SAC330

1. Ethical Decision Making
Part 2
Brent Scobie, PhD

2. Privacy and Confidentiality
 Privacy - in our country, the constitutional right to not be coerced into
providing information
 Confidentiality – the ethical responsibility to protect clients information from
unauthorized disclosure
 Privilege – A client’s legal right; protection from having confidences revealed
publicly, specifically in a court of law. The right to waive belongs to the
client. There are some exceptions.
2

3. Exceptions
 Release of information
 Mandatory reporting of abuse and neglect
 Foreseeable harm to self or others
 Duty to warn and protect
 Court orders (and subpoenas)
 Audits
 Supervision
 When a client files a complaint
3

4. Rule of Thumb
Minimal Disclosure of
information
Disclose only what is
necesary
4

5. Duty to Warn and Protect
A court-created responsibility to protect the public from dangerous
acts. Some of the criteria are based on:
Failure to assess/predict dangerousness
Failure to warn potential victims
Failure to initiate commitment when indicated
Premature discharge from secure environments
5

6. Tatiana Tarasoff Pronsenjit Poddar
Tarasoff v. Board of Regents CA

7. The Tarasoff Rule
 "When a therapist determines, or pursuant to the standards of his profession,
should determine, that his patient presents a serious danger of violence to
another, he incurs an obligation to use reasonable care to protect the
intended victim against such danger.“
 Explicit acknowledgment that one of the protective measures, which could
constitute a legal obligation in itself depending on circumstances, was
warning the intended victim and possibly law enforcement as well.

8. Specific NAADAC/ NCC AP Ethical
Standards

9. Boundaries
 Addiction professionals shall consider the inherent risks
and benefits associated with moving the boundaries of a
counseling relationship beyond the standard parameters.
Providers shall obtain consultation and supervision, and
recommendations shall be documented.

10. Multiple / Dual Relationships
 Addiction professionals shall make every effort to avoid multiple relationships
with a client. When a dual relationship is unavoidable, the professional shall
take extra care to ensure professional judgment is not impaired and there is
no risk of client exploitation. Such relationships shall include, but are not
limited to, members of the provider’s immediate or extended family, business
associates of the professional, or individuals who have a close personal
relationship with the professional or the professional’s family. When
extending these boundaries, providers shall take appropriate professional
precautions such as informed consent, consultation, supervision, and
documentation to ensure that their judgment is not impaired and no harm
occurs. Consultation and supervision shall be obtained, and the
recommendations shall be documented.

11. Exploitation
 Addiction professionals shall be aware of their influential positions with
respect to clients, trainees, and research participants, and shall not exploit
the trust and dependency of any client, trainee, or research participant.
Providers shall not engage in any activity that violates or diminishes the civil
or legal rights of any client. Providers shall not use coercive treatment
methods with any client, including threats, negative labels, or attempts to
provoke shame or humiliation. Providers shall not impose their personal,
religious, or political values on any client. Providers shall not endorse
conversion therapy.

12. Sexual Relationships
 Addiction professionals shall not engage in any form of sexual or romantic
relationship with any current or former client, nor shall they accept as a
client anyone with whom they have engaged in a romantic, sexual, social, or
familial relationship. This prohibition shall include in-person and electronic
interactions and/or relationships. Addiction professionals shall be prohibited
from engaging in counseling relationships with friends or family members.

13. Bartering
 Addiction professionals shall only engage in bartering for professional services
when: (1) the client requests it, (2) the relationship is not exploitative, (3)
the professional relationship is not distorted, (4) federal and state laws and
rules allow for bartering, and (5) a clear written contract is established with
agreement on the value of the item(s) bartered for and number of
corresponding sessions, prior to the onset of services. Providers shall consider
the cultural implications of bartering and discuss relevant concerns with
clients. Agreements shall be specified in a written contract. Providers shall
obtain supervision or consultation, and shall document the recommendations.

14. Gifts
 Addiction professionals shall recognize that clients may wish to show
appreciation for services by offering gifts. Providers shall take into account
the therapeutic relationship, the monetary value of the gift, the client’s
motivation for giving the gift, and the counselor’s motivation for wanting to
accept or decline the gift. Providers shall obtain supervision or consultation
prior to deciding whether or not to accept or decline a gift, and shall
document the recommendations.