Module Eight

Ethics of Prevention and

Bringing It All Together

Format Options for Module 8

Module 8 begins with the Ethics section. Two options are presented below
for leading the application section, Bringing It All Together:

-   Option #1 makes Module 8 a three hour module and draws together work
    from previous modules using the case studies begun in Module 2 and
    used in each subsequent module.

-   Option #2 makes Module 8 a seven and one-half hour module using a
    new activity applying the concepts of the SAPST in a presentation
    exercise.

Module 8 ends with a closing, evaluation, and post-test.

Ethics of Prevention

Time

The anticipated time for the ethics section is one and one half hours.

Learning Objectives

Participants will be able to:

-   Examine a sample code of ethical conduct for prevention
    professionals

-   Make ethical judgments in prevention situations

### INFORMATION SHEET {#information-sheet .HeadInfSheet}

**Code of Ethical Conduct for Prevention Professionals**

> All developing fields need an ethical code to guide behavior. The
> field of substance abuse prevention needs to develop a code of ethics
> to serve as a guide for professional conduct. Circumstances and
> situations often arise in the helping professions that are both
> complex and difficult to handle. A code of ethics can help us make
> good decisions when faced with problematic situations.

The following is a set of ethics for prevention professionals to
consider. The National Association of Prevention Professionals and
Advocates (NAPPA) originally developed these ethical codes. However,
this organization is no longer in existence. As an emerging discipline,
ethical codes of conduct need to be developed and advanced for the field
of prevention to act as a benchmark for positive professional behavior.

> **Preamble**

The Principles of Ethics are a model of standards of exemplary
professional conduct. These Principles of the Code of Ethical Conduct
for Prevention Professionals express the professional\'s recognition of
his/her responsibilities to the public, to service recipients and to
colleagues. They guide members in the performance of their professional
responsibilities and express the basic tenets of ethical and
professional conduct. The principles call for commitment to honorable
behavior, even at the sacrifice of personal advantage. These Principles
should not be regarded as limitations or restrictions, but as goals for
which prevention professionals should constantly strive. They are guided
by core values and competencies that have emerged in the development of
the field.

> **Principles**

1.  **Nondiscrimination**

> A prevention professional shall not discrimi­nate against recipients or
> colleagues based on race, religion, national origin, sex, age, sexual
> orientation, economic condition, or physical or mental disability,
> including persons testing positive for HIV. A prevention professional
> shall broaden his or her understanding and acceptance of cultural and
> individual differences, and in so doing render services and provide
> information sensitive to those differences.

2.  **Competence**

> A prevention professional shall observe the profession\'s technical
> and ethical standards, strive continually to improve personal
> com­petence and quality of service delivery, and discharge professional
> responsibility to the best of his or her ability. Competence is
> derived from a synthesis of education and experience. It begins with
> the mastery of a body of knowledge and skill competencies. The
> maintenance of competence requires a commitment to learning and
> professional improvement that must continue throughout the
> professional\'s life.

A.  Professionals should be diligent in discharging responsibilities.
    Diligence imposes the responsibility to render services carefully
    and promptly, to be thorough, and to observe applicable technical
    and ethical standards.

B.  Due care requires a professional to plan and supervise adequately
    any professional activity for which she or he is responsible.

C.  A prevention professional should recognize limitations and
    boundaries of competencies and not use techniques or offer services
    outside his or her competencies. Each professional is responsible
    for assessing the adequacy of his or her own competence for the
    responsibility to be assumed.

D.  When a prevention professional is aware of unethical conduct or
    practice on the part of an agency or prevention professional, he or
    she has an ethical responsibility to report the conduct or practices
    to appropriate authorities or to the public.

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III. **Integrity**

> To maintain and broaden public confidence, prevention professionals
> should perform all professional responsibilities with the highest
> sense of integrity. Integrity can accommodate the inadvertent error
> and the honest difference of opinion. It cannot accommodate deceit or
> subordination of principle.

A.  Personal gain and advantage should not subordinate service and the
    public trust. All information should be presented fairly and
    accurately. Each professional should document and assign credit to
    all contributing sources used in published material or public
    statements.

B.  Prevention professionals should not misrepresent either directly or
    by\
    implication professional qualifications or affiliations.

C.  A prevention professional should not be associated directly or
    indirectly with any services or products in a way that is misleading
    or incorrect.

**IV. Nature of Services**

> Above all, prevention professionals should do no harm to service
> recipients. Practices shall be respectful and nonexploitative.
> Services should protect the recipient from harm and the professional
> and the profession from censure.

A.  Where there is evidence of child or other abuse, the prevention
    professional shall report the evidence to the appropriate agency and
    follow up to ensure that appropriate action has been taken.

B.  Where there is evidence of impairment in a colleague or a service
    recipient, a prevention professional should be supportive of
    assistance or treatment.

C.  A prevention professional should recognize the effect of impairment
    on professional performance and should be willing to seek
    appropriate treatment for himself/ or herself.

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V.  **Confidentiality**

> Confidential information acquired during service delivery shall be
> safeguarded from disclosure, including---but not limited to---verbal
> disclosure, unsecured maintenance of records, or recording of an
> activity or presenta­tion without appropriate releases.

VI. **Ethical Obligations to Community and Society**

> According to their consciences, prevention professionals should be
> proactive on public policy and legislative issues. The public welfare
> and the individual\'s right to services and personal wellness should
> guide the efforts of prevention professionals who must adopt a
> personal and professional stance that promotes the well-being of all
> humankind.

### WORKSHEET {#worksheet .HeadInfSheet}

**Three Case Studies in Ethics**

**Ethics Case Study 1**

The Center for Alcohol Education, Inc., is a small, struggling nonprofit
agency that targets the prevention of alcohol use among teenagers.
Funding has never been adequate to support its projects, and its
executive director has been considering some layoffs to stay afloat.
Recently, the Bettleheim Brewing Company has let it be known that it
will be providing grant dollars for responsible alcohol use.
Bettleheim's public relations director was recently quoted in the
newspaper as saying that current prevention efforts are one-sided and
distort the facts about responsible alcohol use.

1.  Should the Center for Alcohol Education, Inc., apply for one of
    these grants?

2.  What implications would the acceptance of a grant from Bettleheim
    Brewing Company have on the Center?

3.  Which sections of the Code of Ethics guides the Center in their
    decision?

**Ethics Case Study 2**

For the past ten years, the Institute on Drug Abuse Prevention has been
supporting the DON\'T DO IT curriculum by providing technical
assistance, free materials and training to teachers willing to use it
with their students. The institute has been very successful; over
500,000 students are exposed to the curriculum annually. Recently,
however, two separate universities completed large-scale studies on the
DON\'T DO IT curriculum and found that it did not change student
drug-use behavior; in fact, student drug use increased after the
curriculum was implemented. The executive director has determined that
it would take at least two years to locate and begin supporting a new
curriculum. If she stops facilitating training, she\'s worried about the
reaction of the institute\'s funders, who require that at least 200
teachers be trained annually. The director\'s advisors are telling her
to disregard the study and continue supporting DON\'T DO IT; after all,
if so many teachers are using it, doesn\'t that mean it\'s a good
program?

1.  Should the institute continue facilitating training on the DON\'T DO
    IT curriculum?

2.  Does the institute have any ethical obligation to the teachers who
    are currently using the DON\'T DO IT curriculum and are unaware of
    the study?

3.  Which sections of the Code of Ethics guides the Institute in these
    decisions?

**Ethics Case Study 3**

The Health Advisory Board, a community coalition of health professionals
from a variety of agencies, has applied for a grant available to groups
serving Latino pregnant and parenting teens. The Board has not
previously served this group, but is in need of these funds to implement
its drug abuse prevention curriculum in an urban school district and to
supplement its current funds. Although the Health Advisory Board members
are Caucasian and English speaking, they have selected a local Spanish
speaking Foreign Exchange student from Spain to teach the curriculum.
They have selected a program developed in a predominantly white rural
community that has demonstrated good outcomes and plan to adapt the
program for this new focus group. They will advertise the program to
students as a Latino health and parenting program. The Health Advisory
Board will serve as the governing body and will use their expertise in
designing and completing the program evaluation.

1.  Does the Health Advisory Board have a reasonable plan? Why or why
    not?

2.  Which sections of the Code of Ethics, if any, is the Advisory Board
    in conflict with?

3.  What recommendations would you make to the Health Advisory Board in
    the development of their proposal?

**Source:**

S.H. Mowrer, and T.N. Strader, National association addresses tough
issues, *The Journal of Primary Prevention, 13:1,*73-77. Klewer
Academic/Plenum Publishers (199

### WORKSHEET {#worksheet-1 .HeadInfSheet}

**Bringing it All Together**

You are a community substance abuse prevention coalition based in your
case study community. The following work sheet will guide you in
bringing together your work from the previous SAPST modules, using the
case study which you began in Module 2 and advanced in each subsequent
module.

Please involve all members of your group in recording the answers to the
questions which follow. You will have 30 minutes to complete this work
sheet. Your group will then present this information to another case
study group.

**Our community coalition is named:**

**[SPF 1. Assessment]{.underline}**

**Its focus is the prevention of (be specific about the problem
behavior):**

**Please place an X by the risk factors and protective factors your
group identified in your case study community:**

**RISK FACTORS**

*Community*

> [\_\_\_\_]{.underline} availability of drugs
>
> [\_\_\_\_]{.underline} community laws and norms favorable toward drug
> use
>
> [\_\_\_\_]{.underline} transitions and mobility
>
> [\_\_\_\_]{.underline} low neighborhood attachment and community
> disorganization
>
> [\_\_\_]{.underline} extreme economic deprivation

*Family*

> [\_\_\_\_]{.underline} family history
>
> [\_\_\_\_]{.underline} family management problems
>
> [\_\_\_\_]{.underline} family conflict
>
> [\_\_\_\_]{.underline} parental attitudes and involvement in drug use

*School*

> [\_\_\_\_]{.underline} academic failure beginning in elementary school
>
> [\_\_\_\_]{.underline} lack of commitment to school

*Individual/Peer*

> [\_\_\_\_]{.underline} early and persistent antisocial behavior
>
> [\_\_\_\_]{.underline} alienation/rebelliousness
>
> [\_\_\_\_]{.underline} friends who engage in the problem behavior
>
> [\_\_ \_]{.underline} favorable attitudes toward the problem behavior
>
> [\_\_\_\_]{.underline} early initiation of the problem behavior

*Individual/Peer (continued)*

> [\_\_\_\_]{.underline} gang involvement
>
> [\_\_\_\_]{.underline} constitutional factors
>
> [\_\_\_\_]{.underline} depression and anxiety

**PROTECTIVE FACTORS**

> [\_\_\_\_]{.underline} bonding

[\_\_\_\_]{.underline} opportunities for pro-social involvement

> [\_\_\_\_]{.underline} skills
>
> [\_\_\_\_]{.underline} recognition

[\_\_ \_]{.underline} healthy beliefs and clear standards

**[SPF 2. Capacity]{.underline}**

Describe your case study community's capacity (human, technical, and
financial resources), including cultural competency.

**[SPF 3. Strategic Planning]{.underline}**

Describe the community program for which your coalition completed a
Logic Model, and review the Logic Model.

Describe the program's goals and long term outcomes:

> Describe the program\'s short term outcomes:

Describe the strategies used to attain these goals and objectives:

**Please place an X by the type of strategy the program represents:**

> [\_\_\_\_]{.underline} universal
>
> [\_\_\_]{.underline} selective
>
> [\_\_\_\_]{.underline} indicated

**[SPF 4. Implementation]{.underline}**

Share your thoughts about balancing fidelity and culturally tailoring
the program to your population:

Share your thoughts about planning for sustainability of the program's
outcomes:

**[SPF 5. Evaluation]{.underline}**

Describe your program\'s plans for process and outcome evaluation
(tools, design, internal/external resources):

### WORKSHEET {#worksheet-2 .HeadInfSheet}

**The NPN Presentation Proposal**

**Congratulations!** Your group has been invited to submit a workshop
proposal at the National Prevention Network (NPN) Research Conference
next year. Your proposal will take the form of a 20 min. presentation
outlining your award-winning local initiative, as you have developed it
with the needs, goals and outcomes, & strategies in mind for your select
age group.

Yours is a community-based organization, that**'**s been operating
successfully for the past 5 years. With the lessons you've learned about
carefully assessing needs, increasing capacity, designing & selecting
appropriate (multiple) strategies, as well as delivering & evaluating
successful prevention services at the local level, you're now ready to
share your success at the national level.

Your presentation incorporates tools from all the Modules, and
especially the research & planning material found in Modules 2 & 3 based
on CSAP's Strategic Planning Framework (SPF), CSAP Principles of
Substance Abuse Prevention and NIDA Prevention Principles. Development
and presentation includes [all members]{.underline} of your work group.
Be as thorough as possible & include the following (remember, the
reviewers are strangers and know nothing of your community or program).

**Our community based organization is named:**

**Its focus is the prevention of:**

**[SPF 1. Assessment]{.underline}**

Describe your agency's efforts in assessing community readiness.

Describe your agency\'s efforts in conducting a needs assessment.

Describe your agency\'s efforts in identifying specific problem
behaviors and prioritizing their associated risk and protective factors.

Describe your agency\'s efforts in conducting a resource assessment.

> **Please place an X by the risk factors and protective factors that
> the above project will address:**

**RISK FACTORS**

*Community*

> [\_\_\_\_]{.underline} availability of drugs
>
> [\_\_\_\_]{.underline} community laws and norms favorable toward drug
> use
>
> [\_\_\_\_]{.underline} transitions and mobility
>
> [\_\_\_\_]{.underline} low neighborhood attachment and community
> disorganization
>
> [\_\_\_]{.underline} extreme economic deprivation

*Family*

> [\_\_\_\_]{.underline} family history
>
> [\_\_\_\_]{.underline} family management problems
>
> [\_\_\_\_]{.underline} family conflict
>
> [\_\_\_\_]{.underline} parental attitudes and involvement in drug use

*School*

> [\_\_\_\_]{.underline} academic failure beginning in elementary school
>
> [\_\_\_\_]{.underline} lack of commitment to school

*Individual/Peer*

> [\_\_\_\_]{.underline} early and persistent antisocial behavior
>
> [\_\_\_\_]{.underline} alienation/rebelliousness
>
> [\_\_\_\_]{.underline} friends who engage in the problem behavior
>
> [\_\_ \_]{.underline} favorable attitudes toward the problem behavior
>
> [\_\_\_\_]{.underline} early initiation of the problem behavior
>
> [\_\_\_\_]{.underline} gang involvement
>
> [\_\_\_\_]{.underline} constitutional factors
>
> [\_\_\_\_]{.underline} depression and anxiety

**PROTECTIVE FACTORS**

> [\_\_\_\_]{.underline} bonding

[\_\_\_\_]{.underline} opportunities for pro-social involvement

> [\_\_\_\_]{.underline} skills
>
> [\_\_\_\_]{.underline} recognition

[\_\_ \_]{.underline} healthy beliefs and clear standards

**[SPF 2. Capacity]{.underline}**

Describe your program's efforts in determining internal capacity and
readiness, including cultural competency.

Describe your program's efforts in determining external capacity (human,
technical, and financial).

Describe your agency resources and staff, including the qualifications
of staff

**[SPF 3. Strategic Planning]{.underline}**

Describe your program's efforts to complete a Logic Model.

Describe the program goals (long term community changes):

> Describe the program\'s objectives (short term achievements):

Describe the strategies used to attain these goals and objectives:

Describe your agency's efforts in selecting the type of strategy
(universal, selective, or indicated).

**Please place an X by the type of strategy the above project will
include:**

> [\_\_\_\_]{.underline} universal
>
> [\_\_\_]{.underline} selective
>
> [\_\_\_\_]{.underline} indicated

**Please place an X by the specific strategies that the above**

> **project will include:**
>
> [\_\_\_\_]{.underline} information dissemination
>
> [\_ \_\_]{.underline} education

[\_\_ \_]{.underline} community-based process

[\_\_ \_]{.underline} alternatives

> [\_\_ \_]{.underline} environmental
>
> [*\_* *\_\_*]{.underline} problem identification and referral

**[SPF 4. Implementation]{.underline}**

Describe your agency\'s efforts in implementing best practices.

Describe your agency's efforts in developing and completing Logic Model
and Action Plans.

**[SPF 5. Evaluation]{.underline}**

Describe your agency\'s efforts in evaluation (tools, design,
internal/external resources).

**[Cultural Competency and Sustainability]{.underline}**

Review your answers for each of the 5 SPF steps and make sure that you
have taken into account the need for cultural competence and
sustainability in each stage.

### WORKSHEET {#worksheet-3 .HeadInfSheet}

**The Proposal Scoring Sheet**

> **Complete this worksheet for each community group, based on their
> Presentation Proposal.**

1.  **Assess the adequacy of the program & practices in the following
    areas:**

+-----------+-----------------+-----------------+----------+-----------+
| **Area**  | **Strengths**   | **Weaknesses**  | **A      | **Ad      |
|           |                 |                 | ddresses | dresses** |
|           |                 |                 | Cu       |           |
|           |                 |                 | ltural** | *         |
|           |                 |                 |          | *Sustaina |
|           |                 |                 | **Compe  | bility?** |
|           |                 |                 | tency?** |           |
+-----------+-----------------+-----------------+----------+-----------+
| A         |                 |                 |          |           |
| ssessment |                 |                 |          |           |
+-----------+-----------------+-----------------+----------+-----------+
| Capacity  |                 |                 |          |           |
+-----------+-----------------+-----------------+----------+-----------+
| Comp      |                 |                 |          |           |
| rehensive |                 |                 |          |           |
| Strategic |                 |                 |          |           |
| Planning  |                 |                 |          |           |
+-----------+-----------------+-----------------+----------+-----------+
| Imple     |                 |                 |          |           |
| mentation |                 |                 |          |           |
+-----------+-----------------+-----------------+----------+-----------+
| E         |                 |                 |          |           |
| valuation |                 |                 |          |           |
+-----------+-----------------+-----------------+----------+-----------+

2.  **Assess the strategies employed:**

> \_\_\_\_ Are the strategies related to the program objectives?
>
> \_\_\_\_ Does the program have an objective in support of each
> strategy it wishes to employ?

\_\_\_\_ Would other strategies be more appropriate?

\_\_\_\_ Are the risk factors and protective factors adequately
addressed?

3.  **What developmental stages/ tasks does this approach address?**

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

4.  **Make recommendations for improvement:**

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_