A few years ago I bumped into Carey Davidson (MAC, CIP, ICADAC, CAI) at a conference where we were both commiserating the then-state of affairs of the treatment industry. Carey Davidson is a Board Registered Intervention Specialist and a Certified Intervention Professional who entered the field of addiction out of a sincere desire to help others. Carey holds a Master’s Degree from the esteemed Hazelden Graduate School of Addiction Studies. Carey is President of the Network of Independent Interventionists, sits on the Board of Certification of Addiction Counselors, and is a member of the Association of Intervention Specialists. He recently shared with me his October 31, 2016 article entitled “An Ethical Compass: Navigating the Maze of Addiction Treatment” and I was sincerely floored by its accuracy and felt re-energized that our efforts on this end were aligned with nationally accepted ethical standards.
Below are only some of the highlights of Carey’s article, though I strongly recommend that you read the entire piece, and then re-read it.
Anyone who works in, regulates, or has any form of interest in addiction treatment and recovery should carefully explore Carey’s writings and then judge for yourself.
- Marketers v. Interventionists
At two years sober, I thought I had all the answers. I was heavily involved in my 12 step program and felt incredibly confident in my recovery. I started to gain notoriety in the recovery community, and when people were in crisis, they knew I was a solid resource to whom they could turn for help. I was, and still am— passionate about confronting the disease of addiction. “Why not?,” I thought. So, I did it. I printed up cards and called myself an “Interventionist.” It was easy. I recalled when applying for my real estate license, I was required to be finger printed and participate in a background check. However, all I needed to do to guide vulnerable patients and their often desperate families through this life-threatening disease was print up a card. Without the proper training and certification, I had only one tool— my own recovery experience. I placed many people in treatment, but I’ll never know the extent of damage I may have caused families along the way.
Luckily, after a couple of tough cases in a row, I realized my approach, while legal and extremely common in the field, was not in the best interest of those I served.
Families depended on me to guide them and their loved ones into recovery. The course of their lives would be significantly impacted by my guidance, and the work I had done in my personal recovery program ‘could never substitute for the formal education and clinical training I knew I needed’.
Consequently, I enrolled in the Hazelden Betty Ford Graduate School of Addiction Studies, where on the first day they inform you: “If you are looking to get your Masters in the 12 steps, you’re in the wrong place.”
To fulfill my passion to helping others I went back to school and earned a Masters Level degree in addiction studies and counseling, which included rigorous academics and more than 1,200 clinically supervised hours working with patients. I dedicated myself to education because, although my passion for this field hadn’t changed, my responsibilities to struggling families extended far beyond a simple desire to help people. If I was going to offer myself as a credible resource to the vulnerable, I had to become a trained professional with a solid clinical background.
One key difference between a trained professional and a layperson is that a layperson works solely from personal experience and a professional works from an empirically-evidenced theory.
- The Families of Those in Need
While I can never “undo” what has been done, I have had to own some difficult truths as I’ve moved forward in the field. I now find myself hyperaware of the many untrained interventionists around me who, unfortunately, continue to do harm.
Family can be the most powerful and motivating force in an individual’s life. Those traits, amplified in crisis, can be a family’s greatest asset or liability. There are those in this industry who capitalize on this vulnerability in an unethical manner. It is essential families are able to place their trust in capable, educated, and accountable specialists.
However, because the behavioral health field is so vast, multi-faceted, and unregulated, it’s difficult to know where to begin. Let this article serve as an ethical compass for you to use when navigating the treatment world.
- Questionable Treatment Placement Practices
The point at which your life, or life of someone close to you becomes too unmanageable to handle alone feels unprecedentedly vulnerable and frightening to most families. You want to trust anyone who promises a treatment or, in some cases, even a miracle cure. Because you want so desperately to believe what these self-proclaimed “professionals” say, your judgment can understandably become impaired.
- A Surge of New Professions
It is crucial everyone be aware of the many questionable treatment placement practices that currently exist in the U.S. The 2008 Parity Act and Obamacare made treatment for mental health and substance use more accessible for millions of people.
Consultants, patient brokers, marketers, treatment placement specialists, and other creative professions surged, often, without formal training for those espousing these titles. While these workers are called different names, they serve the same function: to put “heads in beds.” They are people who, through one method or another, receive kickbacks for getting a patient into a particular facility. These so-called professionals make their money directly by placing someone into a specific treatment program who pays them a “bounty,” a “marketing fee,” or “reward” for “placing” the person with them. “Patient Brokers,” in effect, broker lives for cash.
- Interventionists and Treatment Professionals
My intent is not to discredit the challenging and indispensable work of interventionists (or anyone else working in the field). After all, I am one. I married one. However, it is crucial to know there are individuals without any formal behavioral health education, certification, license or clinical training who claim to be “interventionists” or “addiction specialists” that “work” in the addiction field. This is dangerous. Just because a person has been through recovery and/or has watched every season of Intervention on A&E, it does not follow they are qualified to be an Interventionist. While unfortunately legal, it is as reckless as watching Grey’s Anatomy, buying an ambulance, and calling oneself an EMT.
When considering employing the services of an interventionist, or ANY TREATMENT “PROFESSIONAL” involved in recommending a treatment program and involved with patient care, questions must be asked to ensure you find yourself in capable, educated, and ethical hands.
What is the professional’s relevant education? What are their certifications? Does any board license them? How long have they been doing what they do? What qualifies them to make recommendations?
For example, if an interventionist is not able to identify and specifically describe what they do or the intervention modalities they believe would be most effective and why, do not hire them.
If a person who is recommending a treatment center can’t give clear criteria as to why they are recommending a particular center, find out more. Ask if anyone receives any kind of financial compensation or incentives for referrals and/or placement.
Just because someone calls themselves a “professional addiction whatever,” does not mean their decisions are not financially incentivized.
“Kickbacks” have become rampant in the intervention world and can prevent a person from being placed in a program that’s best fit for their needs. Kickbacks can be in the form of money, gifts, or anything that would encourage someone to recommend one program over another in exchange for compensation.
- A Parallel Situation
Your doctor tells you he has discovered a potentially life-threatening tumor in your brain and surgery is required. You panic. You don’t know anything about neurology, let alone a good neurologist or neurosurgeon with experience in tumor removal. You want the best option available, so you ask your doctor to recommend the best neurosurgeon in town.
He or she knows of two neurosurgeons who specialize in the type of procedure that could save your life. One does a decent job, but has recently settled a malpractice suit. Due to the lawsuit, this surgeon’s referrals have decreased and he’s mentioned he would be willing to give your doctor a ‘cut of the profits’ for any surgery sent his way. The other neurosurgeon is highly respected — one of the best in the field. Her schedule is often full and services are in high demand, but your doctor has a good relationship with her and knows he can ask her to find time to perform the procedure.
Your doctor writes down the name and office number of the first neurosurgeon and tells you, with a reassuring smile, he’s the better option. You walk out of his office unaware your wellbeing was just compromised for financial gain.
This scenario seems almost too ridiculous to take seriously, but why is that? First, this is a violation of Stark Law (starklaw.org). Second, it’s difficult to fathom a medical professional would compromise the quality of a life-saving decision because of money. Why is mental health and substance abuse any different if we are, in fact, treating a disease?
This happens to families every day. Most states do not have equivalent laws for non-professionals working in the behavioral health field, and those that do rarely enforce them.
- Who is paying the Addiction Treatment Professional?
If someone offers their services at no charge, more often than not, this is a red flag.
If someone isn’t asking you to compensate them for their services, this often means someone else is. They are fully employed, contracted, or financially incentivized by a specific facility, and they have a professional and monetary obligation or “motivation” to recommend clients to a specific program(s).
An independent professional depends upon being fairly compensated or will not mind telling you how they are compensated if it is other than by patients. A best practice would be to use independent professionals are compensated directly by the families they serve.
Again, I implore you to do your homework. These questions may seem blunt, but a professional worth hiring will not get defensive, will answer directly, and will appreciate your asking.
Addiction and recovery impacts the life of an addict and everyone that is around them.
Sadly, it can become Caveat Emptor, or “Let the Buyer Beware,” when it comes to navigating the world of addiction treatment.
Find a qualified professional to help you. People do get better from addiction; the right treatment and treatment provider can make all the difference in the world. Do your homework, and ask the right questions. It can truly be a matter of life and death.