ETHICS Flashcards
ETHICS
-Behaviors, Practices, and Decisions that address 3 fundamental questions that guide how you conduct yourself to help others improve their physical, social, psychological, familial, or personal condition.
Why is Ethics Important?
-To further the welfare of the client.
Three (3) Fundamental Questions of Ethical Practice:
- ) What is the Right Thing to do?
- ) What is Worth Doing?
- ) What does it mean to be a Good Behavior Analyst?
What is the Right Thing to do?
- Considerations related to Cultural Practices. What may be acceptable in one culture is not in another.
- Differences across Time. What may be acceptable 20 years ago is not today.
Things to Help You Guide the Decision-Making Process
- Professional Training and Experience: Your training as a Behavior Analyst should ALWAYS OVERRIDE your personal history.
- Personal History: Your individual cultural, religious, or social background. If you cannot get help or change your behavior (if your personal history is impacting your clinical decision-making process), excuse yourself from the case.
- The context of Practice: Refers to where you practice and the specific nature of the job (e.g., home, school, etc.). Determines what is legal vs. illegal, ethical vs. unethical.
What is both illegal and unethical?
- ) Misrepresenting promised services or skills.
- ) Stealing a client’s belongings.
- ) Abusing a client, physically, emotionally, financially, socially, or sexually.
- ) Engaging in consensual sexual relations with persons under age 18.
What is legal, but unethical?
- ) Breaking a professional confidence.
- ) Accepting valued heirlooms in lieu of payment.
- ) Engaging in consensual sex with a client over the age of 18.
What are Ethical Codes of Behavior?
- Guidelines that specify what IS a violation.
- Guidelines for deciding a course of action or conducting professional duties.
- Guidelines to help to discriminate between legal and ethical distinctions making us more likely to:
- Provide effective services.
- Maintain sensitivity toward clients.
- Not break the law or our professional standards of conduct.
What is Worth Doing?
- Addresses the goals and objectives of practice and forces us to ask the questions:
1. What are we trying to accomplish?
2. How are w trying to accomplish it?
3. Is the objective social valid?
4. What is the Risk-Benefit ratio?
Social Validity
- When results show meaningful, significant, and sustainable change.
- When the goals, procedures, and results of an intervention are socially acceptable to the client, the behavior analyst, and society.
- Not every skill has social validity.
- Social Comparison:
- Comparison of the performance of clients exposed to the intervention with an equivalent or “typically developing” group.
- Limitation: Normative data may not be really relevant for the client’s functioning. - Subjective Evaluation of Experts:
- Evaluation of the client’s performance by experts who are very familiar with the client.
- Limitation: Subjective evaluation of experts may not tell us about the success of an intervention.
Two (2) Ways to Assess Social Validity
What Does it Mean to be a Good Behavior Analyst?
- Following professional codes of conduct (BACB)
- Keeping client’s welfare in your ideas.
The Golden Rule:
- Do unto others as you would have them do unto you.
A Good Practitioner is Self-Regulating
- Seek ways to calibrate decisions over time to ensure that values, contingencies, and rights and responsibilities are integrated and an informed combination of these are considered.
Three (3) Reasons Why we Abide by Ethics: MHS
- MEANINGFUL CHANGE: To produce MEANINGFUL behavior CHANGE of social significance to the client.
Increase the likelihood of appropriate services being rendered to individuals. - HARM: To reduce/eliminate HARM (e.g., poor treatments, SIB, etc.).
- STANDARDS: To conform to the ethical STANDARDS of learned societies and professional organizations.
What Are Professional Standards?
- “Standards” is an umbrella word for everything
- Standards are written guidelines that provide a direction for conducting the practices associated with an organization.
Behavior Analyst Certification Board:
- Certifies individual practitioners.
- In 1999, the BACB started credentialing behaviorists in the US and other countries. The BACB certification is based in Florida’s certification program. It ensures consumers that individual’s specialization is ABA.
Association for Behavior Analysis (ABA)
- Accredits university programs.
Five (5) Documents That Describe Standards of Professional Conduct and Ethical Practice For ABA: TLCEPBT
- ) TASK LIST: The BCBA and BCaBA Behavior Analyst TASK LIST 4th Edition (BACB), 2015.
- ) CODE: Professional and Ethical Compliance CODE for Behavior Analysts (the “CODE”) (BACB), 2016.
- ) EDUCATION: The Right to Effective EDUCATION (Association for Behavior Analysis (ABA)), 1990.
- ) Psychologists: Ethical Principles of PSYCHOLOGISTS and Code of Conduct (American Psychological Association (APA)), 2010.
- ) BEHAVIORAL TREATMENT: The Right to Effective BEHAVIORAL TREATMENT (Association for Behavior Analysis), 1989.
BCBA and BCaBA Behavior Analyst 4th Edition Task List:
- BACB
- Effective Jan 1, 2015.
- Describes knowledge, skills, and attributes expected of a behaviorist.
- Describes numerous tasks across 3 main sections.
BACB
- Effective Jan 1, 2016. All BACB applicants, certificants, and registrants are required to adhere to the Code.
- Most recent revised version: Aug 11, 2015.
- The BACB has consolidated, updated, and replaced 2 of their old ethical documents:
a. The Professional Disciplinary and Ethical Standards (BACB) and
b. The Guidelines for Responsible Conduct for Behavior Analysts (BACB
Professional and Ethical Compliance Code for Behavior Analysts (AKA: The “Code”)
The code has 2 Parts:
- 10 Sections: These are relevant to professional and ethical behavior of behavior analysts.
- Glossary
Defined by the BACB as “ a paraprofessional who practices under the close, ongoing supervision of a BCBA, BCaBA, or FL-CBA (Florida Certified Behavior Analysts)”.
- Main responsibility: the direct implementation of behavior-analytic services.
- The _____ does NOT design interventions or assessment plans.
- To attain the ____ Credential, you must complete 40 hours of training, pass the ____ Competency Assessment, pass the ____ examination, and more as described on the BACB website.
Registered Behavior Technician (RBT)
________ are considered to be already meeting the standards of the BCaBA an RBT.
BCBA
__________ are considered to be already meeting the standards of the RBT.
BCaBA
You maintain the high standards of behavior of the profession.
-The Code’s Definition of Behavior Analyst:
Behavior analyst refers to an individual who holds the BCBA or BCaBA credential, an individual authorized by the BACB to provide supervision, or a coordinator of a BACB Approved Course Sequence.
Where Code elements are deemed relevant to the practice of an RBT, the term “behavior analyst” includes the behavior technician.
1.0 Responsible Conduct of Behavior Analysts.
- You rely on professionally derived knowledge based on science and behavior analysis when making scientific or professional judgments in human service provision, when engaging in scholarly, or professional endeavors.
1.01 Reliance on Scientific Knowledge
A.) You provide services, teach, and conduct research only within the boundaries of your competence, defined as being commensurate with your education, training, and supervised experience.
B.) You provide services, tech, or conduct research in new areas (e.g., population, techniques, behaviors, etc.):
-ONLY AFTER FIRST undertaking appropriate study, training, supervision, and/or consultation from persons who are competent in those areas. (To be competent in new areas, get the right training 1st!).
1.02 Boundaries Of Competence
You MAINTAIN knowledge of current scientific and professional information information in your areas of practice and undertake ongoing efforts to maintain competence in the skills you use.
1.03 Maintaining Competence through Professional Development
Four (4) Methods of Maintaining Professional Competence: CLAC
- CEUS: Maintain your credential with continuing education units (CEUs).
- Literature: Read appropriate literature (most updated evidence-based, peer-reviewed research).
- Additional Coursework: Obtain additional coursework.
- Conference/Workshop: Attend conferences/workshops.
a. ) You are truthful and honest and arrange the environment to promote truthful and honest behavior in others.
b. ) You do not implement contingencies that would cause others to engage in fraudulent, illegal, or unethical conduct.
c. ) You follow through on obligations and contractual and professional commitments with high quality work and refrain from making professional commitments you cannot keep.
d. ) Your behavior conforms to the legal and ethical codes of the social and professional community of which you are a member.
e. ) If your ethical responsibilities conflict with law or any policy of an organization with which you are affiliated, you: Make known your commitment to this Code and take steps to resolve the conflict in a responsible manner in accordance with law.
1.04 Integrity
- ) You provide behavior-analytic services only in the context of a defined, professional, or scientific relationship or role.
- ) When you provide behavior-analytic services, you: Use language that is fully understandable to the recipient of those services while remaining conceptually systematic with the profession of behavior analysis. - Provide appropriate info PRIOR TO service delivery about the nature of such services and appropriate information later about results and conclusions.
- ) If differences of age, gender, race, culture, ethnicity, national origin, religion, sexual orientation, disability, language, or socioeconomic status significantly affect your work concerning particular individuals or groups, you: Obtain the training, experience, consultation, and/or supervision necessary to ensure the competence of your services, or - Make appropriate referrals.
- ) In your work-related activities, you do NOT engage in discrimination against individuals or groups based on age, gender, race, culture, ethnicity, national origin, religion, sexual orientation, disability, language, socioeconomic status, or any basis proscribed by law.
- ) You do not knowingly engage in behavior that is harassing or demeaning to person with whom you interact in your work based on factors, such as those persons’ age, gender, race, culture, ethnicity, national origin, religion, sexual orientation, disability, language, or socioeconomic status, in accordance with law.
- ) You recognize that your personal problems and conflicts may interfere with your effectiveness. You refrain from providing services when your personal circumstances may compromise delivering services to the best of your abilities.
1.05 Professional and Scientific Relationships
1.05 Professional and Scientific Relationships
- Use language easy to understand WHILE ALSO being conceptually systematic.
- Before Service: Give info about nature of service.
- After Service: Give info about results and conclusions.
a. ) Due to the potentially harmful effects of multiple relationships, you avoid multiple relationships.
- The Code’s Definition of Multiple Relationships: A multiple relationship is one in which a behavior analyst is in both a behavior-analytic role and a non-behavior-analytic role simultaneously with a client or someone closely associated or related to the client.
b. ) You must always be sensitive to the potentially harmful effects of multiple relationships. If you find that, due to unforeseen factors, a multiple relationship has arisen, you: Seek to resolve it.
c. ) You recognize and inform clients and supervisees about the potential harmful effects of multiple relationships.
d. ) You do not accept any gifts from or give any gifts to clients because this constitutes a multiple relationship.
1.06 Multiple Relationships and Conflicts of Interests
Multiple Relationships AKA:
Dual Relationships
- When a principal party, alone or in connection with family, friends, or associates, has a vested interest in the outcome of the interaction.
- The relationship is beneficial to the behavior analyst in some way.
- It involves a personal relationship with crossed boundaries, such as unsolicited gifts or invitations to parties.
- You must guard against crossing any personal or professional boundaries.
General Rule: A practitioner in doubt about what is a crossed boundary should consult a supervisor or trusted and experienced confidante.
Extra Information on Conflicts of Interest
a. ) You do not exploit persons over whom you have supervisory, evaluative, or other authority such as STUDENTS, SUPERVISEES, employees, research participants, and CLIENTS.
b. ) You do not engage in sexual relationships with clients, students, or supervisees, because such relationships easily impair judgment or become exploitative.
1.07 Exploitative Relationships
- The Code’s Definition of STUDENT:
A student is an individual who is matriculated at a college/university. This Code applies to the student during formal behavior-analytic instruction.
- The Code’s Definition of SUPERVISEE:
A supervisee is any individual whose behavior-analytic services are overseen by a behavior analyst within the context of a defined, agreed-upon relationship.
The term client refers to any recipient or beneficiary of the professional services provided by a behavior analyst.
- The term includes, but is not limited to:
(a) The direct recipient of services
(b) The parent, relative, legal representative, or legal guardian of the recipient of services
(c) The employer, agency representative, institutional representative, or third-party contractor for services of the behavior analyst, and/or
(d) Any other individual or entity that is a known beneficiary of services or who would normally be constructed as a “client” or “client-surrogate”.
- The Code’s Definition of CLIENT:
For purposes of this definition, the term client does NOT include:
- Third-party insurers or payers, unless you are hired directly under contract by the third-party insurer or payer.
How long do you refrain from any sexual relationships with clients, students, or supervisees:
AT LEAST 2 YEARS AFTER the date that the professional relationship has formally ended.
You do not barter for services, unless a written agreement is in place for the barter that is:
a. ) Requested by the client or supervisee,
b. ) Customary to the area where services are provided, and
c. ) Fair and commensurate with the value of behavior-analytic services provided.
1.) You have a responsibility to operate in the best interest of your clients.
2.) The term, “CLIENT”, as used here is broadly applicable to whomever you provide services, whether a(n):
- Individual person (i.e., service recipient),
- Parent or guardian of a service recipient,
- Organizational representative, and/or
- Public or private organization, a firm, or a
corporation.
2.0 Behavior Analysts’ Responsibility to Clients.
- You accept as clients only those individuals or entities whose requested services are commensurate with your: Education, Training, Experience, Available Resources, and Organizational policies.
- If you do not have the above-mentioned requirements, you: MUST function under the supervision of or in consultation with a behavior analyst whose credentials permit performing such services.
2.01 Accepting Clients
- Your responsibility is to all parties affected by behavior-analytic services.
- When multiple parties are involved and could be defined as a client, you: -Create a HIERARHY of parties and communicate this from the outset of the defined relationship. - Identify and communicate who the primary ultimate beneficiary of services is in any given situation and advocate for his or her best interest.
2.02 Responsibility
a. You arrange for appropriate consultations and referrals based principally on the best interests of your clients, with appropriate consent, and subject to other relevant considerations, including applicable law and contractual obligations.
b. When indicated and professionally appropriate, you cooperate with other professionals, in a manner that is consistent with the philosophical assumptions and principles of behavior analysis, in order to effectively and appropriately serve your clients.
2.03 Consultation
How to get appropriate consent to make a referral from your client:
- ) Inform your client of the referral process.
- ) Inform them about the other providers’ qualifications.
- ) Provide your client 2-3 referrals so client can choose.
When you agree to provide services to a person or entity AT THE REQUEST OF A THIRD PARTY, you:
- Clarify to the extent feasible the nature of your relationship with each party. This clarification includes:
- Your role (e.g., therapist, organizational consultant,
expert witness, etc.),
- The probable uses of the services you provide or
the information you obtain, and
- Any limits to confidentiality
- Any potential conflicts
Do this at the outset of service
2.04 Third-Party Involvement In Services
If there is a FORESEEABLE RISK of you being called upon to perform CONFLICTING ROLES BECAUSE OF A THIRD PARTY, you:
- Clarify the nature and direction of your responsibilities,
- Keep all parties appropriately informed as matters develop, and
- Resolve the situation in accordance with this Code.
-The parent (or client-surrogate) of the recipient of services is informed of:
- The nature and scope of services to be provided
and
- Their right to all service records and data.
-The Code’s Definition of Service Record: A client’s service record includes, but is not limited to, written behavior-change plans, assessments, graphs, raw data, electronic recordings, progress summaries, and written reports.
When providing services to a MINOR (OR INDIVIDUAL WHO IS A MEMBER OF A PROTECTED POPULATION (e.g., those having limited mental capacity or physical capacity, prisoners, etc.) AT THE REQUEST OF A THIRD PARTY, you ensure:
When a THIRD PARTY MAKES REQUESTS for SERVICES THAT GO AGSINST YOUR RECOMMENDATIONS:
- You are obligated to resolve such conflicts in the best interest of your client.
- If the conflict cannot be resolved, you may DISCONTINUE services to your client following an appropriate transition.
-The rights of the client are paramount and you support clients’ legal rights and prerogatives.
- The Code’s Definition of Rights and Prerogatives:
Rights and prerogatives of clients refers to human
rights, legal rights, rights codified within behavior
analysis, and organizational and administrative
rules and regulations designed to benefit the client.
-When clients and supervisees ask, you must provide an accurate and current set of your credentials.
-You comply with any requirements for criminal background checks.
2.05 Rights and Prerogatives of Clients
Permission for electronic recording of interviews and service delivery sessions:
- You secure this from clients and relevant staff in all relevant settings.
- You must obtain consent for different uses specifically and separately.
How clients and supervisees lodge complaints about your professional practices:
- You MUST inform them of their rights and about procedures to lodge complaints with your employer, appropriate authorities, and the BACB.
- You have a primary obligation and take reasonable precautions to protect the confidentiality of those with whom you work or consult, recognizing that confidentiality may be established by law, organizational rules, or professional or scientific relationships.
- You discuss confidentiality at the OUTSET of your relationship and thereafter as NEW CIRCUMSTANCES may warrant.
- You discuss confidential information obtained in clinical or consulting relationships or evaluative data concerning clients, students, research participants, supervisees, and employees, only for appropriate scientific or professional purposes and only with persons clearly concerned with such matters.
2.06 Maintaining Confidentiality
In order to minimize intrusions on privacy, you:
- Include only germane (i.e., relevant) information to the purpose for which the communication is made.
- In written, oral, and electronic reports, consultations, and other avenues.
Social Media Contexts:
You must NOT share (or create situations likely to result in the sharing) any identifying information (written, photographic, or video) about current clients and supervisees in social media contexts (e.g., on Facebook, Twitter, etc.).
Extra Information on Confidentiality That May be on the Exam:
- Confidentiality is an ETHICAL, but also a LEGAL issue in some states.
- In California, it is both. You should find out about your state and/or country’s individual rules.
- When services to a client begins, the limits to confidentiality must be fully explained: -Child abuse, imminent severe harm to another, or imminent severe harm to the person.
- Use specific forms for reporting deliberate breeches in confidentiality.
Why do Breaches of Confidentiality Occur?
-Breaches occur for two (2) main reasons:
1. Intentional: To protect someone from harm.
2. Unintentional: Is the result of carelessness,
neglect, or a misunderstanding of the nature of
confidentiality.
-If uncertain whether confidentiality applies in a certain situation, assume that IT DOES.
-ACTIONS TO PROTECT CONFIDENTIALITY: Requiring passwords on computers, locking files, not transmitting information wirelessly if it is not encrypted, and confirming the person’s status as a surrogate or legal guardian before giving out information about the client.
Maintain Confidentiality When:
Creating, storing, accessing, transferring, and disposing of records under your control, whether these are written, automated, electronic, or in any other medium.
Maintain and dispose of records: -In accordance with laws, regulations, corporate policies, and organizational policies, and in a manner that permits compliance with the requirements of this Code. -Your state and federal laws may be different than other’s about maintaining and disposing records, so stay current and follow your state and federal laws where you reside. -Why? If you are involved in a lawsuit, you need to have records dating back to what’s legally allowable by your state and/or country.
2.07 Maintaining Records
FOUR (4) MANDATED OR PERMITTED LEGAL REASONS WHY YOU WOULD DISCLOSE CONFIDENTIAL INFORMATION WITHOUT CONSENT:
1. CONSULTATION: To obtain appropriate professional CONSULTATION.
2. PROTECT: To PROTECT the client or others from harm.
3. PAYMENT: To obtain PAYMENT for services, in which instance, disclosure is limited to the minimum that is necessary to achieve the purpose.
4. SERVICES: To provide needed professional SERVICES to the individual or organizational client.
- The parameters of consent for disclosure:
Acquire at OUTSET of the relationship and
Is an ONGOING procedure throughout the
professional relationship.
2.08 Disclosures: CPPS
- Clients have a right to EFFECTIVE TREATMENT (i.e., based on the research literature and adapted to the individual client).
- You always have the obligation to advocate for and educate the client about scientifically supported, most-effective treatment procedures.
- Effective treatment procedures have been validated as having both long-term and short-term benefits to clients and society.
- You ADVOCATE for the appropriate amount and level of service and oversight that is needed to meet the behavior-change program goals.
- You review and appraise the effects of any treatments about which you are aware that might impact the goals of the behavior-change program, to the extent possible.
2.09 Treatment/ Intervention Efficacy
When MORE THAN ONE SCIENTIFICALLY SUPPORTED TREATMENT has been established, consider these factors to help you select interventions for your client:
- Efficiency and cost-effectiveness,
- Risks and side-effects of the interventions,
- Client preference, and
- Practitioner experience and training.
-The behavior-change program is a formal, written document that describes in technological detail every assessment and treatment task necessary to achieve stated goals.
The Code’s Definition of Behavior-Change Program
Document your professional work to:
-Facilitate provision of services later by you or by other professionals,
-Ensure accountability, and
-Meet other requirements or organizations or the law.
You create and maintain documentation in the kind of detail and quality that would be consistent with best practices and the law.
2.10 Documenting Professional Work and Research
-You create, maintain, disseminate, store, retain, and dispose of records and data relating to your research, practice, and other work in accordance with applicable laws, regulations, and policies in a manner that permits compliance with this Code and in a manner that allows for appropriate transition of service oversight at any moment in time.
2.11 Records and Data
You must retain records and data for :
AT LEAST 7 YEARS
EXTRA EXTRA INFO ON MAINTAINING RECORDS THAT MAY BE ON THE EXAM
-According to the APA Ethical Principles of Psychologists and Code of Conduct (2010):
- Records must be kept in a secure area.
- Well-maintained records facilitate the provision of future services, meet agency or institutional requirements, ensure accurate billing, allow for future research, and comply with legal requirements.
- A release must be obtained to attain or give records.
- Record disposal should be complete (shredding best).
EXTRA EXTRA INFO ON MAINTAINING RECORDS THAT MAY BE ON THE EXAM
-According to HIPPA:
-Electronic transmission of confidential records across any unsecured medium (e.g., fax lines in public places, email, etc.) is prohibited.
2.12 Contracts, Fees, and Financial Arrangements: BEFORE SERVICE IMPLEMENTATION, you ensure the following is in place:
- A SIGNED CONTRACT outlining the responsibilities of all parties,
- A review of the SCOPE of behavior-analytic services to be provided, and
- Your OBLIGATIONS under this Code.
When do you reach an agreement with your client specifying compensation and billing arrangements:
-As early as is feasible in a professional or scientific relationship.
Your fee practices are consistent with law. You do not misrepresent your fees. - If there may be any funding limitations that could affect or limit your services to your client: Discuss this with your client as early as is feasible.
2.12 Contracts, Fees, and Financial Arrangements
When FUNDING CIRCUMSTANCES CHANGE, you must:
Revisit with your client the financial responsibilities and limits with your client.
When billing for your services, you:
- Accurately state the nature of the services provided,
- The fees or charges,
- The identity of the provider,
- Relevant outcomes, and
- Other required information.
If you give or take any referral, you:
-Must not receive or provide money, gifts, or other enticements.
Referrals should:
-Include MULTIPLE OPTIONS,
-Be based on objective determination of client need, and
-Be based on subsequent alignment with the repertoire of the referee.
You should tell the client about your relationship to the other party if you make or accept a referral.
2.14 Referrals and Fees