Code of Ethics refresh - Tikanga Matatika 2020 - Dapaanz
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ISSN 2624-4926 Spring Edition 2020
FEATURE T TIKANGA MATATIKA S SPOTLIGHT
Real language, real hope 15 Dapaanz new code of ethics 12 Gaming or gambling? 4
Code
of Ethics
refresh
Tikanga Matatika
Spring Edition 2020
E ED I TORI AL
Editorial
Sue Paton, dapaanz ED
Tuhia ki te rangi passion to make a difference, the knowledge, the
wisdom, the skill – all make this gathering unique. It is
the envy of our overseas visitors, who testify that they
Tuhia ki te whenua have never experienced anything like it.
Tuhia ki te ngākau ō A significant milestone for our sector has been the
ngā tangata formal recognition in 2017 of dapaanz-registered
practitioners as health professionals equivalent to
Ko te mea nui those under the Health Practitioners Competence
Assurance Act such as nurses. This is a recognition of
the excellent work and skill of addiction practitioners,
He tāngata, he tāngata, and the credibility of dapaanz registration and
processes.
he tāngata Another highlight was the strong voice we were able
Tihei mauri ora to capture to influence the development of He Ara
Oranga: The Report of the Government Inquiry into
Mental Health and Addiction. The dapaanz submission
to the Inquiry was informed by two surveys – one of
Nau mai haere mai to the Spring members and the other within our networks of those
2020 edition of Addiction Standard. with lived experience. Almost a third of our
membership (465) responded and we received 200
responses from those with lived experience. It is
It is with both joy and sadness I write my final editorial gratifying that dapaanz elicited such a strong
for dapaanz. It has been such a privilege to serve you response, and that this informed our submission and
and the addiction sector during these past five years. I ultimately influenced the recommendations made in
have loved being part of such an amazing workforce. I He Ara Oranga. Its recommendation for a system
have loved working in addictions for the last 27 years centred on individuals and families rather than on
– but never more than my time at dapaanz. services was an excellent outcome.
There have been lots of changes, both for dapaanz As well as that, thanks to Te Ha Oranga’s He Waka
and the broader sector in the past five years – an Eke Noa, I was able to take the Inquiry Panel to meet
exhilarating time to have served in this role and to help with a group of 30 people in early recovery. This
push through some of those changes. I have spent the experience blew the panel away. They heard very
months since I gave notice reflecting on the sector and clearly what worked for these brave people who had
some personal highlights over my five-year tenure. I shared their stories. He mihi nui ki a matua Stu me te
will name a few here. whānau o He Waka Eke Noa mo to koutou awhina me
maia. It is so important that any system change, and
Nothing quite beats the Cutting Edge experience. The service development is informed by those working on
shift in recent years to greater inclusion of the the front line and those with lived experience. It came
indigenous voice and those of lived experience, I across loud and clear that these voices were heard in
believe, has benefitted us all. Conference numbers He Ara Oranga.
continue to increase on a yearly basis – now nearly at
600. I remember back in the day, when I was part of Before the Inquiry into Mental Health and Addiction,
strategic planning for Cutting Edge, there was a dapaanz supported the People’s Mental Health Report,
concern that, if the conference got over 400, we could which prompted the incoming government’s review. A
lose the sense of whānau. I think this concern can now lot of us were advocating for a review of the mental
be put to bed. The sense of connection and whānau, health and addiction system but had got nowhere
the wairua, the haka that sends chills up the spine, the under the National government of that time. It was not
2
E ED I TORI AL
until the People’s Review, initiated by psychologist During the past five years I have seen tremendous
Kyle MacDonald, caught the attention of the incoming change in the thinking in government and in the
Labour coalition government that a comprehensive addiction sector. The sector used to loudly proclaim
review took place. So good to have played a part in ‘treatment works’. We now recognise that treatment is
this! crucial, but wellbeing and recovery are embedded in
the community. The more people are connected and
The Labour coalition government’s focus on wellbeing participating, the stronger their wellbeing and recovery
has been encouraging and exciting after years of will be.
neglect and much pain and suffering for families. A
welcome increase in government funding into the Treatment kickstarts recovery, but it is really important
addiction and mental health system has led to an to have practitioners and peer workforce working in
increase of access to intervention and treatment, and unison if we are going to make meaningful, lasting
to peer roles. changes in the lives of individuals affected by
addiction, their whānau and their wider communities.
Whatever your politics, the Labour Government’s
commitment to grow the addiction workforce means It is, after all, all about connection.
the result of the election will likely bode well for
people affected by addiction and those working with Some of you will be very disappointed about the result
them. I reckon, it is good to make hay while the sun of the Cannabis Referendum. As a parting gesture, I
shines. encourage you to continue to advocate for a health
approach to addiction. Legalisation has failed, but we
know that harms are dramatically reduced under the
The investment already made in addiction and mental Portugal model of decriminalisation. It would great to
health is a good start, but addiction still remains a have a system here which is not dependent on
major health issue for New Zealanders. It is crucial to discretion and includes a wide range of easily
expand both the practitioner and peer workforce. That accessible help, from harm reduction through to
means creating more training opportunities, including intensive treatment.
supporting people with lived experience who choose
to work in the sector on their journey of recovery. You are invited to the AGM and my poroporoaki – to
Dapaanz is advocating, along with others, to Ministers be held 3pm 19 November at Wharewaka, 2 Taranaki
of Health and Education too, increase funded training St, Waterfront, Wellington 6011. At the AGM, we will
opportunities that will lead to jobs and registration. vote to ratify the new code of ethics – Tikanga
Matatika. You can vote prior to the AGM if you are
unable to make it (you will need to have emailed your
A highlight for me personally during my time at vote by 5pm 18 November).
dapaanz was He Hikoi Mātūtū 2019. This recovery
walk was based on overseas examples where people If you are coming to the AGM/Poroporoaki, please
in recovery walking en masse had had some success register on our website or through the link in our email
at tackling the social stigma attached to addiction. signatures. I would love to see you there.
People in recovery are courageous and become
exemplary members of society, although research has Farewell from me for now. Thanks for being an
shown that the public still holds a dim view of these amazing bunch of people to work for and with.
people. It takes affirmative action to address this
misconception. I loved that our hikoi honoured the He aha te mea nui o te ao?
people and the workforce and brought us together in He tangata, he tangata, he tangata.
such a celebratory, uplifting way.
Noho ora mai
We need a movement to change the conversation
about addiction, treatment and recovery by shining a
light on what actually works for people. We hear a lot
about the health and social ills associated with
addiction but not enough about the people, families,
wider whānau and communities who are positively
affected by recovery.
Sue
3
S
Gaming or gambling?
Andrée Froude of the Problem Gambling similarity to gambling comes in. Giving someone a
Foundation looks at a new danger emerging in randomised reward, where wins are delivered
the world of gaming. intermittently, is a very effective way to get someone
to repeat a behaviour.
The world of online gaming has grown exponentially
and is estimated to reach $196 billion in revenue by A recent paper, co-authored by Dr Aaron Drummond,
2022. But with this massive growth has come a Massey’s School of Psychology, and Dr James Sauer,
concerning convergence between gaming and University of Tasmania’s Department of Psychology,
gambling which is changing the way addiction says that adolescents playing video games that offer
practitioners and regulators alike view online gaming. loot boxes could be being exposed to mechanisms
It’s this ‘grey area’ that gambling regulators around the that are psychologically akin to gambling.
world are grappling with, as they face a booming They analysed loot boxes in 22 games rated as
industry of game developers that are increasingly appropriate for audiences 17 years old or younger.
using tactics from the gambling industry to keep This revealed that loot boxes have structural and
people engaged with their games. psychological similarities with gambling and that nearly
half (45 per cent) of the games they analysed met all
As gaming continues to evolve, questions are being five of the psychological criteria to be considered a
raised about whether we are providing enough form of gambling.
consumer protection for online gamers and whether
there is enough public awareness of these
gambling-like mechanisms within games. One gaming
feature being talked about is the loot box (pictured).
Loot boxes can manipulate players into spending
money and they have been linked to harmful
gambling.
Loot boxes are one of the most common features of
many popular games. They have sparked global
debate over whether they constitute gambling and,
therefore, should be regulated.
A loot box is a digital container of random items that
can be used in some video games – items like a new
character outfit, weapon, or special ability. When a Studies around the world have shown a link between
player pays for a loot box with real-world money, they loot boxes and harmful gambling, not only in adults but
are essentially buying the chance to win a desirable in older adolescents, and this relationship was
item, but there’s no guarantee they will get it and, stronger in the older adolescents than the
actually, good items are rare. relationships observed in adults. Several studies found
people with gambling problems tend to spend more
Paying small amounts of real-world money for items on loot boxes than people without gambling problems.
within video games or to gain some kind of advantage The financial stakes can be high. At the extreme end,
is not a new thing – this has been part of games for large sums of money are being spent – up to $1500
years. The big difference is that, in the past, players for a single item.
knew what they would get for their money, but with
loot boxes players are not paying money for One study concluded that the more money that older
something specific; it is entirely random. For example, adolescents (aged between 16 and 18 years) spent on
players of the football game FIFA 19 pay real-world loot boxes, the greater their problem gambling
money to purchase ‘player packs’ that contain new severity. Adolescent problem gamblers spent more
footballers for their teams. These packs may contain than five times as much money on loot boxes than
rare and valuable players that improve their team's those who did not have a problem.
performance, or they may not. That’s where the
4
In 2018, loot boxes were estimated to generate up to What is needed is effective consumer protection
$30 billion, with this amount predicted to rise to $50 measures including warnings on games that include
billion by 2022. loot boxes and other gambling-like elements, banning
of games that have gambling characteristics, and
In New Zealand, loot boxes do not constitute encouraging game developers to not put those
gambling, according to the Department of Internal elements in their games.
Affairs (DIA), as they don’t fit the ‘legal definition’ of
gambling. Other countries don’t agree; some types of While we wait for the outcome of the Government’s
loot boxes are banned in Belgium and the review, the focus has been on raising awareness of
Netherlands. the issue.
DIA’s Public Discussion Document, released as part of PGF Group partnered with the Classification Office to
its review of online gambling (including gaming), states develop an animated video explaining loot boxes and
that there are limits to what gambling regulators can the risks associated with them. The video, along with a
do, as New Zealand law is unenforceable overseas comprehensive FAQ and a downloadable guide for
and the issue cuts across several other portfolio parents and whanau, is available on the Problem
interests (including Classification, Children, Consumer Gambling Foundation website
Affairs, Health and Social Development). https://www.pgf.nz/lootboxes.html
Photos: CARA NAJAR
Treating addiction using holistic
model Te Whare Tapa Whā
‘Kororia ki te Atua, he maungārongo ki runga i te
whenua, he whakaaro pai ki ngā iwi katoa’ The Wellington Tenths Trust is the organisation which
‘Peace on Earth and goodwill to all people’ represents the Iwi Mana Whenua, Te Ati Awa of
These were the words and teachings of Te Wellington and the Hutt Valley. “As mana whenua, we
Whiti-o-Rongomai and Tohu Kākahi of Parihaka,
are the kaitiaki. As kaitiaki, we manaaki and tautoko
symbolised by the Raukura and the Pore
our manuhiri who reside in our rohe.”
Nga Tekau is a kaupapa Māori AOD Service based in
Manaakitanga is an aspect of importance. First
Petone, Lower Hutt.
meetings with clients begin with a mihi whakatau,
The vision began from the call of the people
karakia, whakawhanaungatanga. Personal
The challenge was taken up
introductions (observance of the rituals of
The service began with one sole person as the
engagement) are important, says Gilbert.
kaiāwhina/counsellor, Pauline Owen (1996)
In this initial engagement, Gilbert says, you are seeing
Todays’ counsellors, Gilbert Douglas and Lena
if you are suited to each other. “Within this process,
Leatherby, use a holistic approach incorporating Te
you have broken the ice, so to speak, and can then
Whare Tapa Whā: taha whānau, taha tinana, taha
get on to the kaupapa of the treatment.”
hinengaro and taha wairua. They treat the whole
person in the context of their whakapapa connections,
and with respect, maintaining their mana.
6
Gilbert and Lena’s counselling process with whai ora is Sometimes, young Māori women don’t want to take
to try to find the whole person. Some lost souls arrive medication because they are frightened and don’t
not knowing who they are, so Nga Tekau, if able to, understand it. Nga Tekau staff can help them
helps them with tracing their whakapapa, which helps understand what’s happening to them, that it’s anxiety,
so much with their sense of identity. or their depression that’s making them feel so terrible.
Often, as a result of the generational fall-out from Gilbert appreciates the fact that their offices are
urban drift after World War II, some clients may not situated on the shore of Te Whanganui-a-Tara. “An
have had a lot to do with their marae and kainga. ideal place to be, by the moana.” On a sunny day, he
Sometimes a gentle probing to remember where they will often take a client down to the water’s edge where
went for holidays as kids, or maybe songs they know, they will sit on a log and continue their korero there,
can tie them back to an area. Nga Tekau might find near Tangaroa. It’s a calming thing.
connections by asking around the various marae in the
area. “The kumara vine can be very helpful. There’s Most whai ora Gilbert and Lena see are referred from
always someone who knew someone’s aunty.” Corrections, but they also get referrals by word of
mouth, from local marae, through other service
Māori clients often experience different ways of being. providers, or through local GPs who know of Nga
Gilbert recalls, during his time on the CATT team, a Tekau’s kaupapa practice and realise it would be a
young man waiting to be assessed had been put in a good fit for certain clients of theirs. The Nga Tekau
room to be interviewed. The staff thought he was team also get walk-ins, and have helped Pākehā and
‘acting out in a dangerous manner’ and were wary. other New Zealanders as well.
Gilbert asked to go in to the room, but was warned the
man was getting physical, gesticulating wildly in a Nga Tekau has a collaborative approach with other
threatening manner. Gilbert went in. He recognised providers with AOD components, for example the City
the tane was doing his haka. Gilbert acknowledged Mission runs a transitional accommodation for men in
the haka, recognising it, and was able to connect to Petone, called The Pa, and will cross-refer. However,
the young man while keeping the young man’s mana Gilbert and Lena do wonder whether some people
intact. who would really benefit from their kaupapa are falling
through the net and not getting referred to them,
instead being sent on to mainstream services. They
would like all those whai ora to be offered the choice
of Nga Tekau.
On a sunny day, Gilbert will often take a client down to the water’s edge where they will sit on a log and continue their korero there, near Tangaroa. It’s a calming thing.
We need to talk about Anna
Anna perches nervously on her sofa, slender arms It is estimated that about 75% of New Zealand adults
wrapped around long limbs. She twists herself drink alcohol and, according to the Ministry of Health,
effortlessly into a human knot. Her long hair is tied one in five adults drinks in a way that could harm
back in a messy half-pony-half-bun. Everything about themselves or others.
Anna is long. She speaks with tones of sadness. She
speaks of hope. Often ricocheting between the two, Manawatu clinical psychologist Dr Jodi Field, who
Anna chats about her love for her child. She talks with works in alcohol addiction, says stigma creates
passion about her work. Life-affirming quotes are barriers to transparency. “People often believe they
framed and dotted around her place. There’s no will be judged negatively because of their addiction.
escaping them. As a lover of words myself and familiar They are reluctant to seek support or disclose the
with the power they hold, I find myself drawn to them. severity of their addiction.”
Anna has a positive attitude. Anna has a bleak outlook.
Once an athlete at national level, she now sweats it Hiding the truth of the problem is common. Hiding
out in a different arena. An arena no one wants to play bottles. Drinking in secret. “As a result, the addiction
in, especially Anna. That arena is alcohol addiction. worsens and attempts to hide the extent of the
problem can increase.”
Most people know someone struggling with alcohol
dependency. Addiction does not discriminate. It can Many drink to soothe a pain. To fill a hole in the soul.
seep its way into the lives of people of all ages, races Countless people self-medicate anxiety and
and backgrounds. It cares not. And there is a silent depression with various substances. Alcohol does
assassin working furiously alongside addiction. That numb and dull the senses. It quiets a turbulent mind
assassin is stigma. Stigma is another word for too. Until it doesn’t. The anxiety often returns with a
discrimination. In the 16th century, ‘stigma’ described vengeance 100 times worse than before.
the mark left by a burning hot iron used on the skin of
criminals. The mark of shame. For some people, when they try to reduce their alcohol
intake, physical withdrawal symptoms may kick in –
In our society today, there is social stigma attached to anything from severe shakes and sweating to seizures.
alcohol dependency. Dependent drinkers are often The withdrawal from alcohol can be dangerous and
thought of with disgust and embarrassment. There is sometimes fatal. There is often a heightened anxiety.
an impression of disgrace. This societal attitude The drinker is now in the depths of a living hell. And
induces shame and self-loathing in the person now, the experienced stigma, which has been biding
suffering from the dependency. its time, can turn in on the sufferer and it becomes
‘self-stigma’.
All too often problem drinking is swept under the rug.
It is regarded as a private matter. This attitude creates Self-stigma is something Anna is all too familiar with. It
a barrier to the person with an alcohol problem getting is the internalising of public prejudice and
help. The stigma tells the problem drinker: ‘What a discrimination. It’s housing those stories in your head
piece of shit you are. You’re a loser. You’re weak and and then accepting them as truth. It is self-loathing,
worthless. Why can’t you sort yourself out? It’s easy, shame, humiliation and severe anxiety. It is often
just don’t drink!’ self-harm. Anna speaks about the nights she’s spent
rocking back and forth in a foetal position, vomiting on
However, if it were that easy, we wouldn’t have the carpet. All night. Longing for the comfort and
600-800 New Zealanders dying annually from escape that sleep can offer.
alcohol-related causes. Alcohol can kill. Stigma can kill.
Alcohol is one of the the most commonly used ‘drugs’
in New Zealand. It is freely available. Anna buys her
wine online. It is delivered in brown paper bags, a nod
to the stereotype.
8
We might be dealing with mental health issues more openly these days but there’s still an elephant or two in the room. Jeanna Thomson says we need to talk about addiction and stigma. Photo: CARA NAJAR Winter Edition 2020 9
And so it begins, the paying of penance for her crimes. She says she has occasionally experienced judgement
The shame. Holed up in her room for weeks on end, within some recovery circles, a place you would least
Anna remains unaware of the day or time. Sucking expect it. And she has had mixed experience seeking
back the wine, desperate to subdue the shaking. help at emergency departments (ED). Presenting with
Sitting on the shower floor trying to disentangle hair severe alcohol withdrawal, she has sometimes felt
that’s remained unwashed for weeks. Then, instead, discrimination. On an admission for a medicalised
ripping it out in chunks. Pulling and pulling, until it lies detox, Anna describes hearing the voices of staff
in a sorry, soggy mess. This ritual may continue in spite talking and laughing about her. She’s unable to
of the pain because Anna may think she deserves it. A advocate for herself. Other times she says she has
kind of atonement. Why does she not reach out for been sent away, only to go home and drink more.
help? Anna no longer goes to ED. And Anna is not alone.
Many people with addiction have had similar
Anna has reached out for help many times and with experiences. A few have reported being sent away
mixed results. She has long been engaged with with the message to ‘try harder’.
specialised addiction counsellors. People she
attributes “her life” to. She has sober connections too, This message needs to change, and it is, slowly. Many
and friends who support her. When asked, Anna tells organisations are working hard to advocate for a
others she is “okay”, “really good”. She commands a systemic shift. One such group working to end
convincing façade. A popular and happy mother of a discrimination, promote recovery, inclusion and
small child. Work’s going great guns. Many accept this. respect is World of Difference. World of Difference is a
Although it’s largely untrue. Anna may even be fooling service user education and research group. Funded by
herself. Few smell a rat! the Health Promotion Agency as part of Like Minds,
Like Mine, the programme works with police and
healthcare providers.
“If people Dr Sarah Gordon, founder of the programme, had this
experience unfair
to say: “We live in a world where we are treated
differently – disabled by prejudice, discrimination and
social exclusion in response to our experiences of
treatment when
mental distress. Our goal is to contribute to creating a
different world, one where our experiences of mental
distress are recognised as an element of natural
accessing help, human difference. Of diversity. And it is no barrier to
us being able to experience recovery, inclusion, and to
they are less likely
exercise our human rights.
“At its most basic, the impact of stereotypes and
to seek and prejudice is discrimination – unfair treatment. It often
results in social exclusion where individuals are denied
engage with help
opportunities (including housing and employment) that
are available to others. This can impinge negatively on
a person's ability to recover and live well.”
in the future. We
Recovery, to restore. A journey of growth and
transformation. This takes solid work that can span a
lifetime. It can be made difficult in a climate of negative
need to reduce the stigma around alcohol addiction.
discrimination
Dr Field says that certain sectors of society believe
that people having problems with alcohol have
brought it upon themselves. “This is created by
people experience.” viewing the problem in terms of the observed
behaviour, rather than the function of the behaviour.”
Learning about trauma a person has experienced can
help in understanding why a person drinks.
10Alcohol addiction is often portrayed in popular culture
as moral weakness. The brown paper bag and the “The commentary
park bench cliché. Unsurprisingly, the biggest judge
can be the troubled person’s internal critic. Meanwhile, around being treated
Anna continues to drink. Anna wants to drink. Having
fallen so far down the scale, she may feel it’s the only poorly and seen as a
choice left. A new narrative is needed.
‘junkie’ or ’drunk’ is
Dr Gordon sums it up: “If people experience unfair
treatment when accessing help, they are less likely to something that I hear
seek and engage with help in the future. We need to
reduce the discrimination people experience. This is all too often.”
going to involve a collective, concerted effort on the
part of our whole community. At the most basic level, it
is about everyone being aware of the issue, then It is our responsibility to challenge and change the
acknowledging that it is not okay. It is about stigma surrounding addiction. As psychologist and
programmes such as the World of Difference being author Brene Brown says: “If you place shame in a
extensively implemented in order to shift the attitudes petri dish, it will flourish and feed on secrecy, silence
and effect sustainable, inclusive behaviours of those in and judgement. If you douse it with empathy, it cannot
the helping professions.” survive.” Anna drowns in her own petri dish of lies. She
is a master of secrecy and adept in silence. No one
If we introduce compassion and connection into our has a true idea of just how much she drinks. Anna has
communities, we will be putting a foot in the right created the perfect environment for the petri dish to
direction. Compassion can counter shame. Connection thrive. Isolation.
will override isolation. Empathy should replace
judgment. Whenever I travel up the coast to meet up with Anna,
we hug. Anna wraps her long limbs around me as if I
Empathy, sharing the feelings of others. The ability to were winching her out of a hole. hanging on for her
put ourselves in someone else’s shoes. To walk dear and delicate life. Eventually we unfold from our
alongside someone on their journey of recovery. Anna human knot. Anna gracefully assumes her wrapped-up
wishes others could experience her reality, even just pose, arms like tendrils quietly resuming their clasp
for an hour. Just to understand it. To slip into her around her sinewy body. Everything about Anna is
shoes. long. Except her life. Anna is now dead.
Dr Field agrees: “Once a person accesses help, they Anna will not turn 40. Alcohol has stolen her life.
can find empathy, support, and compassion. It’s Stigma has been there to assist. I could wax lyrical
incredibly valuable to recognise the courage it takes about all the life events she is now denied, but I don’t
for people to seek help. They have often had to work need to, you can imagine. This is not an article on how
through the idea of being judged for having an we could have saved Anna. Many tried. This is about
addiction. There’s a tendency for certain sectors of examining the things that kept her stuck in that
society to view addiction through the lens of tortured place. Anna could be anyone. It is about
criminality”, not recognising it’s a health problem – one looking honestly into our judgments and beliefs
to be treated with compassion. around addiction and mental health. This is about
being accountable for the part we play, big or small in
“Sadly,” Dr Field says, “the commentary around being the conveyance of shame. It’s learning from the past to
treated poorly and seen as a ‘junkie’ or ’drunk’ is minimise the chance of this happening again. It’s about
something that I hear all too often.” lifting up the rug and confronting what lies beneath.
Spring Edition 2020 11T TIKANGA MATATIKA
Tikanga Matatika – dapaanz
new Code of Ethics
During 2019/20 dapaanz went through a process of A key step in this update was incorporating tikanga
reviewing and revising our Code of Ethics (the Māori into the principles and provisions of the Code to
Code). This is the second revision of the Code better support equity for whānau Māori; also, to ensure
since its initial publication, and this version (once the Code was reflective of the growing diversity of the
ratified at the AGM) will supersede previous
sector and relevant to the whole workforce,
versions.
specifically to practitioners and peer workers.
Dapaanz chose to review the Code in recognition that
Process of revising the Code
systems of health and social care in Aotearoa are
A representative advisory group guided development
undergoing significant change. There is growing
Partners in the process: Te Pou and Te Rau Ora
emphasis on wellbeing and equity, and greater access
Survey of membership for feedback on the draft.
to, and choice of, care. Alongside this, the make-up of
the addiction workforce has become increasingly
Vision for the Code of Ethics
diverse and continues to evolve.
The advisory group developed this vision for the Code:
underpinned
by tikanga
Māori
supports
excellent
fit for
service for
purpose
the person &
dapaanz whānau
code of
ethics
inclusive of
helps us, the
whole
workforce. do
addiction
a good job
workforce
12What is different about the new Here are some examples of the
code / what is the intent? changes in the Code:
1. A unified code Example 1.
The make-up of the workforce has changed since the The three domains in the code are:
Code was last revised. The revised Code applies Manaaki: A key guiding question is: how did the
across the workforce – not just to those in clinical behaviour or practice of the dapaanz member impact
roles. on the mana of others?
The intent in the revised Code is that everyone signing Pono: A key guiding question is: did the dapaanz
up to be a member of dapaanz can comply with the member do right for the right reason?
Code. The Code conveys that all those in the
workforce are valued equally. Pūkenga ahurea: A key guiding question is: is the
dapaanz member applying their knowledge skilfully,
This helps us: working to the top of their scope and seeking
To support the whole addiction workforce continuous improvement?
Ensure the Code is fit for purpose
Support excellence for all our workforce. Example 2.
Mana
So what does this look like in the Code? A dapaanz member: Works to protect and enhance the
There is an emphasis on shared principles that apply mana of every person.
across roles, disciplines and working contexts.
Respects that, for many cultures, wellbeing is
The language in the Code works for everyone – so, for embedded in and connected to family identity or
example, we have used ‘person’ and ‘whānau’ where collective identity, rather than individual identity.
the original Code used ‘client’; we have used ‘dapaanz
member’ where the original used ‘practitioner’. Acknowledges and upholds the principles of active
protection and options when working with Māori.
The provisions of the Code apply to any role. Upholds the rights of Māori to access care and
services centred or aligned in te ao Māori and that
2. Tikanga Māori contribute to whānau ora.
The revised code is infused with tikanga Māori. There
are Māori values and Māori ways reflected through the
code. There is lots of te reo Māori. 3. Balances principles with rules
This helps us The intent in the Code is to be principles-based. An
- To fulfil our Tiriti o Waitangi obligations emphasis on principles supports flexibility, applies
- To do a good job more readily in considering complex issues and
- To support equity for Māori discourages a tick box approach to adherence.
- Demonstrate excellence.
There are still some ‘rules’ in the Code. Eg, complying
with laws; the 2-year rule about inappropriate
relationships.
4. Reflects current best practice
The revised code has been brought up to date to
reflect changes in practice. Items 1 and 2 above are
part of this. The focus on partnership and wellbeing
throughout the code are further examples.
This helps us:
Ensure the Code is fit for purpose.
Do a good job.
Spring Edition 2020 13Here is one example:
Current code Whenever possible, clients should be
the usual primary source of information about
themselves and their own issues.
Revised code Mana motuhake / autonomy
Works in partnership with individuals, whānau and
communities, respecting people’s interpretation of
their own experience.
5. The ethical decision-making guide has been
updated
The key change here is to provide more guidance and
to cue members to seek support and collaborate with
others when making ethical decisions.
What are the implications?
The revised Code states:
In joining dapaanz, members agree to:
Own the Code: identify with the values and
ethical principles reflected in the Code and
acknowledge these as shared with other
dapaanz members.
Use the Code: take responsibility for
understanding and acting in ways that uphold
the values and principles set out in the Code. This Code is openly aspirational – so the expectation
is that all members will aspire to comply with the Code
Be held to the Code: commit to the Code as a and can, if needed, demonstrate that they are doing
framework for evaluating and regulating their this.
practice.
A further implication is that you can expect all your
fellow dapaanz members to do the same, regardless
of role.
Percentagegrowth
Percentage growth
in in Maori
Maori Members
Members overover
the the
pastpast 4 years
4 years
30 Ethical principles don’t change much – how we
26
articulate them and how we expect them to be
25 24.5 demonstrated can change.
21
20
20
The biggest shift in the revised Code is more explicit
reference to obligations under Te Tiriti o Waitangi and
15 the codification of these in the provisions of the Code
as ethical requirements for dapaanz members.
10
Your responsibility as a dapaanz member is to engage
5 with this Code, reflect on it, seek to understand it – if
there are aspects you don’t understand, then this is an
0
2017 2018 2019 2020
opportunity to learn and develop your practice.
Dapaanz is pleased to be able to report a growth in
numbers of our Māori membership.
14F FEATURE
Real language,
real hope
Adapted by Caro Swanson, service user lead, from DO NOT describe people as their label or diagnosis.
‘Recovery Language’ by Otto Wahl Say, for example, “person who experiences psychosis”
rather than “schizophrenic.” We are people NOT a set
Language reflects our beliefs and the way we view of symptoms or a disease. Schizophrenia is
people. We are often unaware of the impact that the increasingly seen as a negative label that has been
words we choose can have on our own attitude as well sensationalised and overused. A more generic
as on those around us. “person who has experience of psychosis” or
“alternate reality” is more acceptable.
The way we speak to and about people is a window
into what we are really thinking. Communication is a DO emphasise abilities, not limitations. Terms that are
highly complex thing. The words we choose can patronising, “othering” (them, those people etc.) or
convey the fact we truly value people – we believe in condescending must be avoided.
them – and we genuinely respect them. Or, the words
we choose can make it clear we do not. DO focus on what is strong instead of what is
wrong.
People who experience mental health and/or addiction
problems can feel and be put down, discouraged, The most respectful way to refer to people is
demoralized, and marginalized. People can either as people.
reinforce that with the language they choose or they
can fight it. Whenever possible, use the person’s name.
None of us should be defined or limited by our There are times when other language has to
challenges, labels or diagnoses, or by a single aspect be used, particularly when putting things into
of who we are. We are people first and foremost. writing.
Consider this… Conveying respect
DO NOT portray successful people who experience
mental health and/or addiction problems as Some options you can use that still convey respect are
super-humans or special. This carries the assumption noted below.
it is rare for people who live with these problems to do
great things. It is also patronising to those who make When referring to a group of people
various achievements. Think about what you’re trying to say about the group
– who is it you are defining?
DO NOT sensationalise mental health and addiction
experience. This means not using terms such as Are you referring to people with experience of mental
“afflicted with,” “suffers from,” “victim of,” and so health or addiction problems?
on.These terms create and convey a sense of
helplessness and victimhood that negate the positive Individuals who experience mental health or
experiences, growth and powerful learning that addiction problems.
experiencing these challenges offer people.
15People who experience mental health or Sione has experience of mental distress.
addiction problems. That someone receives services at your agency?
Are you referring to people who are using Joshua receives services at our agency.
mental health services?
Natalie is one of the people we serve.
Service users.
That someone has a specific diagnosis?
People receiving mental health services.
Alice experiences bipolar disorder.
People being served by the mental health
system. Nick experiences depression.
When referring to an individual How about not using labels at
all?
Again, what is it you are trying to convey?
That someone experiences mental health and/or
addiction problems? Samples of recovery language
The following are some of the terms we have
Ian is working on his recovery. traditionally used to describe people and/or their
behaviours. These terms place judgment and blame
Cathy experiences addiction issues. on the individual and generalise their actions. It is
more helpful to describe the specific situation a person
Manu has lived experience of mental health is facing than to use generic and punitive clinical
problems. terms.
Spring Edition 2020 16Language that promotes acceptance, Worn out language respect and uniqueness Comments 17
Language that promotes acceptance, Worn out language respect and uniqueness Comments
Language that promotes acceptance, Worn out language respect and uniqueness Comments 19
Notice Board AGM/poroporoaki The AGM and poroporoaki for Executive Director Sue Paton to be held 3pm 19 November at Wharewaka, 2 Taranaki St, Waterfront, Wellington 6011. At the AGM, members will vote to ratify the new code of ethics – Tikanga Matatika. You can vote prior to the AGM if you are unable to make it (you will need to have emailed your vote by 5pm 18 November). If you are coming to the AGM/poroporoaki, please register on our website or through the link in our email signatures
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