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Ethical Violations
A Quantitatve Study Comparing Human Service Professions

John Gallagher

John Gallagher MSW, LCDC, LSW, CAC

“Ethical Violations: A Quantitative Study Comparing Human Service Professions” is a research project that studies ethical violations in the substance abuse treatment profession. The primary goal of the study is to develop a better understanding of what factors may contribute to an ethical violation. The most recent data gathered for the current study are from Texas. As seen in Chart 1, Texas Licensed Chemical Dependency Counselors had the highest number of ethical violations each year from 2005-2007, as compared to other human service professions. The other human service professions, known as the comparison groups, consisted of Texas licensed professionals from the following professions: Licensed Professional Counselors, Licensed Marriage and Family Therapists, and Licensed Social Workers. The data for Chart 1 was produced by the Texas Department of State Health Services (Retrieved January 8, 2009 from http://www.dshs.state.tx.us/plc/plc_trends.shtm ).

Chart 1
Texas Licensing Board Total Number of Ethical Violations (2005) Total Number of Ethical Violations (2006) Total Number of Ethical Violations (2007)
Licensed Chemical Dependency Counselor Program 23 36 36
Texas State Board of Examiners of Professional Counselors 12 21 15
Texas State Board of Social Worker Examiners 21 14 10
Texas State Board of Examiners of Marriage and Family Therapists 10 7 1

As seen in Chart 2, an analysis of the total number of licensed professionals within each group and the total number of ethical violations from 2007 was completed to assure that the total number of licensed professionals within each group was not skewing the data. This analysis provided further validation that Licensed Chemical Dependency Counselors have the highest rate of ethical violations, when compared to the other human service professions. Actually, the analysis shows that Licensed Chemical Dependency Counselors are significantly more likely than the comparison groups to violate an ethical standard. The data for Chart 2 was produced by the Texas Department of State Health Services (Retrieved January 8, 2009 from http://www.dshs.state.tx.us/plc/plc_ce.shtm ).

Chart 2
Texas Licensing Board Total Number of Licensed Professionals Total Number of Ethical Violations (2007) Rate of Ethical Violations (approx.)
Licensed Chemical Dependency Counselor Program 7,186 36 1 ethical violation for every 200 licensed professionals
Texas State Board of Examiners of Professional Counselors 15,600 15 1 ethical violation for every 1,040 licensed professionals
Texas State Board of Social Worker Examiners 19,888 10 1 ethical violation for every 1,989 licensed professionals
Texas State Board of Examiners of Marriage and Family Therapists 3,038 1 1 ethical violation for every 3,038 licensed professionals

There is much speculation in the research as to why the total number of ethical violations is higher in the substance abuse treatment profession. The literature has suggested that factors such as recovery status and educational level may contribute to this increased rate of ethical violations (Toriello & Benshoff, 2003). There does appear to be some anecdotal evidence that validates the idea that recovery status and educational level are factors associated with ethical violations in the substance abuse treatment profession. It is estimated that 30-40% of substance abuse treatment professionals are in recovery (Toriello & Benshoff, 2003). The substance abuse treatment profession may have a higher percentage of professionals in recovery, when compared to the other licensees, and this may be a factor that is associated with the data. Substance abuse treatment professionals who are in recovery and practice a 12-Step program may face unique challenges to ethical practice. One of these challenges includes the risk of being exposed to a dual relationship by associating with a current of former patient in a 12-Step meeting.

This does not imply that substance abuse treatment professionals who are in recovery are the cause for the increased rate of ethical violations or that they cannot practice ethically; it may indicate there are additional challenges that these professional may face in managing a potential dual relationship. Additionally, substance abuse treatment professionals who are in recovery may be more likely to use self-disclosure than substance abuse treatment professionals who are not in recovery. As a result, professionals in recovery may be more likely to self-disclose about their own personal recovery and this could cause potential problems, such as lessening professional boundaries and shifting the focus of treatment from the patient to the counselor (Chapman, 1997).

The educational level for substance abuse treatment professionals ranges from a high school diploma to a Doctorate degree. This range in education differs from the educational requirements for the comparison groups. All other clinical licensures in Texas, such as the LCSW, LMFT, and LPC, require a minimum educational level of a Master’s degree. It is hypothesized that substance abuse treatment professionals with only a high school diploma have a higher risk of committing an ethical violation than substance abuse treatment professionals with a college education. The basis for the hypothesis is that the more formal education one attains, the more exposure to clinical concepts involving ethics one experiences. These clinical concepts include learning about ethical dilemmas and the ethical decision-making process. Professionals with a high school diploma are not exposed to this formal education and rely mainly on workshops and seminars which provide fewer hours of education. It is important to mention again that this does not imply that substance abuse treatment professionals with a high school diploma are the cause for the increased rate of ethical violations or that they cannot practice ethically; just that one’s educational level may be a factor that influences ethical practice.

The results of previous research are mixed and there is no conclusive evidence that recovery status or educational level plays a role in ethical violations. However, this does not imply that dialogue about a professional’s recovery status or educational level should become taboo. It is important that ethics training, supervision, agency cultures, and other professional supports provide an environment in which these issues can be discussed in an open, supportive manner. Dialogue surrounding these issues will assist in the growth of the substance abuse treatment profession and lead to the next phase of research related to the substance abuse treatment profession and professional ethics. All are encouraged to begin dialogue on these issues by sharing their experiences and comments on the Recovery Today website, following this article.

John Gallagher will be available to discuss his research during his presentation at the Texas Association of Addiction Professionals – Fort Worth Chapter annual conference in Arlington, Texas from April 16-18, 2009. Please see www.taapfw.org for more information on the conference. Also, Mr. Gallagher will be facilitating an ethics training on March 14, 2009 in the Dallas/Fort Worth, Texas area. Please contact Teresa Sawyer at Teresa@cdstudies.com for details.

References
Chapman, C. (1997). Dual Relationships in Substance Abuse Treatment: Ethical Implications. Alcoholism Treatment Quarterly, 15(2), 73-79.
Toriello, P.J., & Benshoff, J.J. (2003). Substance Abuse Counselors and Ethical Dilemmas: The Influence of Recovery and Education Level. Journal of Addictions & Offender Counseling, 23(2), 83-98.

About the Author

John Gallagher, MSW, LCDC (TX), LSW (PA), CAC (PA) is currently employed as a Case Manager with the Tarrant County Drug Court located in Fort Worth, TX. His past clinical experiences include substance abuse treatment at the Caron Foundation located in Wernersville, PA and dual diagnosis treatment at The Reading Hospital Center for Mental Health located in Reading, PA. Additionally, he has served as an Adjunct Professor in the Addiction Studies program at Alvernia College and is currently pursing his Ph.D. in Social Work at The University of Texas at Arlington.