Ethics Flashcards
1
Q
HISTORICAL IMPLICATIONS
A
- Cultural history and personal experiences with others
abusing power, taught people to react negatively to behavior
modification - People with more reinforcers (resources) taking advantage of
those with fewer - This term evokes many negative feelings
- Brain washing, ECT, lobotomies
2
Q
TODAY
A
- Behavior modification
- ABA, BT, behavioral analysis, CBT
- Based on idea that
- Behavior can be controlled
- it’s desirable to do so for certain objectives
- Problem is that people misuse these tools
3
Q
BEHAVIORAL VIEW OF ETHICS
A
- Ethics – standards of behavior developed by culture to
promote the survival of that culture - Guidelines are an important source of behavioral control
when immediate reinforcers influence individual to behave
in a way that leads to aversive stimuli for others - When members of the same culture learn to follow the
same ethical guidelines, the guidelines exert rule-governed
control over behavior
4
Q
ARGUMENTS AGAINST
CONTROLLING BEHAVIOR
A
- Because of history and experiences, some have argued
that all attempts to control behavior are unethical - Goal of any social help profession involve change in
behavior and behavior control - It is often necessary to change, manage, influence, or
control behavior - Planned Behavioral modification can be viewed as cold
- But more successful if done with warmth and empathy
- It is necessary to ensure that it is done ethically
5
Q
ETHICAL GUIDELINES
A
- Saying there’s a ‘need to be ethical” doesn’t mean people will
behave ethically - Countercontrol
- Person undergoing behavior mod has affect on the person in charge
- Stop seeing a therapist
- But not everyone has this power
- People engaging exerting modification techniques need to be held
accountable
6
Q
ETHICAL GUIDELINES
2
A
- Organizations that have addressed ethical guidelines involved in
behavior modification - Often in charge of licensing or credentials
- Behavior Analyst Certification Board (BACB)
- International certification body for ABA
- Association for Behavioral and Cognitive Therapies (ABCT)
(formerly, the Association for the Advancement of Behavior
Therapy - Association for Behavior Analysis International (ABAI)
(formerly, ABA) - American Psychological Association (APA)
7
Q
ETHICAL GUIDELINES
3
A
- Based on:
- 1977, Behavior Therapy, publication of set of ethical
questions to ask - 1978, Stolz & Associates, a comprehensive report on
ethical issues involved in behavior modification - 1988, Van Houten et al., The Behavior Analyst, published a
statement of clients’ rights - 2002, American Psychological Association’s Ethical
Principles of Psychologists and Code of Conduct
8
Q
AABT ETHICAL QUESTIONS LIST
A
- Maximum involvement by person whose behavior is to be
changed - Fullest considerations of societal pressures on the person,
the therapist, and therapist’s employer - Settings may require some exceptions but not exceptions to ethical practice
9
Q
A. HAVE THE GOALS OF TREATMENT
BEEN ADEQUATELY CONSIDERED?
A
- To ensure that the goals are explicit, are they written?
* 2. Has the client’s understanding of the goals been assured by
having the client restate them orally or in writing?
* 3. Have the therapist and client agreed on the goals of therapy?
* 4. Will serving the client’s interests be contrary to the interests of
other persons?
* 5. Will serving the client’s immediate interests be contrary to the
client’s long-term interest?
10
Q
B. HAS THE CHOICE OF TREATMENT
METHODS BEEN ADEQUATELY
CONSIDERED?
A
- Does the published literature show the procedure to be the best one
available for that problem?
- Does the published literature show the procedure to be the best one
- If no literature exists regarding the treatment method, is the method
consistent with generally accepted practice?
- If no literature exists regarding the treatment method, is the method
- Has the client been told of alternative procedures that might be preferred
by the client on the basis of significant differences in discomfort, treatment
time, cost, or degree of demonstrated effectiveness?
- Has the client been told of alternative procedures that might be preferred
- If a treatment procedure is publicly, legally, or professionally controversial,
has formal professional consultation been obtained, has the reaction of the
affected segment of the public been adequately considered, and have the
alternative treatment methods been more closely re-examined and
reconsidered?
- If a treatment procedure is publicly, legally, or professionally controversial,
11
Q
C. IS THE CLIENT’S
PARTICIPATION VOLUNTARY?
A
- Have possible sources of coercion on the client’s participation
been considered?
- Have possible sources of coercion on the client’s participation
- If treatment is legally mandated, has the available range of
treatments and therapists been offered?
- If treatment is legally mandated, has the available range of
- Can the client withdraw from treatment without a penalty or
financial loss that exceeds actual clinical costs?
- Can the client withdraw from treatment without a penalty or
12
Q
D. WHEN ANOTHER PERSON OR AN
AGENCY IS EMPOWERED TO ARRANGE
FOR THERAPY, HAVE THE INTERESTS OF
THE SUBORDINATED CLIENT BEEN
SUFFICIENTLY CONSIDERED?
A
- Has the subordinated client been informed of the treatment objectives and
participated in the choice of treatment procedures?
- Has the subordinated client been informed of the treatment objectives and
- Where the subordinated client’s competence to decide is limited, have the
client as well as the guardian participated in the treatment discussions to the
extent that the client’s abilities permit?
- Where the subordinated client’s competence to decide is limited, have the
- If the interests of the subordinated person and the superordinate persons
or agency conflict, have attempts been made to reduce the conflict by dealing
with both interests?
- If the interests of the subordinated person and the superordinate persons
13
Q
E. HAS THE ADEQUACY OF
TREATMENT BEEN EVALUATED?
A
- Have quantitative measures of the problem and its progress
been obtained?
- Have quantitative measures of the problem and its progress
- Have the measures of the problem and its progress been
made available to the client during treatment?
- Have the measures of the problem and its progress been
14
Q
F. HAS THE CONFIDENTIALITY OF
THE TREATMENT RELATIONSHIP
BEEN PROTECTED?
A
- Has the client been told who has access to the records?
- Are records available only to authorized persons?
15
Q
G. DOES THE THERAPIST REFER THE
CLIENTS TO OTHER THERAPISTS
WHEN NECESSARY?
A
- If treatment is unsuccessful, is the client referred to other
therapists?
- If treatment is unsuccessful, is the client referred to other
- Has the client been told that if dissatisfied with the treatment,
referral will be made?
- Has the client been told that if dissatisfied with the treatment,
16
Q
H. IS THE THERAPIST QUALIFIED
TO PROVIDE TREATMENT?
A
- Has the therapist had training or experience in treating problems like
the client’s?
- Has the therapist had training or experience in treating problems like
- If deficits exist in the therapist’s qualifications, has the client been
informed?
- If deficits exist in the therapist’s qualifications, has the client been
- If the therapist is not adequately qualified, is the client referred to other
therapists, or has supervision by a qualified therapist been provided? Is
the client informed of the supervisory relation?
- If the therapist is not adequately qualified, is the client referred to other
- If the treatment is administered by mediators, have the mediators been
adequately supervised by a qualified therapist?
- If the treatment is administered by mediators, have the mediators been
17
Q
ETHICAL CONSIDERATIONS
AGAIN
A
- Qualifications of the Behavior Modifier
- Must receive appropriate training – academic and supervised practical
training - For complex problems or ones with risk, clients have a right to a
doctoral-level analyst or therapist - Procedures being used are the most up-to-date
18
Q
QUALIFICATIONS OF THE
BEHAVIOR MODIFIER
A
- Steps to ensure countercontrol and accountability:
- Supervision by members of ABAI, ABCT, or both
- Various certification bodies, such as the American Board of
Professional Psychology Behavior Analysis Certification
Board - BACB identifies what a behavior analyst can do at each
level of certification and what supervision is needed
19
Q
DEFINITION OF PROBLEM AND
SELECTION OF GOALS
A
- Target behaviors selected must be most important for client
and society - Emphasis on teaching functional, age-appropriate skills
- For those with handicaps, focus on teaching skills that
promote independent functioning - Goals should be consistent with the basic rights of the client
to dignity, privacy, and humane care
20
Q
DEFINITION OF PROBLEM AND
SELECTION OF GOALS
2
A
- Steps to ensure countercontrol and accountability:
- Require behavior modifier to clearly specify his or her values
relating to client’s problems - Ideally consistent with client’s
- APA states therapists shouldn’t try to unnecessarily change
client’s values - Client as an active participant in the selection of goals and
identification of target behaviors - Or competent third parties
21
Q
SELECTION OF TREATMENT
METHOD
A
- Use the most effective, empirically validated methods with the least discomfort
and fewest negative side effects - Use least intrusive and restrictive interventions
- No agreement on a continuum of intrusiveness or restrictiveness
- Interventions based on positive reinforcement considered less intrusive than
interventions based on aversive control - Can use aversion but must be wary of harmful side effects, used as a last resort
- Intrusive and restrictive sometimes refer to
- The extent to which clients are given choices and allowed freedom of movement in a
therapeutic environment - The extent to which consequences are deliberately managed as opposed to naturally
occurring
22
Q
SELECTION OF TREATMENT
METHOD
2
A
- Most effective treatment is based on functional assessment of
causes of problem - If aversive methods may work, need to have countercontrol
- Steps to ensure countercontrol and accountability
- Informed consent
- Explain alternatives, pros/cons, choice
- Behavioral contract
- Ethical review committees
23
Q
RECORD KEEPING AND
ONGOING EVALUATION
A
- Maintenance of accurate data throughout the
program - Behavioral assessment before the program
- Ongoing monitoring of target behavior
- Possible side-effects
- Appropriate follow-up evaluation after treatment
- Confidentiality to be respected at all times
24
Q
RECORD KEEPING AND
ONGOING EVALUATION
2
A
- Steps to ensure countercontrol and
accountability: - Client access to records
- Frequent discussions with client about progress in
the program - Periodic peer evaluation of data
25
Q
ABA & AUTISM
A
- Wolf et al. 1964
- Effectiveness of operant conditioning procedures to decrease
interfering behaviors like tantrums and increase pro-social
behaviors (wearing glasses, bedtime behavior, communication
skills) with a boy who was at risk of vision loss and
institutional placement - Took place while institutionalized at first
26
Q
WOLF ET AL., 1964
A
- Procedure
- Tantrums – mild punishment and extinction
- Placed in his closed room when tantrums began
- Took away social contacts
- Allowed for DRO (diffeerential reinforcement of other behavior) – door opened with non-tantrum
behavior - Bedtime – similar
- Put on schedule: bath, cuddling, put to bed, door open
- Closed door if he had to be told to go back to bed
- Glasses wearing
- Shaping procedure: fake glasses to real glasses
- First few sessions used conditioned reinforcer pairing
clicker with candy or fruit. Click because SD for going to
bowl of food - Also, shaper not well-trained, imprecise
- Candy was a weak reinforcer
- Tried it at breakfast (for deprivation), lunch, ice cream was
the winner - Verbal behavior
- Used breakfast as reinforcer to get mimicking, answering
questions - Maintained with approval after established
- Eating behaviors – no silverware, stealing from
other’s plates, throwing food - Told no, put in his room
- Intervention worked
- 6 month follow up: continued to wear glasses, no
tantrums, sleeping problems, more verbal
27
Q
ABA & AUTISM 2
A
- Many studies and programs used with
autistics/individuals with autism - Considered evidence-based practice (National Autism
Center, 2015) - Effective interventions
- Autism rights & neurodiversity activists expressed
concern - “anti-ABA”, “all ABA is abuse” “Autistic Conversion
Therapy” - Why?
- Historical events
- Lovaas
28
Q
- In the 1960s and 1970s, Ivar Lovaas developed behavioral treatments for children
with ASDs. Using an approach he called early intensive behavioral intervention (EIBI),
Lovaas (1966, 1977) focused on strategies to teach social and play behaviors,
eliminate self-stimulatory behaviors, and develop language skills. When EIBI was
applied to children with ASDs younger than 30 months old and continued until they
reached school age, 50% of those children were able to enter a regular classroom at
the normal school age (Lovaas, 1987). Moreover, the behavioral treatment produced
long-lasting gains (McEachin, Smith, & Lovaas, 1993). - Although some reviewers have criticized the experimental design of the
Lovaas study (e.g., Gresham & MacMillan, 1997; Tews, 2007), subsequent
research has established EIBI as the treatment of choice in terms of both
cost and effectiveness for children with ASDs (Ahearn & Tiger, 2013;
Kodak & Grow, 2011; Matson & Smith, 2008; Matson & Sturmey, 2011). - There are an increasing number of government- funded EIBI programs for children
with ASDs. In Canada, for example, EIBI programs are currently available in all
provinces and territories. For examples of behavior modification with children with
ASDs, see Cox, Virues-Ortega, Julio, & Martin, 2017; Dixon, Peach, & Daar, 2017;
Gerencser, Higbee, Akers, & Contreras, 2017; Johnson, Vladescu, Kodak, & Sidener,
2017; Leaf et al., 2017).
A
- In the 1960s and 1970s, Ivar Lovaas developed behavioral treatments for children
with ASDs. Using an approach he called early intensive behavioral intervention (EIBI),
Lovaas (1966, 1977) focused on strategies to teach social and play behaviors,
eliminate self-stimulatory behaviors, and develop language skills. When EIBI was
applied to children with ASDs younger than 30 months old and continued until they
reached school age, 50% of those children were able to enter a regular classroom at
the normal school age (Lovaas, 1987). Moreover, the behavioral treatment produced
long-lasting gains (McEachin, Smith, & Lovaas, 1993). - Although some reviewers have criticized the experimental design of the
Lovaas study (e.g., Gresham & MacMillan, 1997; Tews, 2007), subsequent
research has established EIBI as the treatment of choice in terms of both
cost and effectiveness for children with ASDs (Ahearn & Tiger, 2013;
Kodak & Grow, 2011; Matson & Smith, 2008; Matson & Sturmey, 2011). - There are an increasing number of government- funded EIBI programs for children
with ASDs. In Canada, for example, EIBI programs are currently available in all
provinces and territories. For examples of behavior modification with children with
ASDs, see Cox, Virues-Ortega, Julio, & Martin, 2017; Dixon, Peach, & Daar, 2017;
Gerencser, Higbee, Akers, & Contreras, 2017; Johnson, Vladescu, Kodak, & Sidener,
2017; Leaf et al., 2017).* In the 1960s and 1970s, Ivar Lovaas developed behavioral treatments for children
with ASDs. Using an approach he called early intensive behavioral intervention (EIBI),
Lovaas (1966, 1977) focused on strategies to teach social and play behaviors,
eliminate self-stimulatory behaviors, and develop language skills. When EIBI was
applied to children with ASDs younger than 30 months old and continued until they
reached school age, 50% of those children were able to enter a regular classroom at
the normal school age (Lovaas, 1987). Moreover, the behavioral treatment produced
long-lasting gains (McEachin, Smith, & Lovaas, 1993). - Although some reviewers have criticized the experimental design of the
Lovaas study (e.g., Gresham & MacMillan, 1997; Tews, 2007), subsequent
research has established EIBI as the treatment of choice in terms of both
cost and effectiveness for children with ASDs (Ahearn & Tiger, 2013;
Kodak & Grow, 2011; Matson & Smith, 2008; Matson & Sturmey, 2011). - There are an increasing number of government- funded EIBI programs for children
with ASDs. In Canada, for example, EIBI programs are currently available in all
provinces and territories. For examples of behavior modification with children with
ASDs, see Cox, Virues-Ortega, Julio, & Martin, 2017; Dixon, Peach, & Daar, 2017;
Gerencser, Higbee, Akers, & Contreras, 2017; Johnson, Vladescu, Kodak, & Sidener,
2017; Leaf et al., 2017).
29
Q
LOVAAS & YOUNG AUTISM
PROJECT
A
- Before this program, assumption that people with ASD were “lost
causes” - Positive reinforcers for desired/”normal” behaviors
- Food, saying “good boy,” and /or giving the child a hug or pat
- Attending to lessons or using spoken language, looking at, the
experimenter upon request. - Also used “aversives”
- Slaps, electric shocks and reprimands
- Self-injurious behaviors, self-stimulating behaviors
30
Q
LOVAAS
A
- “One way to look at the job of helping autistic kids is
you have to construct a person. You have the raw
materials but you have to build the person.” - Worked with grad student Rekers to help with grant
funding for - Feminine Boy project
31
Q
AUTISM & ABA
A
- Current procedures & goals
- Use of aversives like electric shock not used in behavior
modification therapy - But punishment & extinction are
- May lead to side effects
- Doesn’t allow for non-compliance, teaching kids to be
neurotypical, masking - Research hasn’t shown lasting trauma, but these individuals
do report feeling that way
