Recovery residence community needs code of ethics

NARR (the National Alliance for Recovery Residences) has become a leader and voice for the field of recovery residences (i.e., sober living, extended care). Organizing nationally in 2011, NARR has gone on to create a national Standard providing a guide and objective measure for operation of all levels of the residential continuum, ranging from peer-based sober living (Level 1) to residential treatment (Level 4). The national Standard and certification offered by NARR affiliates provide a much-needed code of best practices for residential operators, in what historically had been an unregulated part of the recovery industry.

Appropriate quality measures are offered in the Standard that provide an operations guide for residential stakeholders, and these have elevated the industry significantly. Recovery residences standards provide legitimacy and professionalism, enabling the residential recovery field to claim its needed, valid place in the recovery service continuum. The national Standard was adopted in 2011 and updated in 2015, and is currently implemented among NARR’s 20 individual state affiliates.

Still necessary and needed, however, was a national Code of Ethics. Commonly reported ethical issues for recovery residences include:

• Free “rent” in exchange for going to an IOP

• Drug screen companies that offer monetary compensation in exchange for their services … or recovery residences that offer “free rent” in exchange for an insurance card

• Grateful residents or families offering gifts or money

• Promoting a resident to “staff” too early, and/or without suitable training

• Unclear and/or inconsistent financial boundaries

• Discharging a resident for any reason without a next step plan or recommendation, or allowing relapse to occur without appropriate action taken

• Sharing information without a release

• Having “exclusive agreements” with referral sources

• Embellishing on marketing/outreach

• Operating outside of the scope of work of the recovery residence (i.e., providing residence and or service for someone who needs a higher level of care).

The scenarios above provided an overview of “hotspot” issues to address in a national code. NARR leadership teleconferenced weekly for many months to create a concise ethical code that distills and delineates core ethical principles specific to recovery residences. The proposed code addresses:

1. Ethical, fair practice and responsibility to residents

2. Maintaining appropriate boundaries

3. Confidentiality

4. Scope of work—i .e., “staying in our lane”

5. Appropriate drug screen practice

6. Promoting (not compromising) choice for all populations while working in the continuum of recovery

7. Marketing and referral practices

8. Creating and maintaining a healthy, safe home environment

9. Conflict of interest

Currently in the review process at the affiliate level, NARR projects that the national Code of Ethics will be formally adopted this summer. Feedback and input are welcome. You can e-mail me at beth.sanders@hopehomesrecovery.org