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Ethics for the addiction and marketing professional

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Louise Stanger Ed.D, LCSW, CDWF, CIP
Louise Stanger Ed.D, LCSW, CDWF, CIP

From identifying ethical decision-making models to the top issues, Dr. Louise Stanger of All About Interventions provides ethical guidelines for addiction and marketing professionals

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Ethics for the Addiction & Marketing Professional
Ethics: The Addiction & Marketing Professional §  Louise Stanger Ed.D, LCSW, CIP §  Director All About Interventions §  Faculty SDSU Interwork §  Member NII, AIS §  MINT Trainer
Objectives §  Discuss and define ethics §  Identify ethical decision-making models §  Discuss the top ethical Issues §  Discuss competence, confidentiality and mandated reporting §  Identify dual relationships §  Discuss the use of social media as it related to ethics
How do Ethical Problems Occur ? §  People are human, they make mistakes §  Clients misreport §  Inexperience §  Ignorance §  Unpredictable /Unforeseen situations §  Inadequate agency policies §  Guidelines not adequate for situation §  Ethics in conflict with law
What are your top 3 Ethical Concerns?
PatrickMcNamee- Benchmark Recovery Center §  Competence §  Dishonesty about services §  Lack of compassion
Christi Cessna- Constellation §  Misrepresenting your capabilities and preying on vulnerable people §  Overselling and over administering UA §  Kickbacks
Paul Alexander Northbound §  Accreditation and standardization of care §  “CURES” promised as opposed to solutions
Nigel Green-Foundations What do you stand for? §  Folks that do not understand the laws (ignorant of laws) §  Folks that understand the laws, but lack a strong sense of ethics
Questionable Practices §  Internet marketing scams §  Using Brain scans with other unproven treatments and billing the patient §  AP, March 2013
Questionable Practices §  Call centers share patient prospect info between treatment providers §  Call centers run through 5013C non profits
Paying Kickbacks §  To Interventionists §  Paying bounties to for referrals §  Claiming to take a patient’s insurance when reimbursement is low §  To Labs
Questionable Practices §  Promising a cure §  Using nutrient supplements that are proprietary and billing the patient
What’s most Important ?
Whistleblower –False Claim Act §  False Claims Act §  Unlawful for anyone knowingly or willingly submit or cause a fraudulent claim to the government for payment
Kickbacks-Federal Laws Anti-Kick Back Statue –criminal offense for anyone to give a kickback with the intent of influencing referral of patients Ex:Trips , hotels, gifts Stark Law- Physicians Self referral law Kickback occurs when a physician refers a patient to a facility he owns or family has financial interest
Codes of Ethics §  American Association of Advertising Agencies §  Direct Marketing Association §  Public Relations Society of America §  American Marketing Association §  Foundation for Public Affairs §  American Hospital Association §  NATAP
Code Of Ethics §  NAADAC §  NASW- Social Workers §  MFT §  NATAP §  CARF §  Psychologists §  Nurses –Doctors §  Lawyers
Code of Ethics §  Association of Intervention Specialists ( AIS) §  Network of Independent Interventionists (NII) §  Recovery Coaches §  Certified Rehabilitation Counselors
Historical Context §  In Nazi Germany 1945-1946 and 1935 American Public Health research African American men §  1966 Public Health Services established ethical regulation §  1979 Belmont Report (Protection of Human Subjects) §  1970s bio ethics emerged §  1980s Watergate §  1996 Revised Codes §  As professions grow code of ethics are formed
Philosophical History of Ethics: Modernism §  Modernism §  Human reason determines truth on all subjects §  Universal ethical laws §  Individuals are similar and rights are supreme §  Bio-ethics §  Autonomy §  Beneficence-ability to do good §  Nonmaleficence-the duty to cause no harm §  Justice-duty to treat all fairly and distribute goods equally
Philosophical History Of Ethics : Post Modernism §  Diversity, Pluralism and questioning that there are objective laws §  Situational ethics Based on historical and social contexts
What are Ethics? §  Ethics are the beliefs an individual or group maintains about what constitutes correct or proper behavior §  Standards of conduct an individual uses to make decisions.
Do not confuse Ethics and Morality ! §  The word morality comes from Latin word MORES which translates into custom or values §  Morality involves the judgment or evaluation of an ethical system, decision, or action based on socialcultural or religious norm
Competence Integrity Importance Of Human Relationships Dignity of Individual Social Justice Service VALUES
Ethical Principles §  Autonomy §  Beneficence- To do Good-To Do No Harm §  Confidentiality §  Fidelity _To keep ones promise or word, Duty to report , honesty, trustworthiness §  Gratitude §  Justice ( treat all fairly) §  Nonmalefience :The duty to cause no harm §  Reparation –duty to make up for a wrong
Ethical Principles §  Respect for Others §  Universality §  Utility- the duty to provide the greatest good or least harm to greatest number of people §  Ordering
Ethical Considerations n Fiduciary Relationships with Providers n Call Centers n Pay per click n Truth in advertising n Gifts & Kickbacks n Internet Marketing scams
Ethical Principles §  Veracity –To tell the Truth §  Herein lies dilemmas §  Between self, IP, agency and outside world
Ethical Responsibilities §  To Clients §  To Colleagues §  To Practice Settings §  As Professionals §  To Professional Affiliations §  To Broader Society
8 Step Model for Ethical Decision Making §  1. Identify the Problem or Issue - Clinical - Legal - System (polices etc) - Cultural - Ethical - counselors own issues
Steps 2-4 §  Apply a code of ethics §  Determine Nature and Dimensions of Dilemena §  Pros and Cons
Steps 5-8 §  Choose Course of Action §  Implement a Course of Action §  Evaluate the Outcome §  Evaluate the implications
Congress Ethic Model §  Examine §  Think §  Hypothesize §  Identify §  Consult
CONFIDENTIALITY §  Hallmark of Therapeutic Relationship §  Consent Forms §  Mandated Reporting- Duty to Warn §  Exceptions ( Drug Court, federally assisted treatment programs
Confidentiality and Minors §  Age of Consent §  Being Familiar with state laws §  Can Clara or parents know everything if they are under 18?
Informed Consent §  Informed Consent: Description of any reasonable foreseeable risks or discomforts Description of any benefits to the subject or others Disclosure of any alternative treatments, including medications Statement describing extent to which confidentiality of records identifying client will be maintained Explanation on limits of confidentiality Explanation on who to contact in emergency Costs to client Consequences of early withdrawal
Record Keeping §  Client prior hx of services §  Present reason for call §  Dx of bio-psycho-social §  Documentation of any changes since assessment §  Treatment plan goals & objectives (changes in Tx) §  Duration & frequency of service §  Progress notes §  Rec for further treatment- discharge plans §  Doc. Of fees charged and paid §  HIPPA Forms
Competence §  How do you achieve and maintain §  Cultural competence §  Is it ok to practice outside of ones competence?
Wireless Devices n How are these used to protect confidentiality? n Laptops, ipads, Phones, Earpieces, & other devices
Advertising §  Clear, objective truthful statements §  “Number 1 , Unique, Cure “
Visual Wrong doing §  Websites that are misleading §  Fake addresses §  Toll free numbers §  Posting of photos on misleading websites §  Certificates
Social Media n Written Materials n Business Cards n Letterhead etc n Website n Mailings n Texting n Facebook, Twitter and Linked In
BOUNDARIES §  Length of counseling, self disclosure by counselor, confidentiality, giving of gifts, touch or personal communication between counselor and client and client, counselor and supervisor’ §  Intimate relationships §  Personal benefit ( monetary goods , services) §  Emotional dependency needs of counselor §  Altruistic gestures which can be misinterpreted §  Unexpected situations such as meeting sisters new boyfriend who turns out to be a client
DUAL RELATIONSHIPS §  Friendships between client and counselor, supervisor and supervisee §  Sexual Relationships §  Professional –where client and counselor are professional colleagues §  Business dual relationships where counselor and client are business partners or have an employee/employer relationship §  Communal –where both belong to same community (AA, NA, Alanon, SA etc.)
Case Examples §  25 year old. mother is referred after 3rd DUI. She tells you father is a recovered alcoholic and drinks socially. She does not think she has a problem and does not believe she needs treatment or to be abstinent §  What do you do?
Employer Relationships §  A handsome admissions person is your subordinate. He is also in a 12 step program. You invite him for coffee after the meeting. §  ?? Ethical Considerations
Hiring Practices §  Former counselor calls to ask if she/ he can hire a former client of hers and mine from a different treatment center that has less then a year recovery
Business Temptations §  Business Temptations>>> §  What do you do???
Money for Admits §  An admissions officer offers you money for referrals
Consent and HIPPA §  Mother wants to know what daughter is saying about their relationship §  19 yo daughter has not signed consent form for mother
Other Considerations §  You are a substance abuse/mental business professional and are attending the same 12 step meeting as your client do you need to share, what do you do?? §  Organizations referral practices §  Organizations billing practices §  Other Examples
Case Example §  Someone has had an extramarital affair. Son saw. You are husband’s counselor §  What do you do ??
Gifts §  A former client gives you a $100.00 Starbucks card §  A client gives you courtside Laker tickets §  A center offers you referral fees §  ??What do you do
“There is safety in a multitude of counsel”
Resources §  The Ethics of an Addiction Counselor §  NAADAC , The Association of Addiction Professionals §  NASW Code Of Ethics §  NII Code of Ethics §  AIS Code of Ethics §  Ethics Updates http://ethics.sandiego.edu §  The Elements of Ethics for Professionals-Brad Johnson §  APA Ethics Office §  Center for the Study of Ethics in the Professions §  National Board for Certified Counselors; The Practice of Internet Counseling http://www.nbcc.org/assest/ethics/internetcounseling.pdf
Dr. Louise Stanger Ed.D, LCSW, BRI II, CIP §  Faculty SDSU Interwork Institute §  Member NII §  Member AIS §  MINT Trainer of Trainers §  Director All About Interventions §  http://www.allaboutinterventions.com
Ethics for the addiction and marketing professional

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Ethics for the addiction and marketing professional

  • 1. Ethics for the Addiction & Marketing Professional
  • 2. Ethics: The Addiction & Marketing Professional §  Louise Stanger Ed.D, LCSW, CIP §  Director All About Interventions §  Faculty SDSU Interwork §  Member NII, AIS §  MINT Trainer
  • 3. Objectives §  Discuss and define ethics §  Identify ethical decision-making models §  Discuss the top ethical Issues §  Discuss competence, confidentiality and mandated reporting §  Identify dual relationships §  Discuss the use of social media as it related to ethics
  • 4. How do Ethical Problems Occur ? §  People are human, they make mistakes §  Clients misreport §  Inexperience §  Ignorance §  Unpredictable /Unforeseen situations §  Inadequate agency policies §  Guidelines not adequate for situation §  Ethics in conflict with law
  • 5. What are your top 3 Ethical Concerns?
  • 6. PatrickMcNamee- Benchmark Recovery Center §  Competence §  Dishonesty about services §  Lack of compassion
  • 7. Christi Cessna- Constellation §  Misrepresenting your capabilities and preying on vulnerable people §  Overselling and over administering UA §  Kickbacks
  • 8. Paul Alexander Northbound §  Accreditation and standardization of care §  “CURES” promised as opposed to solutions
  • 9. Nigel Green-Foundations What do you stand for? §  Folks that do not understand the laws (ignorant of laws) §  Folks that understand the laws, but lack a strong sense of ethics
  • 10. Questionable Practices §  Internet marketing scams §  Using Brain scans with other unproven treatments and billing the patient §  AP, March 2013
  • 11. Questionable Practices §  Call centers share patient prospect info between treatment providers §  Call centers run through 5013C non profits
  • 12. Paying Kickbacks §  To Interventionists §  Paying bounties to for referrals §  Claiming to take a patient’s insurance when reimbursement is low §  To Labs
  • 13. Questionable Practices §  Promising a cure §  Using nutrient supplements that are proprietary and billing the patient
  • 15. Whistleblower –False Claim Act §  False Claims Act §  Unlawful for anyone knowingly or willingly submit or cause a fraudulent claim to the government for payment
  • 16. Kickbacks-Federal Laws Anti-Kick Back Statue –criminal offense for anyone to give a kickback with the intent of influencing referral of patients Ex:Trips , hotels, gifts Stark Law- Physicians Self referral law Kickback occurs when a physician refers a patient to a facility he owns or family has financial interest
  • 17. Codes of Ethics §  American Association of Advertising Agencies §  Direct Marketing Association §  Public Relations Society of America §  American Marketing Association §  Foundation for Public Affairs §  American Hospital Association §  NATAP
  • 18. Code Of Ethics §  NAADAC §  NASW- Social Workers §  MFT §  NATAP §  CARF §  Psychologists §  Nurses –Doctors §  Lawyers
  • 19. Code of Ethics §  Association of Intervention Specialists ( AIS) §  Network of Independent Interventionists (NII) §  Recovery Coaches §  Certified Rehabilitation Counselors
  • 20. Historical Context §  In Nazi Germany 1945-1946 and 1935 American Public Health research African American men §  1966 Public Health Services established ethical regulation §  1979 Belmont Report (Protection of Human Subjects) §  1970s bio ethics emerged §  1980s Watergate §  1996 Revised Codes §  As professions grow code of ethics are formed
  • 21. Philosophical History of Ethics: Modernism §  Modernism §  Human reason determines truth on all subjects §  Universal ethical laws §  Individuals are similar and rights are supreme §  Bio-ethics §  Autonomy §  Beneficence-ability to do good §  Nonmaleficence-the duty to cause no harm §  Justice-duty to treat all fairly and distribute goods equally
  • 22. Philosophical History Of Ethics : Post Modernism §  Diversity, Pluralism and questioning that there are objective laws §  Situational ethics Based on historical and social contexts
  • 23. What are Ethics? §  Ethics are the beliefs an individual or group maintains about what constitutes correct or proper behavior §  Standards of conduct an individual uses to make decisions.
  • 24. Do not confuse Ethics and Morality ! §  The word morality comes from Latin word MORES which translates into custom or values §  Morality involves the judgment or evaluation of an ethical system, decision, or action based on socialcultural or religious norm
  • 25. Competence Integrity Importance Of Human Relationships Dignity of Individual Social Justice Service VALUES
  • 26. Ethical Principles §  Autonomy §  Beneficence- To do Good-To Do No Harm §  Confidentiality §  Fidelity _To keep ones promise or word, Duty to report , honesty, trustworthiness §  Gratitude §  Justice ( treat all fairly) §  Nonmalefience :The duty to cause no harm §  Reparation –duty to make up for a wrong
  • 27. Ethical Principles §  Respect for Others §  Universality §  Utility- the duty to provide the greatest good or least harm to greatest number of people §  Ordering
  • 28. Ethical Considerations n Fiduciary Relationships with Providers n Call Centers n Pay per click n Truth in advertising n Gifts & Kickbacks n Internet Marketing scams
  • 29. Ethical Principles §  Veracity –To tell the Truth §  Herein lies dilemmas §  Between self, IP, agency and outside world
  • 30. Ethical Responsibilities §  To Clients §  To Colleagues §  To Practice Settings §  As Professionals §  To Professional Affiliations §  To Broader Society
  • 31. 8 Step Model for Ethical Decision Making §  1. Identify the Problem or Issue - Clinical - Legal - System (polices etc) - Cultural - Ethical - counselors own issues
  • 32. Steps 2-4 §  Apply a code of ethics §  Determine Nature and Dimensions of Dilemena §  Pros and Cons
  • 33. Steps 5-8 §  Choose Course of Action §  Implement a Course of Action §  Evaluate the Outcome §  Evaluate the implications
  • 34. Congress Ethic Model §  Examine §  Think §  Hypothesize §  Identify §  Consult
  • 35. CONFIDENTIALITY §  Hallmark of Therapeutic Relationship §  Consent Forms §  Mandated Reporting- Duty to Warn §  Exceptions ( Drug Court, federally assisted treatment programs
  • 36. Confidentiality and Minors §  Age of Consent §  Being Familiar with state laws §  Can Clara or parents know everything if they are under 18?
  • 37. Informed Consent §  Informed Consent: Description of any reasonable foreseeable risks or discomforts Description of any benefits to the subject or others Disclosure of any alternative treatments, including medications Statement describing extent to which confidentiality of records identifying client will be maintained Explanation on limits of confidentiality Explanation on who to contact in emergency Costs to client Consequences of early withdrawal
  • 38. Record Keeping §  Client prior hx of services §  Present reason for call §  Dx of bio-psycho-social §  Documentation of any changes since assessment §  Treatment plan goals & objectives (changes in Tx) §  Duration & frequency of service §  Progress notes §  Rec for further treatment- discharge plans §  Doc. Of fees charged and paid §  HIPPA Forms
  • 39. Competence §  How do you achieve and maintain §  Cultural competence §  Is it ok to practice outside of ones competence?
  • 40. Wireless Devices n How are these used to protect confidentiality? n Laptops, ipads, Phones, Earpieces, & other devices
  • 41. Advertising §  Clear, objective truthful statements §  “Number 1 , Unique, Cure “
  • 42. Visual Wrong doing §  Websites that are misleading §  Fake addresses §  Toll free numbers §  Posting of photos on misleading websites §  Certificates
  • 43. Social Media n Written Materials n Business Cards n Letterhead etc n Website n Mailings n Texting n Facebook, Twitter and Linked In
  • 44. BOUNDARIES §  Length of counseling, self disclosure by counselor, confidentiality, giving of gifts, touch or personal communication between counselor and client and client, counselor and supervisor’ §  Intimate relationships §  Personal benefit ( monetary goods , services) §  Emotional dependency needs of counselor §  Altruistic gestures which can be misinterpreted §  Unexpected situations such as meeting sisters new boyfriend who turns out to be a client
  • 45. DUAL RELATIONSHIPS §  Friendships between client and counselor, supervisor and supervisee §  Sexual Relationships §  Professional –where client and counselor are professional colleagues §  Business dual relationships where counselor and client are business partners or have an employee/employer relationship §  Communal –where both belong to same community (AA, NA, Alanon, SA etc.)
  • 46. Case Examples §  25 year old. mother is referred after 3rd DUI. She tells you father is a recovered alcoholic and drinks socially. She does not think she has a problem and does not believe she needs treatment or to be abstinent §  What do you do?
  • 47. Employer Relationships §  A handsome admissions person is your subordinate. He is also in a 12 step program. You invite him for coffee after the meeting. §  ?? Ethical Considerations
  • 48. Hiring Practices §  Former counselor calls to ask if she/ he can hire a former client of hers and mine from a different treatment center that has less then a year recovery
  • 50. Money for Admits §  An admissions officer offers you money for referrals
  • 51. Consent and HIPPA §  Mother wants to know what daughter is saying about their relationship §  19 yo daughter has not signed consent form for mother
  • 52. Other Considerations §  You are a substance abuse/mental business professional and are attending the same 12 step meeting as your client do you need to share, what do you do?? §  Organizations referral practices §  Organizations billing practices §  Other Examples
  • 53. Case Example §  Someone has had an extramarital affair. Son saw. You are husband’s counselor §  What do you do ??
  • 54. Gifts §  A former client gives you a $100.00 Starbucks card §  A client gives you courtside Laker tickets §  A center offers you referral fees §  ??What do you do
  • 55. “There is safety in a multitude of counsel”
  • 56. Resources §  The Ethics of an Addiction Counselor §  NAADAC , The Association of Addiction Professionals §  NASW Code Of Ethics §  NII Code of Ethics §  AIS Code of Ethics §  Ethics Updates http://ethics.sandiego.edu §  The Elements of Ethics for Professionals-Brad Johnson §  APA Ethics Office §  Center for the Study of Ethics in the Professions §  National Board for Certified Counselors; The Practice of Internet Counseling http://www.nbcc.org/assest/ethics/internetcounseling.pdf
  • 57. Dr. Louise Stanger Ed.D, LCSW, BRI II, CIP §  Faculty SDSU Interwork Institute §  Member NII §  Member AIS §  MINT Trainer of Trainers §  Director All About Interventions §  http://www.allaboutinterventions.com