All members of the Association for Ambulatory Behavioral Healthcare are to be concerned with the ethical practice of treatment, and shall utilize this document as a springboard for determining the scope of practice within their individual programs and the programs with which they come in contact.
A code of ethics for programs representative of ambulatory behavioral healthcare is designed to advance the highest standards for professional conduct. A code of ethics establishes parameters that define individual as well as programmatic conduct in the areas of development and implementation, marketing and advertising, and evaluation and treatment of individuals who are vulnerable and their significant others within the array of programs and services comprising the continuum of ambulatory behavioral healthcare.
This code of ethics is not intended to replace an individual’s responsibility to his/her professional or academic identification and that Association or Academy’s own code of ethical behavior. Nor is it intended to supplant the responsibility of the program and/or parent organization and its administration to ethical deportment as prescribed by licensing, accrediting, and regulatory bodies. Rather it is designed to describe specific ethical guidelines particular to the treatment modalities represented by membership in AABH.
This code of ethics reflects the importance of and respect for the fundamental human, civil, constitutional, and statutory rights of each individual with whom members and their employees have contact.
This code of ethics applies equally to individuals as well as the member organizations, programs, and agencies for whom they provide professional services.
This Code of Ethics was adopted by an overwhelming majority of the AABH membership by mail referendum in August of 1996. Thank you to all who participated in the development and extensive field testing of this very important document. A code of ethics determines unethical behavior as well. As such this document can serve an appellate purpose in cases involving grievance or questionable practice. Violations of this ethical code may provide the basis for the initiation of disciplinary proceedings and the imposition of sanctions up to and including expulsion from membership in the Association, reporting to state licensure Board(s), reporting as required by the Health Care Quality Improvement Act, and applicable professional Associations.
Overall, we as professionals working with populations that are vulnerable bear responsibility for careful realization of personal, programmatic, organizational, financial, and/or political situations and pressures that might lead to the misuse of our influence. In subscribing to this code of ethics, we accept this responsibility, and abide by a commitment to cooperate in its implementation and regulation.
NOTE: Failure to respond to and cooperate fully with official notification from the AABH Ethics Committee of an investigation at any point in this process shall be reason for expulsion from the Association for a period of not less than two years.
Principle I: Adherence
Member programs of AABH, its staff and administration shall recognize and promote standards and guidelines for ambulatory behavioral healthcare programs as published by the Association for Ambulatory Behavioral Healthcare.
Further, an organization, program, or agency bears responsibility to develop and adhere to a code of ethics. This would be reflected in the written philosophy, mission, vision, and goals of the organization or program.
Principle II: Competence
Expertise and mastery of techniques particular to the various modalities of care comprising the continuum of ambulatory behavioral healthcare exists. Within all programs boundaries of proficiency and skill, professional discipline, and professional experience combine to establish practice guidelines and competence.
Programs shall hire, train, and provide for continuing education that maximizes the competence of all staff and the program.
Programs shall represent their competence accurately.
Providers, both individually and as a treatment team, shall recognize their abilities and limitations, and strive for high levels of competence through their own professional development.
Organizations and individual members of AABH should provide clinical treatment within their area of competence and all duties shall be provided with prudent care.
Principle III: Integrity
Programs applying the array of clinical services representative of the continuum of ambulatory behavioral healthcare shall be designed to provide active treatment that has clearly stated boundaries of admission and discharge.
Programs will assist patients to expediently achieve health to the degree that less intensive levels of mental health care would be sufficient.
Programs will be designed for the maximum benefit of the persons served.
No program, nor any individual working within a program shall accept any compensation for referring patients for any professional services. Further, inducements, such as financial incentives, for accepting or providing referrals to other professionals is unethical.
Programs and their administrators and staff shall represent themselves accurately and truthfully.
Common unethical practices include deceitful and deceptive billing, falsification of documentation, commission of a felony, gross negligence, fiduciary impropriety such as fee splitting, and maximization of reimbursement benefits.
AABH and its members are concerned about the ethical conduct of providers of ambulatory behavioral healthcare, and strongly encourage one another to take appropriate action to prevent the continuation of unethical practice.
Principle IV: Professional Conduct
It is the responsibility of the program to recognize its role in the continuum of ambulatory behavioral healthcare, and to assure that the most clinically appropriate environment is foremost when considering a patient’s admission to or discharge from the program.
Any individual in a staff position within a member program is responsible for compliance with the professional standards and code of conduct his/her professional or academic Association or Academy. Further, the program and administration is responsible to the ethical standards of practice as prescribed by the relevant licensing, accrediting, and regulatory bodies.
Programs and individual members shall maintain a commitment to the professional boundaries between patients and staff: dual (professional/personal) relationships are prohibited. The clinical relationship developed within the context of the program shall remain consistent across all transactions between the treatment staff and the patient.
Multiple relationships of a personal purpose between staff and patients and/or their families in any setting outside the boundaries of the program are dependent upon a number of factors. For instance, community size or business contracts would influence the purpose of dual relationships. However in no case shall the therapeutic relationship between the program, staff, patients, and/or their families or legal guardians be exploited, cause conflict within the community, or result in distortion of the purpose of the relationship itself.
Examples of dual relationships include, but are not limited to the following:
- Giving gifts to or receiving gifts from patients, former patients, or members of their families is to be given consideration in terms of the purpose of the gift, and the clinical implications of such behavior.
- Knowledge of, initiation, or participation in the following types of relationships are prohibited: Sexual intimacy with patients, former patients, or members of their families (as well as physical intimacy that could lead to sexual intimacy).
- Dating, or romantic relationships of any kind with patients, former patients, or members of their families.
- Business relationships between the program administration and/or staff members and known current or former patients are prohibited.
Principle V: Marketing/Advertising
Member programs shall portray their services through public and private statements that are forthright and factual. It is unethical to engage in false and deceptive advertising.
Principle VI: Welfare of the Patient
The program, administrators, and staff therein have the responsibility to hold the interest of the patient primary, including a responsibility for protecting patient confidentiality, privacy, self determination, and autonomy. Programs shall not practice discrimination. Member programs shall have a system for informing the patient of his/her rights and responsibilities, a grievance process, a policy that clearly outlines the program and staff’s responsibility for fostering confidentiality, and a process to monitor and evaluate the program’s system for protecting and supporting patient rights and welfare.
The program and its administrators and staff therein shall respect the integrity and welfare of their patients. There shall be no exploitation of the trust of patients. The program shall terminate a clinical relationship when it is reasonably clear that the patient no longer benefits from the relationship and/or program. It is the program’s responsibility to assure that proper referral and continuing care occur.
Patients shall be informed of the benefits and limitations of their participation in the program in language that can be clearly understood. Informed consent shall be obtained from the patient or legal guardian before the patient enters the program. Such consent shall be documented in writing.
Principle VII: Professional Relationships
Current clinical relationships and existing program enrollment shall be respected. Examples include, but are not limited to:
- Individuals currently receiving treatment shall not be enticed nor influenced to relinquish a present therapeutic relationship.
- Should a member program be approached by a potential patient for enrollment, all efforts shall be made to ascertain whether the potential patient is currently enrolled in any other service or program and whether or not admission to the member program would represent a conflict of current therapies being received.
Member programs, administrators, and staff shall use all of the professional, technical, and administrative resources that serve the best interests of the patients. The absence of formal liaison relationships does not relieve the program, administration, and staff of the responsibility to exert planning and persistence in order to arrange for the patient’s needs, which are to be based on both clinical appropriateness and patient preference.
Principle VIII: Scholarship and Research
Informed consent shall be obtained prior to the inception of any research project involving human subjects. Patients shall be specifically informed of the purpose of any research to be conducted using plain language that can be easily understood. Patients shall be further informed that participation is voluntary with no penalty for nonparticipation. The program and/or professional staff are responsible for the communication of potentially positive and negative outcomes to the participants. Any research shall utilize the most current scientific principles and shall be limited to the program’s or researcher’s scope of expertise. There shall be evidence that all relevant literature and prior similar research has been reviewed. Research conducted within a program should undergo academic or organizational review.
Research involving human subjects shall protect the dignity and confidentiality of participants, and shall not involve investigation that in the past has proven to be harmful. The program or any member thereof is responsible for the proper citation of materials previously published. Further, research shall cease at the point that risk to the participants outweighs the intended benefits of the study.
Principle IX: Social Responsibility
Programs, administration, and staff shall recognize their responsibility, in the broadest sense, for the welfare of the community within which they practice. Program administration and staff are to collaborate with the local professional community to develop and support needed levels of care to adequately meet the needs of the community. Further, they have a responsibility to join with their community to improve the perceptions and acceptance of persons suffering with mental illness and/or addictions. Evidence of these efforts shall be reflected in the mission, vision, and goals of the program.
The Due Process Procedures section of this Code of Ethics outlines the process for determining unethical behavior of AABH members, and serves an appellate purpose in cases involving grievance or questionable practices. Violations of this ethical code may provide the basis of the initiation of disciplinary proceedings and the imposition of sanctions up to and including expulsion from membership in the Association, reporting to state licensure Board(s), reporting as required by the Health Care Quality Improvement Act, and applicable professional Associations.
Specific information outlining these procedures can be obtained from the AABH central office by calling (757)673-3741.