All recovery residences provide one or more recovery supportive services (RSS), which are nonprofessional, non-clinical services that assist individuals in achieving long-term recovery from substance use disorders. Research has shown that recovery is facilitated by social support (McLellan et al., 1998), and four types of social support have been identified in the literature (Cobb, 1976; Salzer, 2002).
- Emotional – Demonstrate empathy, caring, or concern to bolster a person’s self-esteem and confidence.
- Informational – Share knowledge and information and/or provide life or vocational skills training.
- Instrumental – Provide concrete assistance to help others accomplish tasks
- Affiliational – Facilitate contacts with other people to promote learning of social and recreational skills, create community, and acquire a sense of belonging.
Sometimes providers and staff mistakenly assume the services they are providing are unregulated. Due to market pressure and requests from parents, referral agents, or funders, recovery residences may unwittingly slide from delivering unregulated services to services that are regulated by local or state laws. This has both legal and ethical ramifications… Examples may include:
- Healthcare, e.g., clinical services
- Money management
- Medication administration
- Food preparation
- Physical trainer
- Many others
Who is delivering the service?
Because so many addiction professionals are also individuals in recovery, a common ethical or legal dilemma occurs when they slip into a dual role, meaning they provide or are perceived as providing nonprofessional recovery support and licensed professional clinical support at the same time, to the same individual or in the same setting. Professional codes of ethics and regulatory requirements may even make it impossible for an individual to take their professional hat off to serve in a purely peer or non-clinical role. During a crisis, they may step out of their peer role into a clinical role, which may have legal and ethical implications.
How is the service marketed or communicated?
Even the perception of staff providing clinical service can cross a legal or ethical line. For example:
- A marketing firm that specialists in addiction treatment take on a nonclinical recovery residence as a new client. They revamp the recovery home’s website using clinical language to describe its services. This is an ethical violation, and it may also be a legal violation.
- A nonclinical recovery residence actively markets that all of its House Managers are licensed counselors, implying that residents will have access to clinical support. This is an ethical violation, and it may also be a legal violation.
What funding is paying for the service?
Even if a service is not generally regulated, the funding you accept may carry restrictions. For example, many states have established credentials for Peer Specialists or Recovery Specialists, and funders may require reimbursed services to be delivered by credentialed and supervised individuals.