The Ethics of Multiple
Roles in Small
Communities
Goals
 Identify multiple types of small community
 Identify possible dual/multiple roles that are common
 Identify the difference between absolute boundary
violations and realistic gray areas
Small Communities
 Physical boundaries
 Spiritual/Philosophical Boundaries
 Ethnic/Racial Boundaries
 Language Boundaries
 Not barriers as this may be due to language preference
 Sexual Orientation
Show of Hands
 Real quick, what small communities do you personally
belong to that you would be willing to share?
NAADAC Code of Ethics
 I. The Counseling Relationship- It is the responsibility of the addiction
professional to safeguard the integrity of the counseling relationship and to
ensure that the client is provided with beneficial services. The client will be
provided access to effective treatment and referral giving consideration to
individual educational, legal and financial needs. . . . The addiction professional
shall provide the client and/or guardian with accurate and complete information
regarding the extent of the professional relationship. In all areas of function, the
addiction professional is likely to encounter individuals who are vulnerable and
exploitable. In such relationships he or she seeks to nurture and support the
development of a relationship of equals rather than to take unfair advantage.
 IV. Professional Responsibility- The addiction professional espouses objectivity and
integrity and maintains the highest standards in the services provided. The addiction professional recognizes that effectiveness in his or her profession is based
on the ability to be worthy of trust. . . Further, the addiction professional
recognizes that those who assume the role of assisting others to live a more
responsible life take on the ethical accountability of living responsibly. The
addiction professional recognizes that even in a life welllived, harm might be
done to others by words and actions.
Other Codes
 Social workers, Professional Counselors, Psychologists,
as well as Marriage and Family Counselors all have their
own ethical codes. In some cases, a profession will have
two competing codes (NBCC and ACA for counselors).
 Each code, with different wording, addresses similar
concerns.
Standard Rural Issues
 Small Community due to physical boundaries
 Lack of resources
 If rural, likely other towns are some distance away
 You may be the only therapist in town
Faith Communities
 Some religious groups are small compared to others, even when
in a larger city
 Some of these groups are distrustful of people outside of the
community
 They want a treatment provider that is within their community
 There may be fears that outsiders will not treat their faith with
respect
 Quakers
 Mennonites
 Orthodox Jews
Ethnic/Racial Communities
 Often boundaries are created through language
 Some larger cities have small neighborhoods that are
overwhelmingly one ethnic group
 At times these groups are also unified as a faith community
 Many groups have historical antagonism to institutionalized
intervention. People of Color access mental health and
substance abuse treatment far less than their white
counterparts.
 There can be fears that “outsiders” won’t understand the
nuances of culture.
Sexual Orientation
 Issues of “Family of Choice”, at times community is created
due to rejection from other communities may have
membership
 The “LGBT” community is not a unified subculture. The most
common issue is transgendered individuals being
“represented” in talk, but not integrated into the community.
 There can be concerns heterosexual treatment providers will
be rejecting at worse and heterocentric at best.
 This community more than most others, eskews traditional
gender roles which may become a point of subtle conflict
Problem Solving model
Ethical Principles
 Core ethical principles that are effected is the idea that
we Not Harm our client and that we Help our client.
 This becomes the key litmus test when looking at a dual
role.
 Does this cause harm, and could it potentially cause harm
 Does failing to take on the dual role fail to offer
appropriate help
 What are additional options or resources
Discussion
Prohibited Activities
 Treatment of individuals
that you have been in a
romantic/sexual
relationship with or their
children
 What are others?
Gray Area
 Treating individuals you
know from other social
groups, church, etc.
 What are others for the
group to discuss?
Story Time
 You tell us, what have you encountered?
 What did you do to resolve this?
 What questions do you have?
 “This one time at the Mennonite Church…”
 “I know the family and have had drinks with him and
friends at the bar, and we serve on a Board together...”
 “They don’t have a lot of money, and the next provider
is an hour away. I am the only provider in this area, but
we are in the same small town. Same church, same
stores, same community…”
Contact Information
Mathew T. Mejia, Psy.D.
James R. Ward, MSW
Licensed Clinical Psychologist
Licensed Professional Counselor
Clinical Director
Steel City Consultants
Pueblo, CO
719-545-3814
SteelCityConsultants@yahoo.com
Licensed Clinical Social Worker
Licensed Addictions Counselor
AcuDetox Specalest
Director of Substance Abuse
Treatment
Steel City Consultants
Pueblo, CO
719-423-8855
jamesrossward@gmail.com