Professional ethics: A shared responsibility

Marcy was a certified substance abuse counselor working in an intensive outpatient program. She was in recovery and had “grown up” in the counseling field after completing treatment and wanting to “give back.” She worked closely with a halfway house where some of the clients on her caseload resided. Marcy's supervisor received a call one day from the director of the halfway house, who stated that he had some concerns about Marcy's relationship with the men in the program. He reported that Marcy had been meeting some of the clients for dinner, taking them to an AA meeting, and then “hanging out” after the meetings.

Marcy's supervisor gave her a professional ethics book to read and told her to stop going to dinner and hanging out with the men. Not fully understanding the dictate or the issues with dual relationships, Marcy continued these behaviors and was asked to resign from her job.

The executive director of the program gave Marcy a letter of recommendation in exchange for her resignation. Marcy sought employment at another program and continued her unethical behavior with clients, which began to escalate. As a result, she was “laid off,” with the director there also giving her written and verbal recommendations.

I would like to say that this example represents a rare situation, but unfortunately it does not. One can easily recognize the dual relationships and unresolved countertransference issues in this example as unethical. But in addition, there is the situation of unreported ethical violations and the letters of recommendation. Many times in my career as a counselor, I have witnessed this very type of situation. What is really happening here?

Professional responsibility

The lack of reporting of ethical violations is a major issue. As licensed or certified professionals, and as supervisors, we are the gatekeepers of our profession. Not only do we have an obligation to our fellow professionals and supervisees to help them understand the nature and severity of such violations, but we also have the legal and ethical obligation to report such violations when they continue to be unresolved.

Principle 8 in the Code of Ethics for NAADAC, The Association for Addiction Professionals, entitled “Preventing Harm,” states, “I understand an obligation to protect individuals, institutions, and the profession from harm that might be done by others. Consequently, I am aware that the conduct of another individual is an actual or likely source of harm to clients, colleagues, institutions, or the profession, and that I have an ethical obligation to report such conduct to competent authorities.”

Counselors have been heard to say, “I don't want to get them in trouble.” Others may say, “I don't want to get involved.” I have received calls from counselors telling me about someone who is acting unethically. My first response is, “What have you done about it?” I encourage them to report the violation. My hands are tied with second-hand information. Passing the buck does not solve a problem; it perpetuates it.

Also perpetuating the problem is the issue of a person receiving a letter of recommendation after being asked to resign for unethical behavior. Not only is the person recommended to another agency, oftentimes calls might be made to help him/her secure another position. Among management in such agencies there is an advantage to this practice. One agency is ridding itself of the problem while passing it to someone else and avoiding risk of legal action for perceived unfair termination. The management at the first agency might hold the belief that it does not have to acknowledge the problem or report it if it can pass the problem to someone else.

The problem is the perpetuation, resulting in the counselor not totally understanding the unethical act because it is not addressed as such. In a way, the unethical behaviors are not only left unresolved, they are encouraged and condoned through default.

Another complication that might arise occurs when the program's director does not have a clinical background. This person might not see the entire picture of ethical violations as long as he/she can avoid legal situations and keep the agency running smoothly. Client welfare is not the primary issue to the director who is thinking fiscally and legally. Or this person might think, “I don't want to ruin their career.”

Rather than allow the counselor to take responsibility for actions, colleagues and supervisors often become dysfunctional enablers. While attempting to protect the person, the agency puts the clients, the agency, the community and our profession at risk. Thus, the unreported and unaddressed behavior continues.

We have a responsibility to help clients understand professional boundaries and ethics. Persons involved in 12-Step programs often do not see any difference between going to dinner with their treatment counselor and having coffee with their sponsor. Without proper supervision and guidance, counselors who have come into the profession as a result of their own recovery and 12-Step journey might be confused regarding this issue as well, especially when their role models in the field have exhibited or condoned similar behavior.

Results of such conduct are far-reaching and include:

• Short- and long-term harm to clients, threatening their stability in recovery;

• Harm to the reputation of the agency and its staff;

• The community's mistrust;

• Damage to the addictions field by sending the message that we, at the expense of client welfare, “take care of our own”;

• Litigation against the agency, staff and the offending counselor; and

• Increased professional liability insurance rates.

A call to action

What should be done when these behaviors occur? There are steps to take when you are aware of unethical behaviors:

• Take immediate action-don't think if you ignore it, it will go away.

• Talk to the person in violation-help him or her to understand the error, and take further action if the situation is unresolved.

• Report the matter to your supervisor and discuss your intention to report the behavior to the appropriate licensure board.

• Report to the licensure board the exact nature of the violation, including times, dates and specifics of the incidents being reported.

Finally, as gatekeepers of our profession, we need to educate those who are unwittingly encouraging unethical behavior, helping them first to understand that they are doing harm by passing the problems to other agencies. They need a thorough understanding of the role of ethics, the seriousness of ethical violations and the importance of safeguarding the welfare of the clients that we serve. Are you a gatekeeper or a perpetuator?