Professional Boundaries in Outpatient Drug and Alcohol Rehabilitation Programs

Case Overview

This case study delves into a complex situation involving a patient who, after maintaining sobriety for seven years, suffered a relapse. The individual sought help from an Intensive Outpatient Program (IOP) where they developed an infatuation with their assigned clinical alcohol and drug counselor.

Allegedly, the counselor did not maintain professional boundaries, which adversely affected the patient’s recovery. The plaintiff asserts that this inappropriate relationship resulted in an unnecessarily prolonged stay in the program. In addition, the malfeasance allegedly resulted in questionable prescriptions of Klonopin and Ketamine. This case necessitates expert insight from a Licensed Clinical Social Worker or Licensed Clinical Alcohol & Drug Counselor to assess potential liability.

Questions to the expert and their responses

How often do you manage patients as a counselor in an outpatient drug and alcohol program?

As a Licensed Clinical Social Worker based in New Jersey with fifteen years of experience under my belt, I frequently manage patients enrolled in outpatient drug and alcohol programs.

My work primarily involves adolescents and adults grappling with depression, anxiety, substance use disorders, aggressive behavior, self-harm behaviors, and suicidal ideations.

What is the provider's responsibility if a patient shows romantic intentions?

In situations where a patient develops romantic feelings towards their provider, the latter’s responsibility is clearly defined. Most IOPs have stringent ethics and boundaries policies.

Moreover, according to the New Jersey State Board of Social Work Examiners, social workers are prohibited from engaging in sexual contact with clients within 24 months of service provision. This prohibition extends indefinitely if the former client is vulnerable to emotional or cognitive disorders.

About the expert

This expert is a seasoned Licensed Clinical Social Worker with over 15 years of experience, holding licensure in both New Jersey and Connecticut. They have an extensive academic background, including a BA in Sociology and Religious Studies, an MSW, and a PhD in Social Work from Rutgers University. Their professional journey spans various roles such as senior primary therapist at a women's trauma program, director of research and evaluation at Safe Horizon, faculty advisor of social work at the University of Southern California, and currently serving as a lecturer of social work at a New Jersey university and vice president of population health at an outpatient and supportive housing firm in New Jersey.