The article by Scott (2000), discusses the ethical issues that counselors and psychologists face during addiction counseling. Addiction counselors come across ethical challenges that are unique as compared to other counselors. According to Scott (2000), the moral difficulties that addiction counselors face include the lack of continuity and communication between clinical practice and research, lack of agreement over the fundamental professional credentials, the questionable propensity of team work in the field of addiction, and specific issues of privileged and confidential communication. Moreover, they also face the challenges of boundaries of professional practice in making decisions concerning treatment and unusual situations of informed consent (Scott, 2000).
Lack of continuity and communication
In many programs of addiction treatments, counselors rarely accommodate research and theory into clinical practice. Most offer treatments using traditional methods looking at what had been done in the past. They rely on clinical anecdotes. Individual experiences, as well as testimonials to aid others. Practitioners mostly rely on their best theory disregarding other theories without fully comprehending its ideas and implications. Most counselors use the classic disease model which has worked for many addicts (Scott, 2000). Nonetheless, it has failed to work on other addicts as well. Thus, practitioners should also try different models for clients who do not benefit from the disease model.
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Lack of agreement over the fundamental professional credentials
Scott (2000) notes that addiction counseling has lower clinical standards than other types of counseling. Because of this, they require specialized training in both behavioral and chemical addictions, preventing relapse, neuropsychological processes in addiction, evaluation, and personalized treatment planning. Additionally, treatment plans are mostly uniform instead of individualized for people by their clinical presentation as well as individual needs. Since addictive processes are complex, addiction counselors should be held to similar standards as other professionals in counseling; they should possess the fundamental specialized coursework as well as experience on current research about addiction and treatment. It is also seen that addiction counselors who hold the standard credentials have little experience or training in addictions. For this reason, they are not well equipped to assist individuals with addictions (Scott, 2000).
Questionable propensity of teamwork
Most addiction treatments depend on group work since they lack sufficient resources for personalized care. Group treatments are not advisable because they lack the supervision of licensed professionals hence their confidentiality and privileged communication may not be protected. It is also vital to screen clients to examine their appropriateness or inappropriateness for group treatment. Nevertheless, in many treatment groups, clients are organized into categories without carrying out screening.
Confidentiality and Privileged Communication
Following Scott (2000), federal laws protect clients information; therefore, information concerning a client may be dissipated only with the client’s consent. Additionally, the information of a client can only be used in criminal investigations or prosecution if there is a court order. In group treatments, communications may not be seen as confidential as numerous persons with addictions often have legal problems. Even though a licensed counselor should observe confidentiality, group members are not bound by such regulations. Group members may gossip outside or also inform authorities on communication disseminated in the group.
Treatment decision boundaries
Scott (2000) acknowledges that not all treatment methods will work for everyone. An addiction counselor should be able to see if a treatment method is not useful for a person and recommend other treatments that may help the person. Dual relationships are also unethical in counseling. Most addiction practitioners are in recovery and attend treatment programs such as Alcoholics Anonymous. Therefore, they regularly find themselves in dual relationships with their clients whereby they are a peer in groups and a therapist in treatment. This may be challenging as professional boundaries, and counselor’s anonymity may be compromised. Also, if the counselor relapses, the client may even relapse as his or her self-efficacy about recovery will be affected.
Unusual situations of informed consent
Once a client has been initially treated especially through detoxification, addiction counselors should respect their consent rights to additional treatment or to entirely withdraw from treatment.
My insights on the topic
During addiction counseling, it is imperative for counselors to integrate both research and theory. Carrying out various research on current information about chemical and behavioral addictions is essential as it will aid in the process of counseling. Also, practitioners should recognize that not all treatment methods are useful for everyone. A counselor should be able to advocate for another treatment method if the first treatment method that the counselor was using is not helping the client. Thus, conducting research is fundamental. Additionally, since we lack adequate resources for performing individualized treatments, addiction counselors should screen clients to see if group counseling can help them. If the clients are inappropriate for group treatments, counselors should find a way of helping them individually. Moreover, it is essential for addiction counselors to protect their clients’ confidential information even during criminal investigations unless presented by a court order. Confidentiality should be observed as clients give testimonies in treatment programs trusting that their identities and sensitive information will be protected.
Implementation of these findings in a treatment setting
Following Brooks (2009), consent to treatment is essential. In a treatment setting, I will ensure that I obtain the permission of my clients before offering additional therapies. Before suggesting the next phase of treatment after detoxification, it is vital for clients to communicate whether they would want to continue with the treatment as treatment will only work if clients believe that they need to overcome addiction for themselves and not for others. Once a client acknowledges that he or she needs treatment, it would be easy for a counselor to help the client discover their paths to recovery.
As a counselor in a treatment setting, integrating research into practice will be my priority. I will research on various treatment methods and will only utilize them once there is enough proof of their efficacy. During treatment, if a client is not benefiting from one approach, it will be suitable for me to switch to another treatment method that I see fit. For this reason, all my clients will benefit from treatment as I will offer treatment based on a client’s needs.
Protecting my client's information is also essential. I will ensure that I safely store my clients’ files to protect them from being accessed by unauthorized individuals (Miller, Sorensen, Selzer, & Brigham, 2008). I will ensure that I do not discuss any information about any of my clients with other people or the authorities.
References
Brooks, M. K. (2009). Treatment of Adolescents with Substance Use Disorders. Center for Substance Abuse Treatment , 302-305.
Miller, W. R., Sorensen, J. L., Selzer, J. A., & Brigham, G. S. (2008). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal of Substance Abuse Treatment , 25-39.
Scott, C. G. (2000). Ethical Issues in Addiction Counseling. University of North Florida , 209-214.
