations, cross-cultural competency, assessment measures, evaluation, supervision, consulting, ethical dilemmas, research and publication.
Know and Follow Ethical Principles
A professional code of ethics provides a philosophical framework that health care professionals, like substance abuse counsellors, use to inform their practice. Ethical principles extend beyond what may be morally right and wrong in a given cultural context. Medical ethics are standards developed over time by doctors, nurses, psychologists and counsellors. Professional codes identify behaviours, dispositions, principles and beliefs that practitioners embrace in the interest of patient health, safety and well-being.
Like other health care specialists, substance abuse counsellors follow an ethical code grounded in the ethical principles of autonomy, beneficence, justice and nonmaleficence. The Quantum Units Education organization suggests that these four ethical principles are the cornerstone of effective substance abuse counselling.
Example:
Autonomy refers to the right of clients to make their own decisions, such as choosing whether to enter alcohol or drug treatment at the urging of their family. Addictions can have a powerful hold on a client. Resistance is likely to occur if the substance abuse counsellor uses coercion, manipulation or fear tactics to pressure the client into treatment. The code of conduct for substance abuse counsellors suggests that they roll with client resistance and respect autonomy. They build rapport, offer support and educate the client on the goals of treatment.
Beneficence requires substance abuse counsellors to act in their client’s best interests. Health promotion is an important component of beneficence. The substance abuse counsellor considers benefits and risks to the client in recommending interventions and treatment modalities. Offered services may include residential treatment, out-patient group counselling, living in a half-way house and aftercare recovery groups, for example.
Justice refers to equitable access to health care resources. The code of ethics of addiction counsellors requires them to advocate for client access to medications, hospital beds and treatment programs, for example. Options and resources are identified and presented to the client. The substance abuse counsellor lobbies for fair and unbiased distribution of limited resources.
Nonmaleficence is the ethical principle of doing no harm. Substance abuse counsellors must be patient and respectful of all clients even those who may be angry, belligerent and hostile to the idea of alcohol or drug treatment. Addiction counsellors do not involve clients in studies or experiments without fully informed, freely given consent. They must also perform their job within the scope of their license and training.
Maintain Strict Confidentiality
Confidentiality is essential to building trust in a client-counsellor relationship. Prior to meeting with the client, a substance abuse counsellor must provide written information and answer any questions related to informed consent for counselling services. Informed consent is also required for the release of certain private health information to third parties such as insurance carriers.
The substance abuse counsellor has an ethical duty to confidentially maintain diagnostic summaries, treatment plans and case notes in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Violations of HIPAA can harm the client and result in revocation of the substance abuse counsellor’s license.
Narrow exceptions to the rule allow disclosure of confidential information if a serious or imminent threat of harm arises, according to the Substance Abuse and Mental Health Services Administration.
Demonstrate Professional Behaviour
Substance abuse counsellors must have a strong ethical core and demonstrate professionalism in their interactions with clients, colleagues and the general public. Core values include honesty, integrity and empathy for clients struggling to overcome addictions. They strive for multicultural understanding and may advocate for social justice at a facility. They may also push for change in public policy.
Substance abuse counsellors take their job seriously and do not engage in dangerous behaviours that may cause harm to others and tarnish their reputation, such as drinking and driving. They step away from their job and seek help if their own substance use causes impairment. Moreover, they do not commit illegal acts or mismanage accounts.
Set Appropriate Client Boundaries
Appropriate client-counsellor relationships require clearly defined boundaries, according to Keisha Mclean-Green, director of the Absolute Advocacy organization. The substance abuse counsellor recognizes the vulnerability of clients and does not engage in personal friendships or socializing with clients outside the office. Boundaries are also important in working with families of the client.
Ethical codes of conduct make it clear that the needs of clients are primary. Substance abuse counsellors must refrain from meeting their own needs in the counselling session, such as talking about their personal problems and using clients as confidants. Agency rules must be followed regarding meeting clients after hours, calling clients at home and accepting gifts. Ethical codes and state laws strictly prohibit harassment, abuse, sexual acts and involvement with clients.
Use Teletherapy Appropriately
The use of teletherapy, also called E-Therapy, continues to expand via webcams, smartphones, laptops and tablets. The NAADAC code of ethics for substance abuse counsellors states that additional training or certification is advisable before offering this service. Along with technical proficiency, addiction counsellors must ensure that equipment and location are HIPAA compliant.
Additionally, informed consent forms must advise the client of the risks and benefits of teletherapy. Other important considerations include instructions for seeking help in an emergency when the therapist is unavailable. Further, the client and therapist should not assume the client’s insurance will cover this type of counselling. Options for payment of services should be discussed and agreed upon before proceeding.
Keep Skills Fresh
Substance abuse counsellors read professional journals to stay abreast of emerging trends, such as increased use of vaping devices among teens and opioid use in rural communities. They look forward to completing training that will fulfill continuing education requirements for the renewal of their state alcohol and drug counsellor license. Consistent with their ethical code of conduct, substance abuse counsellors continually assess their own skills and acknowledge areas where additional training could be helpful.
Depending on their academic background, some substance abuse counsellors may conduct research and publish their findings to advance the field of addiction studies. The code of ethics for addiction counsellors stipulates that joint authorship must be acknowledged. Sources must be properly cited, and copyright laws followed.
Apply with BAPSA to learn more about substance abuse counselling ethics.