Prevention Ethics

By Vince Mercuri M.Ed., CADC, LPC

Getting to Know Yourself

Ethical Issues for the Professional

• Use/Abuse of PowerInequity in the relationshipDifferent faces of power

• Issues of CompetitionControl Losing focus/Keeping focus

*• Issues of Competency

Knowing one’s limitsAppropriate

• ReferralsOn going professional developmentAppropriate interventions

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• Issues of Intimacy and Boundaries

Social relationships with participants/attendees or former

The recovering professional, dual relationship

Attraction to a participant /attendee

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• Role Modeling ConcernsOn duty and off duty concernsValue imposition

• Honesty or DeceptionLying and leaving out detailsFraud

Ethics

• Rules, standards, codes or principles which provide guidelines for morally right behavior and truthfulness in specific situations.

Ethics has been defined as:

• The study of human actions in respect to their being right or wrong.

• The voluntary actions we carry out with sufficient knowledge and choice.

• The systematic general science of right and wrong conduct.

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• The Greek word for ethics and the Latin term for morals both have their roots in the Greek word ETHOS meaning custom or habitual mode of conduct.

• Morals are defined as actual patterns of conduct.

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• Guidelines for morally right behavior/rules of conduct.

• Standards of right and wrong that prescribe what humans ought to do in terms of rights, obligations, benefits to society, fairness or specific virtues.

Comparing Aspects of Law and Ethics

• Definition:Law – set of governing rules.

Ethics – Principles, standards, guide to conduct.

Moral Values – Beliefs formed through the influence of family, culture, and society.

Comparing Aspects of Law and Ethics

• Main Purpose:Law – to protect the public.

Ethics – to elevate standard of competence.

Moral Values – to serve as a guide for personal ethical conduct.

Comparing Aspects of Law and Ethics

• Standards:Law – minimal, promotes smooth functioning of

society.

Ethics – builds values and ideals.

Moral Values – serves as a basis for forming a personal code of ethics.

Comparing Aspects of Law and Ethics

• Penalties for Violation:Law – civil or criminal liability. Upon conviction:

fine, imprisonment, revocation of license, or other penalty as determined by courts.

Ethics – Suspension or eviction from professional society membership, as decided by peers.

Moral Values – difficulty in getting along with others.

History

In the history of ethics, there are three principle standards of conduct, each which has been proposed as the highest good:

Depending on the social setting, the authority invoked for good conduct is:

1. The will of God- obedience to the Divine

commandments in Scriptural texts. 2. The pattern of nature

- conformity to the qualities attributed to human nature

3. The rule of reason- ethical conduct will result from rational thought.

Four Major Factors That Help Define Our Behaviors with Clients

1. Internalized moral code

2. Sense of guilt

3. Personal standards

4. Responsibility for actions

Key Concepts in Ethics

• BeneficenceTo do goodTo help othersFor whose good?Participants/Attendee best interest

• Non MalfeasanceTo do no harm

• AutonomySelf determinationSelf governanceInformed consent promotedVoluntary status implied

• JusticeGiving each person his/her dueEquality as human beings impliedOne person cannot be sacrificed for

sake of another

• Human DignityAttribute of human life beyond statistical,

economic and physical existenceMaximum dignity and respect to the

individual

• Sanctity of LifeAbsolute value of lifeTransition times of life are crucial

• ConsistencyA goal in making moral decisions within

widely applicable systemsGeneral guidelines so new decisions

are not made every time

• UtilitarianismThe greatest good for the greatest

number

• Ethical Relativism“Right” is what a particular society

defines as right

• Integrity and ProprietyAvoid unlawful conductAvoid sexual misconductAvoid fraud related conduct

• Competence and Professional DevelopmentRefusal to function outside the

boundaries of skill and knowledge

• Obligation to update and expand skill and knowledge

• Remaining current and state of the art with issues and concerns in policy

and practice

• Non-discrimination/Acknowledging DiversityAppropriate services regardless of race, creed, colorGender and age sensitive servicesCultural sensitivity

• Confidentiality/PrivacyProtection of all information obtained in

course of professional services

• Fair FeesReasonable charges commensurate with services performedConsideration given to ability to pay

• Avoidance of Dual RelationshipsRefusal to participate in the development

or maintenance of exploitative relationships.

Involves present and participant/attendeeAvoidance of conflict of interest

• Appropriate Instructional Methods Appropriate referral/closure process

• Duty to WarnProtects safety and welfare of

participant/attendeeApplied in situations involving danger

to self or others

Limitations of codes of ethics

• Not always sufficient as reference guides; more generic than specific.

• Sections of codes may conflict with other codes, laws and judicial decisions.

• Codes are often reactive, not proactive.• Many topics exist on which codes are silent so

no guidance is available.• Codes do not explain how to choose one

course of action over another.

Deterrents to Ethical Responsibilities

• Ignorance of standards.• Financial advantages.• Fear of making a poor decision.• Fear of being chastised by others.• Fear that taking a strong moral stand may lead

others to examine your behavior.• High need for affection or acceptance• Poor impulse control• Acting under the influence of drugs/alcohol

The Cost of Poor Ethics

• Loss of confidence in the organization

• Deteriorating relationships among co-workers

• Declining productivity

• Absenteeism

The Rewards of Good Ethics

• Improve organizational reputation

• Increased sense of purpose

• Less time spent on office politics and gossip

• Less risk of legal fines and sanctions

• Improved pride and morale

Three Litmus Tests for Ethical Conduct

1. The Skunk Test: Does this course of conduct smell?

Source: Adapted from “Doing the Right Thing: Business Ethics and Board of Directors”, Directors Monthly. National Association of Corporate Directors, WDC.

Three Litmus Tests for Ethical Conduct

2. The Child Test: Would I advise my own child to do this?

Three Litmus Tests for Ethical Conduct

3. The Newspaper test: Would I like my board/loved one to read about this?

Five Useful Questions To Ask In Making Ethical Decisions

1. What is my gut reaction?

2. With whom do I identify?

3. What further information do I need?

4. What are the ethical issues involved?

5. What should social policy/protocol be?

Developmental Model of Ethical Behavior and Decision Behavior

• Step I – Ethical Sensitivity Recognizing the ethical nature of a situation.

• Step II – Guiding Principles Identifying principles that help to define

and/or frame choice.

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• Step III – Strategy/ Plan Developing a strategy or plan of action to

deal with the situation.

• Step IV – Action Putting the strategy/plan into action.

The Ethics Check

• Is It Legal?Take into consideration:

1. Civil Law2. Criminal Law3. Company Policy4. Standard of Conduct

• Is It Balanced?Will the decision be fair?Or, will it heavily favor one party over another, in the short or long term?

• How Will It Make me Feel About Myself?This question focuses on your

emotions and your own standards of morality.

PCB Code of Ethics

Review

Case Study #1 Sally has been teaching in the school district forten years. She is well respected by student andcolleagues alike, particularly because of her abilityto establish good rapport with her students. Shehas been active in facilitating the EducationalAwareness group at school and has been workingwith ten students this semester. Jennifer, a groupmember, seems to be struggling harder than mostgroup members in this semester’s group.

She, in fact, came to Sally earlier in the term andrevealed her concerns about her experimentationwith alcohol and her fear of “really liking it.” Shehas also confided in Sally about problems herparents are experiencing and her mother’sincreasing use of pills to cope. Jennifer had begunto show some progress in the group whensuddenly things seemed to take a turn for theworse. She began to isolate and withdraw and toldSally that her parents were splitting up.

Rumor has it that Jennifer has again been seendrinking at the bus stop. Sally decided to set upsome special sessions with Jennifer. She herselfhad been through her own parents divorce as ateen. She feels sharing this experience andgiving Jennifer some extra support will help pullher through this difficult time.

Case Study #2

Peggy is employed at the local community mentalhealth center in the prevention and educationdepartment. She offers workshops in stressmanagement, parenting skills, adult children ofalcoholics and has even done some after schoolgroups, for kids in single parent homes. Monday,when she held the first night of her spring ACOAclasses, she discovered that one of the attendees

the adult daughter of her neighbor who lives twodoors away. The neighbor has been in a recoveryprogram for several years and has been open withneighbors about her recovery in a 12 step program.She wished that her daughter would get help inexploring her own issues and had occasionallyexpressed her concerns to Peggy. Ruth knowsPeggy since she visits her mom every week. PeggyWelcomed Ruth to the group and is pleased shehas taken this step for her growth.

Case Study #3Phil and Brad have worked on the preventionteam for several years and, as a result of theirprofessional interactions, have developed afriendship as well. Brad has been noticing somesubtle changes in Phil and has recently discoveredthat he has been drinking heavily. Phil’s wife toldBrad’s wife at a company Christmas party, butasked that she not tell Brad. Brad’s wife felt shecould not keep such a confidence and shared the

information with him. This only confirmed hisworst fears, as he had begun to worry about

Phil’sdeteriorating attitude and a decline in his workperformance. Brad has been trying to pick upsome of the slack since he cares for Phil, but it isbecoming very burdensome and is affecting hisown attitude at work. He wants to help Phil butfears any action could jeopardize both their workrelationship and their friendship.

Case Study #4

Alex, the prevention specialist at his high school,has been approached by the parent group to dosomething special for the spring semester. Theyhave heard about Jack Sparta, a former drugaddict who quit using and has turned cop, who offers a dynamite program for schools. Hepresents an assembly in which he tells his storyand the program has received rave reviews,

reportedly encouraging kids who are gettinginvolved with drugs to turn to the school adultsfor help and intervention. Districts have reportedreaching as many as 25 kids from one assembly,not to mention raising awareness of countlessstudents about drug use and heading them offfrom using. Sparta also makes himself available forsmall group sessions if kids want to talk to himpersonally. The parent group has already gottenpreliminary support from the local mental healthcenter to provide on site counselors.

Case Study #5Michael has been working this past year in theprevention services department of the mentalhealth agency where he is employed. Hetransferred to prevention after getting “burnedout” while working with addicted kids. He is asharp therapist and the move was a good one. Hisaddiction knowledge base is viewed as an asset tothe team and his connections in the treatmentcommunity have increased over his years as

treatment specialist. Mike received a call at homeone evening with an offer to do a training seminarfor a local parent group. His name had been highlyrecommended and the event will be sponsored bya local brewing company. Mike is to be paid asubstantial amount to do the keynote address.Mike agreed and decided to take a vacation dayfrom work for the event. When he began toprepare for the talk he realized he had a lack ofexperience with prevention issues but felt drivenby his need for extra income.

Case Study #6You are a certified Prevention Specialist for asmall non-profit agency. You are presentingevidence based curriculum at a local high school.A colleague, who works at a different agency,offers to burn a copy of his curriculum andworkbook materials for you to use in yourclassroom presentation. It is a curriculum valuedat $1,500, not to mention future workbooksavings.

Case Study # 7Janice is a member of the Core Team who hasbeen working with Rhonda in an afterschoolsupport group. Rhonda was ambivalent and bitterwhen she entered the group. She could not seehow a 15 year old could ever be happy as a soberteenager. She was certain the fun had stoppedforever. Over time, however, Rhonda had made aturn around and shown many positive gains thatsupported her through a recovery program.

Rhonda’s parents are extremely grateful and attribute their daughter’s growth to the attentionand energy Janice gave her. At Christmas Janicereceived a package in the mail and opened it tofind a beautiful gold pen set with a note of thanksFrom Rhonda’s parents. Along with theirexpressions of gratitude they shared theiranticipation of Rhonda’s future involvement inthe group.

Case Study #8

Mark is a youth prevention worker doing drug education in his community. Mark smokes. What ethical issues are raised by his behavior? What standards of personal behavior should the staff be held to? How do you articulate these standards?

Case Study #9

Mary is a prevention coordinator. She just inherited 10,000 shares each in a brewing company and a tobacco company. Does that ownership conflict with her professional role? What should she do? What does she have to do? What would you do if you were her supervisor?

Case Study #10

Joes works a street worker for a prevention center. Through his informal network, he heard confessions about criminal activity, impending gang fights, large cocaine purchases, and a possible attempt at suicide. What ethical standards should guide his actions? What should he do in each of the four situations? To whom can Joe talk about this?

Case Study #11

I’m working toward preventing ATOD use andI’m asked to support a needle exchange

programdoes this conflict with my prevention standardsin believing that prevention has been co-optedfor another goal.

Case Study #12

You are a prevention specialist contractedthrough your agency to provide various evidenced based programs at a local middleschool. While checking your personal face bookaccount you notice that a student in one of yourclasses has friended you.