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Ethics in Addictions Counseling

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Ethics in Addictions Counseling Leigh Falls, Ed.S., LPC, NCC What is addiction? Abuse vs. Dependency Behaviors which can become addictive Etiology of addiction ... – PowerPoint PPT presentation

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Title: Ethics in Addictions Counseling


1
Ethics in Addictions Counseling
  • Leigh Falls, Ed.S., LPC, NCC

2
What is addiction?
  • Abuse vs. Dependency
  • Behaviors which can become addictive
  • Etiology of addiction
  • Symptoms associated with addictive behaviors
  • Why is this relevant to you?

3
Addictions Counselor
  • Competent and trained and experienced working
    with addictions in general, not just substance
    abuse

4
Counselor Credentials
  • Personal Addictions History?
  • Masters or Ph.D. degree
  • National Certification
  • Licensed as a LPC/Psychologist /LCSW/LCDC
  • Specialty Training and Supervision
  • Continuing Education

5
There is a High Correlation Between Addictive
Behaviors and Criminal Activity.
  • Theft/Burglary
  • Physical Assault
  • Domestic Violence
  • Sexual Assault
  • Kleptomania

6
Criminal Behavior
  • Offense Cycle
  • Criminal Thinking
  • Adrenalin Fix
  • Psychopathy vs. Sociopathy

7
Carnes (1992) 4 Step Addiction Cycle
  • Preoccupation
  • Ritualization-Patterns of Language and Behavior
  • Compulsive Behavior
  • Despair and Powerlessness

8
Preoccupation
  • May be feeling powerless, depressed, anxious
  • In order to regain a sense of mastery the person
    fantasizes to make self feel better
  • Individuals experience obsessions that center on
    obtaining gratification through the object of
    their addiction

9
Ritualization
  • A series of behaviors designed to obtain the
    addictive object
  • Unique language, non verbal communications, or
    behavioral patterns that communicate membership
    in this special group
  • Grooming, casing, scoring, getting trashed etc.

10
Acting Out on Compulsive Behavior
  • Craving/Urges
  • Unable to refrain from obtaining gratification
  • Poor Impulse Control
  • Thinking Errors Sees self as victim of society
    justifies or rationalizes behavior to self
  • Offenders may use alcohol or drugs before an
    offense in order to use it as an excuse for their
    criminal behavior
  • Adrenalin Fix

11
Despair and Feeling Powerless
  • Condemning self-talk
  • Internalized guilt
  • Effort to regain sense of control and inner
    harmony
  • Return to preoccupied behavior

12
Counseling Modalities
  • Detox / Outside Intervention (police/school)
  • Initial Assessment
  • Anabuse, DeproProvera, other medication
  • Individual Counseling
  • Group Counseling
  • Family counseling
  • Self-Help

13
Crispy Creamed
  • High burnout rate among addiction and offender
    counselors
  • Population resistant to treatment
  • Systemic issues families, court, front-line
    staff, managed care
  • Symptoms exhaustion, depersonalization, and
    reduced personal accomplishment
  • Switching jobs, sub-par service
  • Impaired professionals

14
Ethical Issues Involved in Addictions and
Offender Counseling
  • Competence
  • Informed Consent
  • Confidentiality
  • Potentially Detrimental Counselor-Client
    Relationship
  • Responsibility to Client
  • Values
  • Multicultural Issues

15
Competence
  • Credentials
  • Differential Diagnosis Skills
  • Dual Diagnosis
  • Specialized treatment LSOTP
  • Refer or get appropriate supervision and
    education, if you dont have the skills

16
Informed Consent
  • Patients need treatment when they are under the
    influence of drugs/alcohol and may not be able to
    think clearly
  • Offenders and substance abusers may be mandated
    to counseling court order, probation/parole
    condition, CPS plan, work or licensing boards.
  • Competence of dual diagnosed bipolar or
    schizophrenic patients

17
Informed Consent What to do???
  • Explain thoroughly all issues
  • Explain at length limits of confidentiality
  • Explore options other than treatment and
    consequences
  • Allow client to make the choice and take
    responsibility for the consequences
  • Check for understanding
  • Go over it again if necessary

18
Confidentiality
  • Mandated reporting child abuse, subpoena, 3rd
    party reimbursement
  • Federal Protection
  • Confidentiality Issues in Group
  • Minors

19
Potentially Detrimental Counselor-Client
Relationships
  • Dual Relationships
  • Counselor is a Recovering Addict
  • Small Town
  • Sexual Relationships
  • Working Outside Specialty Area
  • Counselor Burnout

20
Responsibility to Client
  • Who is the client? Patient, court, community,
    family, 3rd party payment, your boss????
  • Client welfare is your primary concern

21
Values Clarification
  • Personal Values
  • Religious Values
  • Substance Abuse Abstinence vs. Controlled
    Drinking
  • Heinous Crimes
  • Specialized Techniques PPG, Aversion therapy,
    psychotropic medication

22
What to do about value conflicts
  • Asses your values against the program philosophy
  • Supervision
  • Referral
  • Address prior to beginning counseling
  • Discuss with client

23
Multicultural Issues
  • Therapeutic Rapport
  • Listen to and Process Client Feedback
  • Racial Differences
  • Socioeconomic Status
  • Education
  • Religious Differences
  • Street Culture
  • Drug Culture
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