S.C. Code Regs. § § 36-23
Current through Register Vol. 48, No. 11, November 22, 2024
Section 36-23 - Code of Ethics for Addiction Counselors(A) The Counseling Relationship (1) Client Welfare: Addiction Counselors understand and accept their responsibility to ensure the safety and welfare of their client, and to act for the good of each client while exercising respect, sensitivity, and compassion. Providers shall treat each client with dignity, honor, and respect, and act in the best interest of each client.(2) Informed Consent: Addiction Counselors understand the right of each client to be fully informed about treatment and shall provide clients with information in clear and understandable language regarding the purposes, risks, limitations, and costs of treatment services, reasonable alternatives, their right to refuse services, and their right to withdraw consent within time frames delineated in the consent. Providers have an obligation to review with their client - in writing and verbally - the rights and responsibilities of both Providers and clients. Providers shall have clients attest to their understanding of the parameters covered by the Informed Consent.(3) Limits of Confidentiality: Addiction Counselors clarify the nature of relationships with each party and the limits of confidentiality at the outset of services when agreeing to provide services to a person at the request or direction of a third party.(4) Addiction Counselors shall guard the individual rights and personal dignity of their clients in the counseling relationship through an awareness of the impact of stereotyping and unwarranted discrimination.(5) Legal Competency: Addiction Counselors who act on behalf of a client who has been judged legally incompetent or with a representative who has been legally authorized to act on behalf of a client, shall act with the client's best interests in mind, and shall inform the designated guardian or representative of any circumstances which may influence the relationship. Providers recognize the need to balance the ethical rights of clients to make choices about their treatment, their capacity to give consent to receive treatment-related services, and parental/familial/representative legal rights and responsibilities to protect the client and make decisions on their behalf.(6) Mandated Clients: Addiction Counselors who work with clients who have been mandated to counseling and related services shall discuss legal and ethical limitations to confidentiality.(7) Multiple Therapists: Addiction Counselors shall seek to obtain a signed Release of Information from a potential or actual client if the client is working with another behavioral health professional. The Release shall allow the Provider to strive to establish a collaborative professional relationship.(8) Multiple/Dual Relationships: Addiction Counselors shall make every effort to avoid multiple relationships with a client. When a dual relationship is unavoidable, the professional shall take extra care so that professional judgment is not impaired and there is no risk of client exploitation.(9) Group: Addiction Counselors shall clarify who "the client" is, when accepting and working with more than one person as "the client." Provider shall clarify the relationship the Provider shall have with each person. In group counseling, Providers shall take reasonable precautions to protect the members from harm.(10) Financial Disclosure: Addiction Counselors shall truthfully represent facts to all clients and third-party payers regarding services rendered, and the costs of those services.(11) Communication: Addiction Counselors shall communicate information in ways that are developmentally and culturally appropriate. Providers offer clear understandable language when discussing issues related to informed consent. Cultural implications of informed consent are considered and documented by Provider.(12) Treatment Planning: Addiction Counselors shall create treatment plans in collaboration with their client. Treatment plans shall be reviewed and revised on an ongoing and intentional basis to ensure their viability and validity.(13) Level of Care: Addiction Counselors shall provide their client with the highest quality of care. Providers shall use ASAM or other relevant criteria to ensure that clients are appropriately and effectively served.(14) Documentation: Addiction Counselors and other Service Providers shall create, maintain, protect, and store documentation required per federal and state laws and rules, and organizational policies.(15) Advocacy: Addiction Counselors are called to advocate on behalf of clients at the individual, group, institutional, and societal levels. Providers should speak out regarding barriers and obstacles that impede access to and/or growth and development of clients. When advocating for a specific client, Providers obtain written consent prior to engaging in advocacy efforts.(16) Referrals: Addiction Counselors shall recognize that each client is entitled to the full extent of physical, social, psychological, spiritual, and emotional care required to meet their needs. Providers shall refer to culturally - and linguistically - appropriate resources when a client presents with any special needs that are beyond the scope of the Provider's education, training, skills, supervised expertise, and licensure.(17) Exploitation: Addiction Counselors are 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.(18) Sexual Relationships: Addiction Counselors shall not engage in any form of sexual or romantic relationship with any current or former client for a period of 5 years after last professional contact, nor accept as a client anyone with whom they have engaged in a romantic, sexual, social, or familial relationship. This prohibition includes in-person and electronic interactions and/or relationships. Addiction Counselors are prohibited from engaging in counseling relationships with friends or family members with whom they have an inability to remain objective.(19) Termination: Addiction Counselors shall terminate services with clients when services are no longer required, no longer serve the client's needs, or the Provider is unable to remain objective. Counselors provide pre-termination counseling and offer appropriate referrals as needed. Providers may refer a client, with supervision or consultation, when in danger of harm by the client or by another person with whom the client has a relationship(20) Coverage: Addiction Counselors shall make necessary coverage arrangements to accommodate interruptions such as vacations, illness, or unexpected situation.(21) Abandonment: Addiction Counselors shall not abandon any client in treatment. Providers who anticipate termination or interruption of services to clients shall notify each client promptly and seek transfer, referral, or continuation of services in relation to each client's needs and preferences.(22) Fees: Addiction Counselors shall ensure that all fees charged for services are fair, reasonable, and commensurate with the services provided and with due regard for clients' ability to pay.(23) Self-Referrals: Addiction Counselors shall not refer clients to their private practice unless the policies, at the organization at the source of the referral, allow for self-referrals. When self-referrals are not an option, clients shall be informed of other appropriate referral resources.(24) Commissions: Addiction Counselors shall not offer or accept any commissions, rebates, kickbacks, bonuses, or any form of remuneration for referral of a client for professional services, nor engage in fee splitting.(25) Enterprises: Addiction Counselors shall not use relationships with clients to promote personal gain or profit of any type of commercial enterprise.(26) Bartering: Addiction Counselors can engage in bartering for professional services if: (a) the client requests it,(b) the relationship is not exploitative, (c) the professional relationship is not distorted,(d) federal and state laws and rules allow for bartering, and(e) a clear written contract is established with agreement on value of item(s) bartered for and number of sessions, prior to the onset of services. Providers consider the cultural implications of bartering and discuss relevant concerns with clients. Agreements shall be delineated in a written contract. Providers shall seek supervision or consultation in regards to the bartering agreement and document that interaction.(27) Uninvited Solicitation: Addiction Counselors shall not engage in uninvited solicitation of potential clients who are vulnerable to undue influence, manipulation, or coercion due to their circumstances.(B) Confidentiality and Privileged Communication(1) Confidentiality: Addiction Counselors understand that confidentiality and anonymity are foundational to addiction treatment and embrace the duty of protecting the identity and privacy of each client as a primary obligation. Counselors communicate the parameters of confidentiality in a culturally-sensitive manner.(2) Addiction Counselors shall adhere to all applicable federal and state laws and regulations in regards to documentation, accessibility of records, sharing, disclosures, privacy, limits of confidentiality, imminent danger, court subpoenas, payers, encryption, storage and disposal of records, video recording, federal regulations stamp, diseases, record transfer, temporary assistance, termination, and consultation.(C) Professional Responsibilities and Workplace Standards(1) Integrity: Addiction Counselors shall conduct themselves with integrity. Providers aspire to maintain integrity in their professional and personal relationships and activities. Regardless of medium, Providers shall communicate to clients, peers, and the public honestly, accurately, and appropriately.(2) Nondiscriminatory: Addiction Counselors shall provide services that are nondiscriminatory and nonjudgmental. Providers shall not exploit others in their professional relationships. Providers shall maintain appropriate professional and personal boundaries.(3) Fraud: Addiction Counselors shall not participate in, condone, or be associated with any form of dishonesty, fraud, or deceit.(4) Harassment: Addiction Counselors shall not engage in or condone any form of harassment, including sexual harassment.(5) Credentials: Addiction Counselors shall claim and promote only those licenses and certifications that are current and in good standing.(6) Scope of Practice: Addiction Counselors shall provide services within their scope of practice and competency, and shall offer services that are science-based, evidence-based, and outcome-driven. Providers shall engage in counseling practices that are grounded in rigorous research methodologies. Providers shall maintain adequate knowledge of and adhere to applicable professional standards of practice.(7) Proficiency: Addiction Counselors shall seek and develop proficiency through relevant education, training, skills, and supervised experience prior to independently delivering specialty services. Providers engage in supervised experience and seek consultation to ensure the validity of their work and protect clients from harm when developing skills in new specialty areas.(8) Self-Monitoring: Addiction Counselors are continuously self-monitoring in order to meet their professional obligations. Providers shall engage in self-care activities that promote and maintain their physical, psychological, emotional, and spiritual well-being.(9) Qualified: Addiction Counselors shall work to prevent the practice of addictions counseling by unqualified and unauthorized persons and shall not employ individuals who do not have appropriate and requisite education, training, licensure and/or certification in addictions.(10) Advocacy: Providers shall be advocates for their clients in those settings where the client is unable to advocate for themselves.(11) Referrals: Addiction Counselors shall not refer clients, or recruit colleagues or supervisors, from their places of employment or professional affiliation to their private practice without prior documented authorization. Providers shall offer multiple referral options to clients when referrals are necessary. Providers will seek supervision or consultation to address any potential or real conflicts of interest.(12) Promotion: Addiction Counselors shall ensure that promotions and advertisements concerning their workshops, trainings, seminars, and products that they have developed for use in the delivery of services are accurate and provide ample information, so consumers can make informed choices. Addiction Counselors shall not use their counseling, teaching, training or supervisory relationships to deceptively or unduly promote their products or training events.(13) Testimonials: Addiction Counselors shall be thoughtful when they solicit testimonials from former clients or any other persons. Providers shall discuss with clients the implications of and potential concerns, regarding testimonials, prior to obtaining written permission for the use of specific testimonials. Providers shall seek consultation or supervision prior to seeking a testimonial.(14) Reports: Addiction Counselors shall take care to accurately, honestly and objectively report professional activities and judgments to appropriate third parties (i.e., courts, probation/parole, healthcare insurance organizations and providers, recipients of evaluation reports, referral sources, professional organizations, regulatory agencies, regulatory boards, ethics committees, etc.).(15) Advice: Addiction Counselors shall take reasonable precautions, when offering advice or comments (using any platform including presentations and lectures, demonstrations, printed articles, mailed materials, television or radio programs, video or audio recordings, technology-based applications, or other media), to ensure that their statements are based on academic, research, and evidence-based, outcome-driven literature and practice.(16) Dual Relationship: When Addiction Counselors are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, they shall clarify role expectations and the parameters of confidentiality with their colleagues.(17) Illegal Practices: When Addiction Counselors become aware of inappropriate, illegal, and/or unethical policies, procedures and practices at their agency, organization, or practice, they shall alert their employers. When there is the potential for harm to clients or limitations on the effectiveness of services provided, Providers shall seek supervision and/or consultation to determine appropriate next steps and further action. Providers and Supervisors shall not harass or terminate an employee or colleague who has acted in a responsible and ethical manner to expose inappropriate employer employee policies, procedures and/ or practices.(18) Credit: Addiction Counselors shall give appropriate credit to the authors or creators of all materials used in their course of their work. Providers shall not plagiarize another person's work.(D) E-Therapy, E-Supervision and Social Media (1) Definition: "E-Therapy" and "E-Supervision" shall refer to the provision of services by an Addiction Counselor using technology, electronic devices, and HIPAA-compliant resources. Electronic platforms shall include and are not limited to: land-based and mobile communication devices, fax machines, webcams, computers, laptops and tablets. E-therapy and e-supervision shall include and are not limited to: tele-therapy, real-time video-based therapy and services, emails, texting, chatting, and cloud storage. Providers and Clinical Supervisors are aware of the unique challenges created by electronic forms of communication and the use of available technology, and shall take steps to ensure that the provision of e-therapy and e-supervision is safe and as confidential as possible.(2) Competency: Addiction Counselors who choose to engage in the use of technology for e-therapy, distance counseling, and e-supervision shall pursue specialized knowledge and competency regarding the technical, ethical, and legal considerations specific to technology, social media, and distance counseling. Competency shall be demonstrated through means such as specialized certifications and additional course work and/or trainings.(3) Informed Consent: Addiction Counselors, who are offering an electronic platform for e-therapy, distance counseling/case management, e-supervision shall provide an Electronic/Technology Informed Consent. The electronic informed consent shall explain the right of each client and supervisee to be fully informed about services delivered through technological mediums, and shall provide each client/supervisee with information in clear and understandable language regarding the purposes, risks, limitations, and costs of treatment services, reasonable alternatives, their right to refuse service delivery through electronic means, and their right to withdraw consent at any time. Providers have an obligation to review with the client/supervisee - in writing and verbally - the rights and responsibilities of both Providers and clients/supervisees. Providers shall have the client/ supervisee attest to their understanding of the parameters covered by the Electronic/Technology Informed Consent.(4) Verification: Addiction Counselors who engage in the use of electronic platforms for the delivery of services shall take reasonable steps to verify the client's/supervisee's identity prior to engaging in the e-therapy relationship and throughout the therapeutic relationship. Verification can include, but is not limited to, picture ids, code words, numbers, graphics, or other nondescript identifiers.(5) Missing Cues: Addiction Counselors shall acknowledge the difference between face-to-face and electronic communication (nonverbal and verbal cues) and how these could influence the counseling/supervision process. Providers shall discuss with their client/supervisee how to prevent and address potential misunderstandings arising from the lack of visual cues and voice inflections when communicating electronically.(6) Links: Addiction Counselors who provide e-therapy services and/or maintain a professional website shall provide electronic links to relevant licensure and certification boards to protect the client's/supervisee's rights and address ethical concerns.(7) Friends: Addiction Counselors shall not accept clients' "friend" requests on social networking sites or email (from Facebook, Instagram, etc.), and shall immediately delete all personal and email accounts to which they have granted client access and create new accounts. When Providers choose to maintain a professional and personal presence for social media use, separate professional and personal web pages and profiles are created that clearly distinguish between the professional and personal virtual presence.(8) Social Media: Addiction Counselors shall clearly explain to their clients/supervisees, as part of informed consent, the benefits, inherent risks including lack of confidentiality, and necessary boundaries surrounding the use of social media. Providers shall clearly explain their policies and procedures specific to the use of social media in a clinical relationship. Providers shall respect the client's/supervisee's rights to privacy on social media and shall not investigate the client/supervisee without prior consent.(E) Research and Publication (1) Research: Research and publication shall be encouraged as a means to contribute to the knowledge base and skills within the addictions and behavioral health professions. Research shall be encouraged to contribute to the evidence-based and outcome-driven practices that guide the profession. Research and publication provide an understanding of what practices lead to health, wellness, and functionality. Researchers and Addiction Counselors make every effort to be inclusive by minimizing bias and respecting diversity when designing, executing, analyzing, and publishing their research.(2) Consistent: Researchers plan, design, conduct, and report research in a manner that is consistent with relevant ethical principles, federal and state laws, internal review board expectations, institutional regulations, and scientific standards governing research.(3) Confidentiality: Researchers are responsible for understanding and adhering to state, federal, agency, or institutional policies or applicable guidelines regarding confidentiality in their research practices. Information obtained about participants during the course of research is confidential.(4) Protect: Researchers shall seek supervision and/or consultation and observe necessary safeguards to protect the rights of research participants, especially when the research plan, design and implementation deviates from standard or acceptable practices.(5) Clients: Researchers may conduct research involving clients. Researchers shall provide an informed consent process allowing clients to freely, without intimidation or coercion, choose whether to participate in the research activities. Researchers shall take necessary precautions to protect clients from adverse consequences if they choose to decline or withdraw from participation.(6) Explanation: Once data collection is completed, Researchers shall provide participants with a full explanation regarding the nature of the research in order to remove any misconceptions participants might have regarding the study.(7) Publication: Addiction Counselors who author books, journal articles, or other materials which are published or distributed shall not plagiarize or fail to cite persons for whom credit for original ideas or work is due. Providers shall acknowledge and give recognition, in presentations and publications, to previous work on the topic by self and others.(8) e-publishing: Addiction Counselors shall recognize that entering data on the internet, social media sites, or professional media sites constitutes publishing.(9) Credit: Addiction Counselors shall assign publication credit to those who have contributed to a publication in proportion to their contributions and in accordance with customary professional publication practices.(10) Student Material: Addiction Counselors shall seek a student's permission and list the student as lead author on manuscripts or professional presentations, in any medium, that are substantially based on a student's course papers, projects, dissertations, or theses. The student reserves the right to withhold permission.(11) Proprietary: Addiction Counselors who review material submitted for publication, research, or other scholarly purposes shall respect the confidentiality and proprietary rights of those who submitted it. Providers who serve as reviewers shall make every effort to only review materials that are within their scope of competency and to review materials without professional or personal bias.Added by State Register Volume 30, Issue No. 5, eff May 26, 2006; State Register Volume 42, Issue No. 05, eff. 5/25/2018; State Register Volume 43, Issue No. 05, eff. 5/24/2019; State Register Volume 46, Issue No. 05, eff. 5/27/2022.