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

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

Transcript of Ethics in Addictions Counseling Leigh Falls, Ed.S., LPC, NCC.

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

Ethics in Addictions Counseling

Leigh Falls, Ed.S., LPC, NCC

Page 2: Ethics in Addictions Counseling Leigh Falls, Ed.S., LPC, NCC.

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?

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Addictions Counselor

Competent and trained and experienced working with addictions in general, not just substance abuse

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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

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There is a High Correlation Between Addictive Behaviors and Criminal Activity.

Theft/Burglary Physical Assault Domestic Violence Sexual Assault Kleptomania

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Criminal Behavior

Offense Cycle Criminal Thinking Adrenalin Fix Psychopathy vs.

Sociopathy

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Carnes (1992) 4 Step Addiction Cycle

Preoccupation Ritualization-Patterns of

Language and Behavior Compulsive Behavior Despair and

Powerlessness

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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

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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.

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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

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Despair and Feeling Powerless

Condemning self-talk Internalized guilt Effort to regain sense of control and inner

harmony Return to preoccupied behavior

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Counseling Modalities

Detox / Outside Intervention (police/school)

Initial Assessment Anabuse, DeproProvera, other

medication Individual Counseling Group Counseling Family counseling Self-Help

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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

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Ethical Issues Involved in Addictions and Offender Counseling

Competence Informed Consent Confidentiality Potentially Detrimental

Counselor-Client Relationship

Responsibility to Client Values Multicultural Issues

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Competence

Credentials Differential Diagnosis Skills Dual Diagnosis Specialized treatment: LSOTP Refer or get appropriate

supervision and education, if you don’t have the skills

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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

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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

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Confidentiality

Mandated reporting –child abuse, subpoena, 3rd party reimbursement

Federal Protection Confidentiality Issues in

Group Minors

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Potentially Detrimental Counselor-Client Relationships

Dual Relationships Counselor is a

Recovering Addict Small Town Sexual Relationships Working Outside

Specialty Area Counselor Burnout

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Responsibility to Client

Who is the client? Patient, court, community, family, 3rd party payment, your boss????

Client welfare is your primary concern

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Values Clarification

Personal Values Religious Values Substance Abuse –

Abstinence vs. Controlled Drinking

Heinous Crimes Specialized Techniques:

PPG, Aversion therapy, psychotropic medication

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What to do about value conflicts

Asses your values against the program philosophy

Supervision Referral Address prior to

beginning counseling Discuss with client

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Multicultural Issues

Therapeutic Rapport Listen to and Process

Client Feedback Racial Differences Socioeconomic Status Education Religious Differences Street Culture Drug Culture