Ethics for the addiction and marketing professional

Ethics for the Addiction & Marketing Professional

Ethics: The Addiction & Marketing Professional §  Louise Stanger

Ed.D, LCSW, CIP §  Director All About

Interventions §  Faculty SDSU

Interwork §  Member NII, AIS §  MINT Trainer

Objectives

§  Discuss and define ethics §  Identify ethical decision-making models §  Discuss the top ethical Issues §  Discuss competence, confidentiality and

mandated reporting §  Identify dual relationships §  Discuss the use of social media as it

related to ethics

How do Ethical Problems Occur ?

§  People are human, they make mistakes §  Clients misreport §  Inexperience §  Ignorance §  Unpredictable /Unforeseen situations §  Inadequate agency policies §  Guidelines not adequate for situation §  Ethics in conflict with law

What are your top 3 Ethical Concerns?

PatrickMcNamee-Benchmark Recovery Center §  Competence

§  Dishonesty about services

§  Lack of

compassion

Christi Cessna- Constellation

§  Misrepresenting your capabilities and preying on vulnerable people

§  Overselling and over administering UA

§  Kickbacks

Paul Alexander Northbound

§  Accreditation and standardization of care

§  “CURES”

promised as opposed to solutions

Nigel Green-Foundations What do you stand for?

§  Folks that do not understand the laws (ignorant of laws)

§  Folks that understand the laws, but lack a strong sense of ethics

Questionable Practices

§  Internet marketing scams

§  Using Brain scans with other unproven treatments and billing the patient

§  AP, March 2013


§  Call centers share patient prospect info between treatment providers

§  Call centers run through 5013C non profits

Paying Kickbacks

§  To Interventionists §  Paying bounties to

for referrals §  Claiming to take a

patient’s insurance when reimbursement is low

§  To Labs


§  Promising a cure

§  Using nutrient supplements that are proprietary and billing the patient

What’s most Important ?

Whistleblower –False Claim Act

§  False Claims Act §  Unlawful for

anyone knowingly or willingly submit or cause a fraudulent claim to the government for payment

Kickbacks-Federal Laws

Anti-Kick Back Statue –criminal offense for anyone to give a kickback with the intent of influencing referral of patients

Ex:Trips , hotels, gifts

Stark Law- Physicians Self referral law

Kickback occurs when a physician refers a patient to a facility he owns or family has financial interest

Codes of Ethics

§  American Association of Advertising Agencies

§  Direct Marketing Association §  Public Relations Society of America §  American Marketing Association §  Foundation for Public Affairs §  American Hospital Association §  NATAP

Code Of Ethics

§  NAADAC §  NASW- Social

Workers §  MFT §  NATAP §  CARF §  Psychologists §  Nurses –Doctors §  Lawyers

Code of Ethics

§  Association of Intervention Specialists ( AIS)

§  Network of Independent Interventionists (NII)

§  Recovery Coaches §  Certified

Rehabilitation Counselors

Historical Context

§  In Nazi Germany 1945-1946 and 1935 American Public Health research African American men

§  1966 Public Health Services

established ethical regulation §  1979 Belmont Report

(Protection of Human Subjects)

§  1970s bio ethics emerged

§  1980s Watergate

§  1996 Revised Codes

§  As professions grow code of ethics are formed

Philosophical History of Ethics: Modernism

§  Modernism §  Human reason

determines truth on all subjects

§  Universal ethical laws §  Individuals are similar

and rights are supreme

§  Bio-ethics

§  Autonomy §  Beneficence-ability to

do good §  Nonmaleficence-the

duty to cause no harm

§  Justice-duty to treat all fairly and distribute goods equally

Philosophical History Of Ethics : Post Modernism

§  Diversity, Pluralism and questioning that there are objective laws

§  Situational ethics Based on historical and social contexts

What are Ethics?

§  Ethics are the beliefs an individual or group maintains about what constitutes correct or proper behavior

§  Standards of conduct an individual uses to make decisions.

Do not confuse Ethics and Morality !

§  The word morality comes from Latin word MORES which translates into custom or values

§  Morality involves the judgment or evaluation of an ethical system, decision, or action based on socialcultural or religious norm

Competence

Integrity

Importance Of Human Relationships

Dignity of Individual

Social Justice

Service

VALUES

Ethical Principles

§  Autonomy

§  Beneficence- To do Good-To Do No Harm

§  Confidentiality §  Fidelity _To keep ones

promise or word, Duty to report , honesty, trustworthiness

§  Gratitude

§  Justice ( treat all fairly)

§  Nonmalefience :The duty to cause no harm

§  Reparation –duty to

make up for a wrong

Ethical Principles

§  Respect for Others §  Universality §  Utility- the duty to

provide the greatest good or least harm to greatest number of people

§  Ordering

Ethical Considerations

n Fiduciary Relationships with Providers

n Call Centers n Pay per click n Truth in advertising n Gifts & Kickbacks n Internet Marketing

scams

Ethical Principles

§  Veracity –To tell the Truth

§  Herein lies dilemmas §  Between self, IP,

agency and outside world

Ethical Responsibilities

§  To Clients §  To Colleagues §  To Practice Settings §  As Professionals §  To Professional

Affiliations §  To Broader Society

8 Step Model for Ethical Decision Making

§  1. Identify the Problem or Issue

- Clinical - Legal - System (polices etc) - Cultural - Ethical -

counselors own issues

Steps 2-4

§  Apply a code of ethics

§  Determine Nature and Dimensions of Dilemena

§  Pros and Cons

Steps 5-8

§  Choose Course of Action

§  Implement a Course of Action

§  Evaluate the Outcome

§  Evaluate the implications

Congress Ethic Model

§  Examine §  Think §  Hypothesize §  Identify §  Consult

CONFIDENTIALITY

§  Hallmark of Therapeutic Relationship

§  Consent Forms

§  Mandated Reporting- Duty to Warn

§  Exceptions ( Drug Court, federally assisted treatment programs

Confidentiality and Minors

§  Age of Consent §  Being Familiar

with state laws

§  Can Clara or parents know everything if they are under 18?

Informed Consent

§  Informed Consent: Description of any reasonable foreseeable risks or discomforts Description of any benefits to the subject or others Disclosure of any alternative treatments, including medications Statement describing extent to which confidentiality of records

identifying client will be maintained Explanation on limits of confidentiality Explanation on who to contact in emergency Costs to client Consequences of early withdrawal

Record Keeping

§  Client prior hx of services §  Present reason for call §  Dx of bio-psycho-social §  Documentation of any changes

since assessment §  Treatment plan goals &

objectives (changes in Tx) §  Duration & frequency of service §  Progress notes §  Rec for further treatment-

discharge plans §  Doc. Of fees charged and paid §  HIPPA Forms

Competence

§  How do you achieve and maintain

§  Cultural competence

§  Is it ok to practice outside of ones competence?

Wireless Devices

n How are these used to protect confidentiality?

n Laptops, ipads, Phones, Earpieces,

& other devices

Advertising

§  Clear, objective truthful statements

§  “Number 1 , Unique, Cure “

Visual Wrong doing

§  Websites that are misleading

§  Fake addresses §  Toll free numbers §  Posting of photos

on misleading websites

§  Certificates

Social Media

n Written Materials n Business Cards n Letterhead etc n Website n Mailings n Texting n Facebook, Twitter

and Linked In

Dr.Louise Stanger Ed.D, LCSW, BRI II Director All About Interventions Faculty SDSU Interwork Institute Membership Chair NII Network of Independent Interventionists Member AIS Association of Independent Interventionists MINT Trainer of Trainers [email protected] www.Allaboutinterventions.com 1-619-507-1699 - mobile All information in this Communication including attachments, is strictly confidential and intended solely for delivery to and authorized use by the addressee(s) identified above, and may contain information protected by law . The materials in this email are private and may contain Protected Healthcare Information. If you are not the intended recipient, be advised that any unauthorized use ,disclosure , copying , distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error , please immediately notify the sender via telephone or returned mail.

Dear Friends and Colleagues, NEW NEWS: I am excited to share my new website and updates from my private practice and my company, ALL ABOUT INTERVENTIONS. My team has expanded and I have formed collaborative partnerships with other top notch professionals to bring you the best in substance abuse and mental health recovery services. SERVICES: We continue to help family, loved ones, partners, friends, high profile persons and executives by remaining client centered. Individualized Treatment Planning, Case Management , Monitoring, Motivational Sober Coaching , Alternative Sentencing, Friend and Family recovery/ accountability coaching are all

available. Highlights: PRESENTATIONS: Moment of Change Conference, Palm Beach, WATT San Fernando Valley, Aurora Behavioral Health, San Diego, Twin Town Treatment Centers , LA County, New Found Life, Long Beach, Lifestyle Intervention Conference, Las Vegas, WCSAD La Quinta , Ca. TEACHING: San Diego State University Interwork Institute Human Behavior, Solution Focused Counseling grad and post grad course work. LEARNING: The referral network of clients, families, friends and employees with whom we work rely on our diligence to visit treatment centers across the country and engage in relevant continuing education so we may make the best possible treatment placements DOING GOOD: I serve as the pro bono president of the Sydney D Holland Foundation which helps at risk women. Hats off to La Fuente Treatment Center., Friendly House, Michaels House, Foundations, The Control Center and the DBT Center of Beverly Hills for willingness to work with scholarship recipients. PUBLISHED: "What to do When OutPatient Fails" with B Lamm for The San Diego Psychologists "Interventions are Not Made For TV" Cengae Press Opposing Viewpoints REEL NEWS: Steven G Kaplans' , Rainstorm Entertainment is producing , "IT'S SO EASY", the life and times of Duff McKragan, Guns and Roses drummer and bassist. I serve as the addiction expert. EVIDENCE SUGGESTS: Did you know that evidence suggests that a person who is the recipient of an invitational intervention is more likely to be successful in treatment and less likely to leave AMA then a person who self admits!!!!!! And in the words of my good friend, Ed Spatola RECOVERY, IT'S A BEAUTIFUL THING Let me hear from you, Louise [email protected] 619-507-1699










BOUNDARIES

§  Length of counseling, self disclosure by counselor, confidentiality, giving of gifts, touch or personal communication between counselor and client and client, counselor and supervisor’

§  Intimate relationships §  Personal benefit ( monetary goods , services) §  Emotional dependency needs of counselor §  Altruistic gestures which can be misinterpreted §  Unexpected situations such as meeting sisters new

boyfriend who turns out to be a client

DUAL RELATIONSHIPS

§  Friendships between client and counselor, supervisor and supervisee

§  Sexual Relationships §  Professional –where client and

counselor are professional colleagues

§  Business dual relationships where counselor and client are business partners or have an employee/employer relationship

§  Communal –where both belong to same community (AA, NA, Alanon, SA etc.)

Case Examples

§  25 year old. mother is referred after 3rd DUI. She tells you father is a recovered alcoholic and drinks socially. She does not think she has a problem and does not believe she needs treatment or to be abstinent

§  What do you do?

Employer Relationships

§  A handsome admissions person is your subordinate. He is also in a 12 step program. You invite him for coffee after the meeting.

§  ?? Ethical Considerations

Hiring Practices

§  Former counselor calls to ask if she/he can hire a former client of hers and mine from a different treatment center that has less then a year recovery

Business Temptations

§  Business Temptations>>>

§  What do you do???

Money for Admits

§  An admissions officer offers you money for referrals

Consent and HIPPA

§  Mother wants to know what daughter is saying about their relationship

§  19 yo daughter has not signed consent form for mother

Other Considerations

§  You are a substance abuse/mental business professional and are attending the same 12 step meeting as your client do you need to share, what do you do??

§  Organizations referral practices §  Organizations billing practices

§  Other Examples

Case Example

§  Someone has had an extramarital affair. Son saw. You are husband’s counselor

§  What do you do ??

Gifts

§  A former client gives you a $100.00 Starbucks card

§  A client gives you courtside Laker tickets

§  A center offers you referral fees

§  ??What do you do

“There is safety in a multitude of counsel”

Resources

§  The Ethics of an Addiction Counselor §  NAADAC , The Association of Addiction Professionals §  NASW Code Of Ethics §  NII Code of Ethics §  AIS Code of Ethics §  Ethics Updates http://ethics.sandiego.edu §  The Elements of Ethics for Professionals-Brad Johnson

§  APA Ethics Office §  Center for the Study of Ethics in the Professions §  National Board for Certified Counselors; The Practice of Internet

Counseling http://www.nbcc.org/assest/ethics/internetcounseling.pdf

Dr. Louise Stanger Ed.D, LCSW, BRI II, CIP

§  Faculty SDSU Interwork Institute §  Member NII §  Member AIS §  MINT Trainer of Trainers §  Director All About Interventions

§  http://www.allaboutinterventions.com

Ethics for the addiction and marketing professional

Health & Medicine

situation ethics

s bio ethics

strong sense of ethics

ethical regulation

ethical issues

ethical problems

ethical concerns

laws ignorant of laws