ETHICAL AND LEGAL CONSIDERATIONS FOR ADDICTION TREATMENT
Think about the last time you were treated for a medical issue. You probably signed a form giving your consent to be treated and a form giving your doctor permission to share confidential medical information with approved individuals, such as your spouse or primary care physician. Physicians are required by law and by a professional code of ethics to obtain a patient’s informed consent before providing treatment. They are also required to protect a patient’s privacy and confidentiality, except in instances when the patient has given permission to share confidential medical information.
Addiction professionals are also bound by laws and a professional code of ethics that require informed consent and confidentiality. In this Discussion, you will consider how specific laws and ethical standards apply to treatment planning with one of the cases you focused on in this course.
RESOURCES
LEARNING RESOURCES
Required Readings
Ethical Standards and Laws Relevant to Treatment Planning
The Association for Addiction Professionals. (2021, January 1). Introduction to NAADAC/NCC AP ethical standardsLinks to an external site.. https://www.naadac.org/code-of-ethics
SAMHSA. (2021). Substance abuse confidentiality regulationsLinks to an external site.. https://www.samhsa.gov/about-us/who-we-are/laws-regulations/confidentiality-regulations-faqs
Document: Treatment Planning: Informed Consent and Confidentiality Download Treatment Planning: Informed Consent and Confidentiality(PDF)
Case Studies
Walden University, LLC. (2022). Week 3 case study: ReggieLinks to an external site. [Interactive media]. Walden University Blackboard. https://waldenu.instructure.com
Walden University, LLC. (2022). Week 4 case study: ChristinaLinks to an external site. [Interactive media]. Walden University Blackboard. https://waldenu.instructure.com
Walden University, LLC. (2022). Week 5 case study: AlexLinks to an external site. [Interactive media]. Walden University Blackboard. https://waldenu.instructure.com
State Credentials for Addiction Professionals
Addiction-Counselors.com. (n.d.) Addiction/substance abuse counselor requirements by stateLinks to an external site.. https://www.addiction-counselors.com/
Note: Using the link above, search for your state’s credentialing requirements for addiction professionals. Your state may list specific coursework that you must have to obtain credentialing. This will give you an idea on what knowledge areas, skills, and abilities you may need to develop in relation to the treatment of addiction. Requirements vary greatly from state to state. If the Addiction-Counselors.com website does not list specific coursework or knowledge that you need in your state, you may be able to find this information going to your state’s licensing board web site.
If your state does not list specific coursework requirements, you may want to determine the required exam for your state and review the content areas covered in the exam. This will give you an idea on what knowledge areas, skills, and abilities you might need to develop in relation to treatment planning. Following are two commonly used exams for Addiction Professionals:
IC&RC Exam
If your state requires you to pass the IC&RC examination for Alcohol and Drug Counselors or complete coursework that addresses the IC&RC domains/tasks, download the Candidate Guide for the IC&RC Alcohol and Drug Counselor Examination listed below. Review the section entitled, “Content,” which includes domains and tasks that are covered in the exam.
IC&RC. (2017). Candidate guide for the IC&RC Alcohol and Drug Counselor examinationLinks to an external site.. https://www.decertboard.org/sites/default/files/applications/ADC_Candidate_Gudie_2017.pdf
NAADAC Exam
If your state requires you to pass one of the NAADAC exams, visit one of the following websites and scroll to the bottom of the page for examination details and suggested preparation materials. This will give you an idea of the content areas covered in the exam.
NAADAC. (n.d.). NCAC I written examinationLinks to an external site.. https://www.naadac.org/ncac-i
NAADAC. (n.d.). NCAC II written examinationLinks to an external site.. https://www.naadac.org/ncac-ii
Treatment Planning Knowledge, Skills, and Abilities
SAMHSA. (2016). Improving cultural competence: Quick guide for cliniciansLinks to an external site.. https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4931.pdf
Read pp. 21-37 only (Sections entitled, Culturally Responsive Evaluation and Treatment Planning and Behavioral Health Treatment for Major Racial and Ethnic Groups.
SAMHSA. (2017). Addiction counseling competencies: The knowledge, skills, and attitudes of professional practiceLinks to an external site.. https://store.samhsa.gov/sites/default/files/d7/priv/sma12-4171.pdf
Section 2: Practice Dimensions
II. Treatment Planning (pp. 53-67)
V. Counseling (pp. 99-130)
VIII. Professional and Ethical Responsibilities (pp 151-160)
Professional Development
IC&RC. (n.d.). Free study resourcesLinks to an external site.. https://internationalcredentialing.org/Resources/Documents/Free%20Study%20Resources.pdf
NAADACLinks to an external site.. (n.d.). https://www.naadac.org/: Explore the Education, Resources, and Conference & Events tabs for opportunities and resources to further your knowledge, skills, and abilities in addiction treatment planning.
TO PREPARE:
Identify the case study you selected in the subject line of your post.
Case study 5 ALEX.
Diagnostic Summary
This is a 17-year-old single Asian-American male. He comes to treatment with a chief complaint of a marijuana problem, referred by his mother. He was born and has lived in Hart City all his life. He lives with his mother in a single-family home in a predominately white, middle-class neighborhood. He and his family have been victims of hate crimes in the neighborhood, and he does not feel safe. His 18-year-old sister left for college earlier this year with a full scholarship to an Ivy League school that is 2000 miles away. His parents are divorced after 20 years of marriage. His mother was born in Hart City, of immigrant parents. His mother is a human © 2022 Walden University, LLC Page 11 of 11 resource manager at Hart City Hospital. His father immigrated from China with his parents when he was 12 years old and works as a procurement manager for a big box store in Hart City. His father is currently addicted to Oxycontin after becoming addicted following a prescription for a back surgery. His continued use of Oxycontin led to the divorce and his father has never received treatment. The service user is a high school student in the 12th grade. His mother will not allow him to get a job until his grades improve. He is maintaining a C average in school and is enrolled in several Advanced Placement courses. He has difficulty keeping up with his peers and is embarrassed about looking stupid. He is bored in school and finds it difficult to pay attention to his teachers and focus on completing his work. He is concerned about his capability of going to college which he always thought he would attend. He played on the high school soccer team last year and he was bullied when the other team members found out he was gay, and he has decided not to play again this year. The service user has a strained relationship with his father who does not approve of him being gay. He also has a strained relationship with his mother because she constantly nags him about his grades and about using marijuana. He has lied to his mother about using marijuana on multiple occasions. He says using marijuana is no big deal because it’s a plant. He also says marijuana is safer than the pills his father takes. He is in a relationship with a significant other. He has been dating his boyfriend (also 17 years old) for 2 years. The service user began using marijuana when he was 15 due to peer pressure from his boyfriend. He only smoked marijuana on the weekends at the beginning. His use increased to multiple times a day after someone spray painted a racial slur on his garage door. He uses marijuana to relax. He smokes joints, uses a bong, and eats edibles. His longest period of sobriety was 4 days when he went on a road trip with his mother a few weeks ago. He has increased tolerance. He reports withdrawal symptoms of headaches and anxiety. He has purchased marijuana, which is illegal. He has experienced changes in grades as a consequence of substance use. He has not received treatment for his marijuana addiction. He has no past or present use of other drugs. His medical status is good, with no issues reported. He has recently gained weight. He has a history of depressed mood. He denies any self-harm or thoughts of harming others. He has normal sleep patterns. He has difficulty concentrating. He has an average energy level. He enjoys spending time with friends listening to music and watching movies and TV. His only source of support is his boyfriend and another long-term friend from elementary school. The friend from the elementary school does not get along with the boyfriend because he believes the boyfriend is a bad influence. The service user is willing to get treatment to make his mother happy, but he is not internally motivated for treatment. His relapse potential is high and his recovery environment is fair. He has a stable home to live in and the support of his mother, but he does not feel safe in his neighborhood.
NAADAC, the Association for Addiction Professionals NCC AP: The National Certification Commission for Addiction Professionals CODE OF ETHICS Effective 1.1.2021 PRINCIPLES • Introduction to NAADAC/NCC AP
Ethical Standards • Principle I: The Counseling Relationship •
Principle II: Confidentiality and Privileged Communication •
Principle III: Professional Responsibilities and Workplace Standards •
Principle IV: Working in A Culturally‐Diverse World •
Principle V: Assessment, Evaluation and Interpretation •
Principle VI: E‐Therapy, E‐Supervision and Social Media • Principle VII: Supervision and Consultation • Principle VIII: Resolving Ethical Concerns • Principle IX: Publication and Communications INTRODUCTION TO NAADAC/NCC AP ETHICAL STANDARDS i‐1 NAADAC and NCC AP recognize that their members, certified counselors, and other service providers live and work in many diverse communities. NAADAC shall have the responsibility to create a Code of Ethics that shall be relevant for ethical deliberation and guidance. The terms “addiction professionals” and “providers” shall include and refer to NAADAC Members, certified or licensed counselors offering addiction‐specific services, and other service providers along the continuum of care from prevention through recovery. “Client” shall include and refer to individuals, couples, partners, families, or groups, depending on the setting.
respond to the following.
Ethical considerations are paramount in addiction treatment planning, ensuring that professionals uphold the highest standards of care and adhere to legal and ethical guidelines. This essay explores two ethical standards from Principle I of the NAADAC/NCC code of ethics that are relevant to treatment planning and discusses the steps to adhere to these standards in creating a treatment plan for a service user in the selected case study. Additionally, the essay addresses the steps required to obtain informed consent and maintain confidentiality in the treatment planning process, with reference to ethical standards, state laws, and federal laws.
Non-Discrimination: This ethical standard prohibits addiction professionals from engaging in discriminatory practices based on factors such as age, race, gender, sexual orientation, and socioeconomic status. It emphasizes treating all clients with fairness, respect, and without bias. In the case study of Alex, who faces discrimination due to his sexual orientation and ethnicity, this ethical standard requires the addiction professional to create a treatment plan that addresses these unique challenges and ensures a safe and inclusive environment.
Informed Consent and Autonomy: This standard underscores the importance of respecting the autonomy and self-determination of clients. Addiction professionals must provide clients with clear and comprehensible information about the treatment process, potential risks, benefits, and alternatives. In the context of Alex’s case, the ethical standard of informed consent necessitates that the addiction professional discusses the treatment options, goals, potential outcomes, and collaboratively involves Alex in the decision-making process.
Adhering to Ethical Standards in Treatment Planning: To uphold the non-discrimination standard, the addiction professional should conduct a thorough assessment of Alex’s experiences with discrimination and victimization. The treatment plan should incorporate strategies to address his emotional and psychological well-being, build resilience, and enhance his coping skills. Furthermore, the professional should create a supportive environment that validates Alex’s feelings and experiences, promoting his sense of belonging.
In alignment with the informed consent standard, the addiction professional should engage Alex in an open dialogue about his treatment options. This involves discussing different therapeutic modalities, their potential benefits, and possible challenges. The professional should also ensure that Alex has a clear understanding of the treatment goals, progress markers, and potential changes to the plan. Obtaining Alex’s informed consent will empower him to actively engage in the treatment process and make informed decisions about his recovery journey.
Obtaining Informed Consent and Maintaining Confidentiality: To obtain informed consent from Alex, the addiction professional should provide detailed information about the treatment plan, its objectives, methods, and potential risks. The professional should encourage Alex to ask questions, express concerns, and seek clarification as needed. Informed consent should be documented, ensuring that Alex’s agreement to the treatment plan is well-documented and transparent.
Maintaining confidentiality involves complying with state and federal laws that protect the privacy of individuals seeking addiction treatment. The professional should explain the limits of confidentiality, such as circumstances where disclosure may be necessary to prevent harm to self or others. Additionally, the professional should create a secure system for storing and sharing confidential information, ensuring that only authorized individuals have access to Alex’s treatment records.
Ethical considerations play a pivotal role in addiction treatment planning, guiding professionals to provide comprehensive and client-centered care. By adhering to ethical standards such as non-discrimination and informed consent, addiction professionals ensure that treatment plans address clients’ unique needs and empower them to make informed decisions about their recovery journey. Moreover, obtaining informed consent and maintaining confidentiality uphold clients’ rights and promote a trusting and collaborative therapeutic relationship.
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