This module contains links and information for the
Ethics portion of the LADAC Exam

The material on this page is reviewed in the Test Preparation Workshop

This module emphasizes ethics that are covered on the level one credentialing exams.  If you have already had basic ethics, you might prefer a more advanced class, or a special topics ethics class.  This outline is from the NAADAC ethics. These principles are on the test NCAC I (LADAC exam) outline.  The content is very similar to the CADAC ethics. 
 

  NCAC I (LADAC exam)

Principle 1: Non-Discrimination

The NAADAC member shall not discriminate against clients or professionals based on race, religion, age, gender, disability, national ancestry, sexual orientation or economic condition.

a. The NAADAC member shall avoid bringing personal or professional issues into the counseling relationship. Through an awareness of the impact of stereotyping and discrimination, the member guards the individual rights and personal dignity of clients.
b. The NAADAC member shall be knowledgeable about disabling conditions, demonstrate empathy and personal emotional comfort in interactions with clients with disabilities, and make available physical, sensory and cognitive accommodations that allow clients with disabilities to receive services.

The first principle is one of nondiscrimination and states that alcoholism and drug abuse counselors “must not discriminate against clients or professionals based on race, religion, age, handicaps, national ancestry, sexual orientation or economic condition. Although this seems fairly straightforward, it brings up questions up questions about how to avoid discrimination in making decisions of who will receive service when there is a waiting list.

Principle 2: Responsibility

The NAADAC member shall espouse objectivity and integrity, and maintain the highest standards in the services the member offers.

a. The NAADAC member shall maintain respect for institutional policies and management functions of the agencies and institutions within which the services are being performed, but will take initiative toward improving such policies when it will better serve the interest of the client.
b. The NAADAC member, as educator, has a primary obligation to help others acquire knowledge and skills in dealing with the disease of alcoholism and drug abuse.
c. The NAADAC member who supervises others accepts the obligation to facilitate further professional development of these individuals by providing accurate and current information, timely evaluations and constructive consultation.
d. The NAADAC member who is aware of unethical conduct or of unprofessional modes of practice shall report such inappropriate behavior to the appropriate authority.

The second principle concerns responsibility as a teacher and a practitioner. It states: The alcoholism and drug counselor must espouseobjectivity and integrity, and maintain the highest standards in the services the counselor offers.

a.       The alcoholism and drug abuse counselor, as teacher, must recognize the counselor’s primary obligation to help others acquire knowledge and skill in dealing with the disease of chemical dependency.

b.      The alcoholism and drug abuse counselor, as practitioner, must accept the professional challenge and responsibility deriving from the counselor’s work.

The principle is fairly self-explanatory. It describes the responsibility that chemical dependency counselors have when they represent themselves to the public and disperse information about the profession.  This principle specifically mentions “the disease of chemical dependency”. Some professionals in the field might have difficulty with promoting this concept in exclusion of other models.

Principle 3: Competence

The NAADAC member shall recognize that the profession is founded on national standards of competency which promote the best interests of society, of the client, of the member and of the profession as a whole. The NAADAC member shall recognize the need for ongoing education as a component of professional competency.

a. The NAADAC member shall recognize boundaries and limitations of the member's competencies and not offer services or use techniques outside of these professional competencies.
b. The NAADAC member shall recognize the effect of impairment on professional performance and shall be willing to seek appropriate treatment for oneself or for a colleague. The member shall support peer assistance programs in this respect.

The Third principle addresses the issue of competence and the need for ongoing education and training. The issue of competence not only means having competence in the treatment of chemical dependency but also not treating problems outside of this competence, nor allowing others without this competence to treat alcohol and other drug abuse.  The third principle also requires counselors to seek help for themselves and their colleagues if they become impaired in any way. This is especially important for the substance abuse field where the possibility of relapse is a reality.  This presents a dilemma for the treatment center that believes that relapses are to be expected in the recovery process, yet denies credibility as a role model to the chemical dependency counselor who relapses. 

      Principle three states: The alcoholism and drug abuse counselor must recognize that the profession is founded on national standards of competency which promote the best interests of society, of the client, of the counselor and of the professional as a whole.  The counselor must recognize the need for ongoing education as a component of professional competency.

a.       The alcoholism and drug abuse counselor must prevent the practice of alcoholism and drug abuse counseling by unqualified and unauthorized persons.

b.      The alcoholism and drug counselor who is aware of unethical conduct or of unprofessional modes of practice must report such violations to appropriate certifying authority.

c.       The alcoholism and drug abuse counselor must recognize boundaries and limitations of counselor’s competencies and not offer services or use techniques outside of these professional competencies.

d.      The alcoholism and drug abuse counselor must recognize the effect of professional impairment on professional performance and must be willing to seek appropriate treatment for oneself or for a colleague.

      Competence is difficult to define, but it is an important issue in the treatment of chemical dependency counseling. When chemical dependency treatment specialists assume that they can provide everything their clients need to achieve recovery from addiction, they are taking on an enormous task and doing their clients a disservice by isolating them from professionals with unique skills that can aid in their client’s recovery and treatment. Addiction is usually clustered with a number of other problems such as legal difficulties, financial problems, lack of job skills, medical problems, sexual dysfunction, marital problems, parenting problems, lack or transportation, educational deficits, inadequate social skills, and general living difficulties. The more of these problems that are attacked in the course of treatment, the better the potential for success.

The issue of competency becomes even more of a problem if the chemical dependency counselor decides to set up a private practice.  In many states there are no legal constraints preventing chemical dependency counselors, whether credentialed or not.  This is a very different situation than working as part of a treatment team in a hospital or treatment clinic.  Private practice requires far more competence and professional training. Bissell and Royce (1987) recommend that, “along with specialized training in chemical dependency counseling, a master’s degree should be the minimum legal requirement for private practice.

 

Principle 4: Legal and Moral Standards

The NAADAC member shall uphold the legal and accepted moral codes which pertain to professional conduct.

a. The NAADAC member shall be fully cognizant of all federal laws and laws of the member's respective state governing the practice of alcoholism and drug abuse counseling.
b. The NAADAC member shall not claim either directly or by implication, professional qualifications/affiliations that the member does not possess.
c. The NAADAC member shall ensure that products or services associated with or provided by the member by means of teaching, demonstration, publications or other types of media meet the ethical standards of this code.

The fourth principle discusses legal standards and moral standards. It states: The alcoholism counselor must uphold the legal and accepted moral codes which pertain to professional conduct.

a.       The alcoholism and drug abuse counselor must not claim either directly or by implication, professional qualification/affiliations that the counselor does not possess.

b.      The alcoholism and drug counselor must not use the affiliation with the National Association of Alcoholism and Drug Abuse Counselors for purpose that is not consistent with the stated purposes of the Association.

c.       The alcoholism and drug abuse counselor must not associate with or permit the counselor’s name to be used in connection with any services or products in a way that is incorrect or misleading.

d.      The alcoholism and drug abuse counselor associated with the development of promotion of books or other products offered for commercial sale must be responsible for ensuring that such books or products are presented in a professional or factual way (NAADAC,1993.p.2A).

 

Principle 5: Public Statements

The NAADAC member shall honestly respect the limits of present knowledge in public statements concerning alcoholism and drug abuse.

a. The NAADAC member, in making statements to clients, other professionals, and the general public shall state as fact only those matters which have been empirically validated as fact. All other opinions, speculations, and conjecture concerning the nature of alcoholism and drug abuse, its natural history, its treatment or any other matters which touch on the subject of alcoholism and drug abuse shall be represented as less than scientifically validated.
b. The NAADAC member shall acknowledge and accurately report the substantiation and support for statements made concerning the nature of alcoholism and drug abuse, its natural history, and its treatment. Such acknowledgment should extend to the source of the information and reliability of the method by which it was derived.

The fifth principle is also concerned with public statements that might mislead the public or present inaccurate information. It states: The alcoholism and drug abuse counselor must respect the limits of present knowledge in public statements concerning alcoholism and other forms of drug addiction.

a.       The alcoholism and drug abuse counselor who represents the field of alcoholism counseling to clients, other professionals, or to the general public must report fairly and accurately the appropriate information.

b.       The alcoholism and drug abuse counselor must acknowledge and document materials and techniques used.

c.       The alcoholism and drug abuse counselor who conducts training in alcoholism or drug abuse counseling skills or techniques must indicate to the audience the requisite training/qualifications required to properly perform these skills and techniques (NAADAC, 1993, p.2A)

Principle 6: Publication Credit

The NAADAC member shall assign credit to all who have contributed to the published material and for the work upon which the publication is based.

a. The NAADAC member shall recognize joint authorship and major contributions of a professional nature made by one or more persons to a common project. The author who has made the principal contribution to a publication must be identified as first author.
b. The NAADAC member shall acknowledge in footnotes or in an introductory statement minor contributions of a professional nature, extensive clerical or similar assistance and other minor contributions.
c. The NAADAC member shall in no way violate the copyright of anyone by reproducing material in any form whatsoever, except in those ways which are allowed under the copyright laws. This involves direct violation of copyright as well as the passive assent to the violation of copyright by others.

The sixth principle concerns giving credit to authors and concerns giving credit to authors and contributors to published materials, such as books, articles, and pamphlets. It is not an acceptable practice to plagiarize another person’s writings or to present another person’s theories, techniques, or work as the author’s original ideas. Written credit must be given to the originator of the work. The principle specifically states:

The alcoholism and drug abuse counselor must assign credit to all who have contributed to the published material and for the work upon which the publications is based.

a.       The alcoholism and drug abuse counselor must recognize joint authorship, major contributions of a professional character, made by several persons to a common project. The author who has made the principle contributions to a publication must be identified as a first listed.

b.      The alcoholism and drug abuse counselor must acknowledge in footnotes or an introductory statement minor contributions of a professional character, extensive clerical or similar assistance, and other minor contributions.   

c.       The alcoholism and drug abuse counselor must acknowledge, through specific citations, unpublished, as well as published material, that has directly influenced the research or writing.

d.      The alcoholism and drug abuse counselor who compiles and edits for publication the contributions of others must list oneself as editor along with the names of those others who have contributed (NAADAC, 1993. P2).

Principle 7: Client Welfare

The NAADAC member shall promote the protection of the public health, safety and welfare and the best interest of the client as a primary guide in determining the conduct of all NAADAC members.

a. The NAADAC member shall disclose the member's code of ethics, professional loyalties and responsibilities to all clients.
b. The NAADAC member shall terminate a counseling or consulting relationship when it is reasonably clear to the member that the client is not benefiting from the relationship.
c. The NAADAC member shall hold the welfare of the client paramount when making any decisions or recommendations concerning referral, treatment procedures or termination of treatment.
d. The NAADAC member shall not use or encourage a client's participation in any demonstration, research or other non-treatment activities when such participation would have potential harmful consequences for the client or when the client is not fully informed. (See Principle 9)
e. The NAADAC member shall take care to provide services in an environment which will ensure the privacy and safety of the client at all times and ensure the appropriateness of service delivery.

The seventh principle moves away from the protection of the public and the profession to outlining the doctrine of client welfare. This guideline for protecting client welfare can be useful to the counselor in making difficult decisions. At times, however, it can be difficult to determine who the client is. For example, a supervisor who discovers that a counselor has been unethical during a supervision session may have a conflict between reporting this behavior to the program director and/or certification board and feeling that the counselor may have believed he or she was revealing this to the supervisor in confidence. This confusion can be eliminated if the counselor who is in supervision understands from the beginning that the supervisor is being paid by the program director to make certain that good and ethical treatment is being provided to the program clients and that confidentiality will not be guaranteed to the supervisees.  The principle gives examples of when client welfare should be protected:

The alcoholism and drug abuse counselor must respect the integrity and protect the welfare of the person or group with whom the counselor is working.

a.       The alcoholism and abuse counselor must respect the integrity and protect the welfare of the person or group with whom the counselor is working.

b.      The alcoholism and drug abuse counselor, in the presence of professional conflict must be concerned primarily with the welfare of the client.

c.       The alcoholism and drug abuse counselor must terminate a counseling or consulting relationship when it is reasonable clear to the counselor that the client is not benefiting from it.

d.      The alcoholism and drug abuse counselor, in referral cases, must assume the responsibility for the client’s welfare either by termination by mutual agreement and/or by the client becoming engaged with another professional. In situations when a client refuses treatment, referral or recommendations, the alcoholism and drug abuse counselor must carefully consider the welfare of the client by weighing the benefits of continued treatment or termination and must act in the best interest of the client.

e.       The alcoholism and drug abuse counselor who asks a client to reveal personal information from other professionals or allows information to be divulged must inform the client of the nature of such transactions. The information released or obtained with informed consent must be used for expressed purposes only.

f.        The alcoholism and drug abuse counselor must not use a client in a demonstration role in a workshop setting where such participation would potentially harm the client.

g.       The alcoholism and drug abuse counselor must ensure the presence of an appropriate setting for clinical work to protect the client from harm and the counselor and the professional from censure.

h.       The alcoholism and drug abuse counselor must collaborate with other health care professionals in providing a supportive environment for the client who is receiving prescribed medication (NAADAC, 1993, p.3A).

Principle 8: Confidentiality

The NAADAC member working in the best interest of the client shall embrace, as a primary obligation, the duty of protecting client's rights under confidentiality and shall not disclose confidential information acquired in teaching, practice or investigation without appropriately executed consent.

a. The NAADAC member shall provide the client his/her rights regarding confidentiality, in writing, as part of informing the client in any areas likely to affect the client's confidentiality. This includes the recording of the clinical interview, the use of material for insurance purposes, the use of material for training or observation by another party.
b. The NAADAC member shall make appropriate provisions for the maintenance of confidentiality and the ultimate disposition of confidential records. The member shall ensure that data obtained, including any form of electronic communication, are secured by the available security methodology. Data shall be limited to information that is necessary and appropriate to the services being provided and be accessible only to appropriate personnel.
c. The NAADAC member shall adhere to all federal and state laws regarding confidentiality and the member's responsibility to report clinical information in specific circumstances to the appropriate authorities.
d. The NAADAC member shall discuss the information obtained in clinical, consulting, or observational relationships only in the appropriate settings for professional purposes that are in the client's best interest. Written and oral reports must present only data germane and pursuant to the purpose of evaluation, diagnosis, progress, and compliance. Every effort shall be made to avoid undue invasion of privacy.
e. The NAADAC member shall use clinical and other material in teaching and/or writing only when there is no identifying information used about the parties involved.

The eighth principle concerns the ethical principle of confidentiality. The ethical principle of confidentiality is presented by NAADAC in the following way:

The alcoholism and drug abuse counselor must embrace, as a primary obligation, the duty of protecting the privacy of clients and must not disclose confidential information acquired, in teaching, practice or investigation.

a.       The alcoholism and drug abuse counselor must inform the client and obtain agreement in areas likely to affect the client’s participation including the recording of an interview, the use of interview material for training purposes, and observation of an interview by another person.

b.      The alcoholism and drug abuse counselor must make provisions for the maintenance of confidentiality and the ultimate disposition of confidential records.

c.       The alcoholism and drug abuse counselor must reveal information received in confidence only when there is clear and imminent danger to the client or to other persons, and then only to appropriate professional workers or public authorities.

d.      The alcoholism and drug abuse counselor must discuss the information obtained in clinical or consulting relationships only in appropriate settings, and only for professional purposes clearly concerned with the case. Written and oral reports must present only data germane to the purpose of the evaluation and every effort must be made to avoid undue invasion of privacy.

e.       The alcoholism and drug abuse counselor must use clinical and other material in classroom teaching and writing only when the identity of the persons involved is adequately disguised (NAADAC, 1993, p.3A).

Principle 9: Client Relationships

It is the responsibility of the NAADAC member to safeguard the integrity of the counseling relationship and to ensure that the client has reasonable access to effective treatment. The NAADAC member shall provide the client and/or guardian with accurate and complete information regarding the extent of the potential professional relationship.

a. The NAADAC member shall inform the client and obtain the client's agreement in areas likely to affect the client's participation including the recording of an interview, the use of interview material for training purposes, and/or observation of an interview by another person.
b. The NAADAC member shall not engage in professional relationships or commitments that conflict with family members, friends, close associates, or others whose welfare might be jeopardized by such a dual relationship.
c. The NAADAC member shall not exploit relationships with current or former clients for personal gain, including social or business relationships.
d. The NAADAC member shall not under any circumstances engage in sexual behavior with current or former clients.
e. The NAADAC member shall not accept as clients anyone with whom they have engaged in sexual behavior.

The ninth principle describes factors that would interfere with the counselor-client relationship or compromise the client or the therapy process. These problems have been referred to as dual relationships and are discouraged because of the erosion that takes place in the therapy process as well as the potential harm to the client. Dual relationships exist whenever a counselor has any other relationship with a person who is their client, and they become unethical if there is any harm or potential for harm to the client or benefit to the counselor (Dove, 1995). Dual-relationship dilemmas are very common, particularly in the treatment of chemical dependency, and include sexual exploitation of clients, which is considered to be one of the most harmful, yet most common, violations (Vasquex, 1988).

 This ninth principal also covers informing clients, or guardians of minor clients, about the potential impact of their participation in therapy that is recorded, observed, or used for demonstrations and how this information will be used. In working with minors, the parents or legal guardians have the legal right to privileged communication and can request information about the therapy of a minor. Usually, it is in the best interest of the minor client for the parents or guardians to agree to the confidentiality of the therapy content.

Principle 10: Interprofessional Relationships

The NAADAC member shall treat colleagues with respect, courtesy, fairness, and good faith and shall afford the same to other professionals.

a. The NAADAC member shall refrain from offering professional services to a client in counseling with another professional except with the knowledge of the other professional or after the termination of the client's relationship with the other professional.
b. The NAADAC member shall cooperate with duly constituted professional ethics committees and promptly supply necessary information unless constrained by the demands of confidentiality.
c. The NAADAC member shall not in any way exploit relationships with supervisees, employees, students, research participants or volunteers.

The tenth principle concerns inter-professional relationships. Professional therapists need to respect other professions and cooperate with them in the provision of services. It is not useful to the client or the profession of chemical dependency counseling to discredit another therapist or type of therapy. Although there has been a history of professional bashing in the chemical dependency field, most of this was born out of an early history of the treatment failure of psychoanalysts who were treating alcoholism or out of the insecurity of untrained chemical dependency counselors who feared that trained professionals might take their jobs. It may be tempting for chemical dependency counselors to believe their clients when they tell stories of the incompetencies of their previous therapists, and it may make them feel more competent themselves.

Principle 11: Remuneration

The NAADAC member shall establish financial arrangements in professional practice and in accord with the professional standards that safeguard the best interests of the client first, and then of the counselor, the agency, and the profession.

a. The NAADAC member shall inform the client of all financial policies. In circumstances where an agency dictates explicit provisions with its staff for private consultations, clients shall be made fully aware of these policies.
b. The NAADAC member shall consider the ability of a client to meet the financial cost in establishing rates for professional services.
c. The NAADAC member shall not engage in fee splitting. The member shall not send or receive any commission or rebate or any other form of remuneration for referral of clients for professional services.
d. The NAADAC member ,in the practice of counseling ,shall not at any time use one's relationship with clients for personal gain or for the profit of an agency or any commercial enterprise of any kind.
e. The NAADAC member shall not accept a private fee for professional work with a person who is entitled to such services through an institution or agency unless the client is informed of such services and still requests private services.

The eleventh principle is concerned with policies of remuneration or fees for services. It states: The alcoholism and drug abuse counselor must establish financial arrangements in professional practice and in accord with the professional standards that safeguard the best interests of the client, of the counselor and of the profession.

a.       The alcoholism and drug abuse counselor must consider carefully the ability of the client to meet the financial cost in establishing rates for professional services.

b.      The alcoholism and drug abuse counselor must not send or receive any commission or rebate or any other form of remuneration for referral of clients for professional services. The counselor must not engage in fee splitting.

c.       The alcoholism and drug abuse counselor in a clinical or counseling practice must not use one’s relationship with clients to promote personal gain or the profit of any agency or commercial enterprise of any kind (NAADAC, 1993 p.4A).

Principle 12: Societal Obligations

The NAADAC member shall to the best of his/her ability actively engage the legislative processes, educational institutions, and the general public to change public policy and legislation to make possible opportunities and choice of service for all human beings of any ethnic or social background whose lives are impaired by alcoholism and drug abuse.

NAADAC is comprised of members who, as responsible health care professionals, believe in the dignity and worth of human beings. In the practice of their profession they assert that the ethical principles of autonomy, beneficence and justice must guide their professional conduct. As professionals dedicated to the treatment of alcohol and drug dependent clients and their families, they believe that they can effectively treat its individual and familiar manifestations. NAADAC members dedicate themselves to promote the best interests of their society, of their clients, of their profession, and of their colleagues.
 

The twelfth principle describes the social obligations for the chemical dependency counselor. Alcoholism and other drug abuse is not only a medical or psychological problem, it is very much a social concern. The public atmosphere concerning this problem has shifted over the course of United States history.  Alcoholism has been seen as a moral weakness, something to be attacked through prohibition; an untreatable problem; a disease; an illness; a psychiatric disorder, a family problem; and a social menace when it involves drunk driving.  This principle states:

The alcoholism and drug abuse counselor must advocate changes in public policy and legislation to afford opportunity and choice for all persons whose lives are impaired by the disease of alcoholism and other forms of drug addictions. The counselor must inform the public through active civic and professional participation in community affairs of the effects of alcoholism and drug addiction and must act to guarantee that all persons, especially the needy and disadvantaged, have access to the necessary resources and services (NAADAC, 1993,p.4A).         

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References

References:

Association for Advanced Training in The Behavioral Sciences (2001), NBCC Study Guide.

Corey, G. (1996) Theory and practice of Counseling and Psychotherapy, 5^th edition. Library of Congress Cataloging-in- Publication Data 60-83.

Corey, G. (1991) Manual for Theory and Practice of Counseling and Psychotheropy, 4^th edition. Library of Congress Cataloging- in- Publication Data168-169.

Davis & Coleman (1997) Multicultural Counseling Competencies. Library of Congress Cataloging-in-Publication Data.

U.S. Department of Health and Human Services Public Health Service (2000) Substance Abuse Treatment for Persons with HIV/AIDS.