Legal and Ethical Standards for Addiction Counseling

Hi, my name is Lena Scheffield. I’m one of the online instructors here at Sober College School of Addiction Studies. I’m based out of Miami, Florida where I’m in private practice. I’m a licensed mental health counselor. I’ve also have certifications in eating disorders and in addictions. So I’ve been a certified addiction professional, which is our certification in Florida, and I have a master’s addiction counseling certification through NAADAC, which is a national certification.

Many of you may have gotten into this field because of your own recovery, some of the work that you’ve personally or a family member, or perhaps you’re the kind of person it seems like everybody was always coming to you for…and you’re always helping people with their problems. That’s a great motivation to pursue this field. But one of the things that you’re going to be learning is that in addition all the academic work that you’re going to be learning about different theories and different evidence-based treatment models is that, it’s an…this is a field where you’re always doing a lot of self-exploration and you always have to kind of check in with yourself.

We have a lot of responsibility as addiction counselors. People are really coming to us in a lot of pain, and they want us to try to help them kind of get out of the mess that they’re in. There’s limits to what we can do. It’s very easy as counselors, especially when you’re first starting out, to try to take on a lot more than what your role really requires or permits. As counselors, we have to follow legal and ethical standards. We have to have boundaries. We have to make sure that we are acting in the best interest of clients at all times. So while we may be learning about ourselves in the process, we have to make sure that that’s not interfering with the work that we’re doing with clients or the messages that we’re giving to the treatment community.

Some of the areas that we are always trying to be aware of and we want to keep each other in check, if you have peers that are working in this field too, are things like confidentiality. This is really, really important. It’s the cornerstone of all counseling. Now, you know you have to check with your state in terms of the legal statutes. But for the most part, everything that clients tell us is confidential. That’s why they’re coming to us, because they know that it’s gonna be a safe place to talk about things. There are exceptions, of course. In most states, it is if the client is going to really, really hurt themselves, if they’re suicidal, okay? Suicidal is every different than just if they’re gonna be going out and doing some pretty self-destructive behaviors. That, we do have to keep confidential. We got to advise them against it but it is confidential.

If they’re going to engage in any kind of behavior that might really harm somebody else, physically, homicidal kind of behavior, again, not that they are going to go out and break somebody’s heart or they’re gonna cheat on their spouse, which could be hurtful, but that again is something the we keep confidential. And then the other the significant areas that if we suspect any child abuse or elder abuse. So you do have to check with your state, but those are areas that we have to address, we have to tell somebody, everything else is confidential. It means that you cannot to your family and friends about it. You cannot go to meetings and talk about something that you’ve heard or that a client has mentioned to you.

It’s a very unique role that counselors have. We’re not their friends, we’re not their family members, we’re not their sponsors, we’re not their mentors or their coaches, it’s a professional responsible role. Along with it, you get the privilege of helping people, really turn their lives around. Some of the other areas that we need to watch for as people in the counseling field is our own self-care. There’s a term called “vicarious traumatization.” We are listening to people and we’re often listening to some very, very painful stories or things that may bring up issues, and that’s what…even just listening to it, listening to it, if you’re empathetic and you’re a caring person for being in this field, so we’re starting to feel it.

A lot of times, if we don’t take good care of ourselves and treat ourselves with kindness and compassion, it’s very easy for us to then lose our effectiveness. A lot of times, we talk about having boundaries with clients, but you also need to have boundaries with yourself. So role modeling balance in life. If we’re trying to get our clients to have a variety of things in their life and be able to sleep well and make sure that they’re eating properly, are we doing it, or are we demonstrating that we are overachievers and we’re constantly working and we’re not taking care of ourselves? So, again, we need to be in our best condition so that we could help other people, and again, role modeling for them. And taking care of yourself so that you can be around for a long time to continue doing this work.

One of the other ways that we could try to be the best counselors that we have be is by continuing to learn, going to workshops, going to conferences. It’s great way to connect with other people and to find out what other people are doing out there. You may have gone through a recovery program of your own network wonderfully and you want to reproduce it, but that may not be the best way for some of your clients. We need to have, we call it, kind of we need to have a lot of tools in our toolbox so that when we encounter each client and each situation and at each phase of treatment that we have different options to give them in different ways to maybe guide them or to help them kind of find their path.

Every client is different, every person is different. What worked for you might not work for them, and it doesn’t mean that they are not compliant or that it’s…that there are flood somehow. We’re all different so we need to be able to be attuned to the client, kind of see how they’re responding to things and whether or not we need to make some modifications. So, in order to do that, we need to know about a lot of different approaches and a lot of different ways of interacting with people.

Now, it’s not to say that you have to learn everything because we can’t possibly learn every kind of treatment modality there is out there. But the more that you have and the more you can kind of tweak it and you may also recognize that there’s things that you can’t do but you think would be in the best interest of the client. So that’s another one of the kind of professional boundaries that we need to have is knowing when it’s time to refer out or knowing what our own limits. We can only work within the scope of what we know and what we’re qualified to do. As an addiction counselor, there’s things that you could do that a lot of other people are not permitted to do. But there’s things that maybe you can’t do, so may have to consult with a psychologist or a psychiatrist if you’re concerned about some behaviors that maybe you’re not sure whether or not they might benefit from medication or not.

So even just knowing things that we don’t do is helpful, because then, it’s triggering you a time like, “Okay, we need a consultation here. We need to get some additional help.” It’s not something that I do, but I know somebody who may be able to help you with this. That’s how you’re really taking care of the whole person and you’re not responsible for doing it all yourself, okay? So that’s something that we have to check in with ourselves, again, that we’re not supposed to be able to do it all ourselves. Any of you who have kind of tendencies towards perfectionism, that maybe a little bit hard to accept that part, but we do want to work as a team.

The teamwork is a little bit easier if you’re working in a treatment facility, but you may be working in private practice and you’re only working in office by yourself. So you want to have resources, not only your own community, but even around the country. You want to know about different treatment programs, different modalities, different meetings that are in town so that you have a broader list of resources. To be able to do your work well, you need to have good people to support you in what you’re doing.

In any profession, we are expected to meet certain competencies. That means that there are certain standards, certain kinds of behaviors that we can demonstrate that we understand what they are, we understand why they are important, and that we show that we know kind of what it is. It may not be your area of expertise, but you’re aware of the importance of these competencies. So, in the addiction counseling field, there’s the tips 21 that list all of the competencies, and you want to be aware of what the ethical and legal guidelines are for your state. Each of your certification boards have on their websites what the ethical standards are.

I have them printed out and near my desk because there are times where I’m not sure about something and I want to go and consult with them. Just by reading it, sometimes, it clarifies things for me. Or if it something that’s uncertain then I will consult with somebody else to see whether or not, is this really gonna be acceptable? Is this okay? Is this ethical kind of behavior? So you want to know what is appropriate for your role, for your profession. Again, that’s different when you’re professionally interacting with the client, then maybe what you could do if you’re somebody’s sponsor or a family member or a friend. When you’re an addiction counselor, you do have guidelines that you have to abide by.

Being an addiction counselor is a wonderful profession. It’s very rewarding, you’re gonna meet wonderful people along the way, our clients are incredible people. And to see the changes that they’re making and people who are really, really making this incredible efforts in their life, it’s heartwarming, even though sometimes it’s frustrating, but there is so much joy that comes with this. The other benefit is that you’re going to be helping to mentor other people and you’re going to be teaching other professionals sometimes. There are times where you do have to be educating physicians about addiction or therapists about addiction and vice versa.

Good luck with your studies. Good luck in your field. Continue to learn, continue to grow, and continue to share your inspiration. Wish you the best of luck in all your endeavors.