Substance Abuse Counselors and Ethical Dilemmas: The Influence of Recovery and Education Level

Article excerpt

The authors examined the impact of substance abuse counselor (SAC) recovery status and education level on (a) SACs' sensitivity to ethical dilemmas and (b) extent to which training might help resolve dilemmas. Results revealed a significant difference between SACs with a graduate degree and SACs with an associate's degree/high school diploma regarding sensitivity to ethical dilemmas, with the latter being more sensitive. This study could be used to develop educational materials to improve SAC competency in resolving ethical dilemmas.

The norm for human service professions over the past 45 years has been to establish codes of ethics. The American Psychological Association adopted its first code of ethics in 1953, and the American Counseling Association espoused its code of ethics in 1961. Rehabilitation counselors, under the auspices of the National Rehabilitation Counseling Association (NRCA), adopted a code in 1972. By 1987, a joint committee representing NRCA, the American Rehabilitation Counseling Association, and the Commission on Rehabilitation Counseling Certification revised the code for rehabilitation counselors. Other professions or disciplines that have adopted ethical codes include social workers, forensic psychologists, vocational experts, and rehabilitation administrators (Blackwell, Martin, & Scalia, 1994).

In fact, substance abuse counseling ethical codes have been adopted nationally by the National Association of Alcoholism and Drug Abuse Counselors (NAADAC, 1995) and also at the state level by bodies such as the Illinois Alcohol and Other Drug Abuse Professional Certification Association (IAODAPCA, 1992). A study conducted in 1997 (St. Germaine, 1997) found that 14 of 40 state credentialing boards require substance abuse counselors to follow the NAADAC code of ethics, so no one code takes precedent. Consequently, counselors can refer to several codes that may have conflicting rules or canons.

Ethics Education

Most accrediting and certification bodies for the human service professions (e.g., Council on Rehabilitation Education [CORE], IAODAPCA) now require training in ethics, including 33 of 40 state certification boards for substance abuse counselors (St. Germaine, 1997). Generally, the training covers issues corresponding to six major areas of professional ethics: confidentiality, dual relationships, informed consent and business practices, competence, sensitivity to differences, and interventions (Bednar, Bednar, Lambert, & Waite, 1991; Blackwell et al., 1994; Byington, Fischer, Walker, & Freedman, 1997; Carroll & Schneider, 1985; Claiborn, Berberoglu, Nerison, & Somberg, 1994; Corey, Corey, & Callahan, 1993; Keith-Spiegel & Koocher, 1985; Matkin, 1982; Mucowski, 1992; Pedersen, 1989, 1997; Pope, Tabachnick, & Keith-Spiegel, 1987, 1988; Pope & Vasquez, 1991; Rhodes, 1986).

A code of ethics provides general principles to guide and direct professional behavior. Ethical codes, however, may possess limits (Ibrahim & Arredondo, 1990; Pedersen, 1989; Pope & Vasquez, 1991). Ethical codes alone cannot resolve some ethical issues; guidelines within a code may conflict with laws, statements of practices, or regulations. Also, there may be a conflict because of the counselor's personal values or agency policy and practices. To be understood in a cultural context, codes may need to be adapted to specific cultures. And, because of the diverse makeup of the profession, all of its members might not agree on all standards. Therefore, ethical codes, although necessary, may be insufficient for exercising ethical responsibility (Corey et al., 1993; Kitchener, 1984; Millard & Rubin, 1992; Wilson, Rubin, & Millard, 1990).

Ethical Decision Making

Ethical Principles and Dilemmas

The gaps and contradictions in ethical codes require the counselor to have a deeper understanding of the fundamental basis for dealing with ethical dilemmas (Kitchener, 1984). …