Section 10: Ethics Flashcards
Ethics and 3 Fundamental Questions
- behaviors, practices, and decisions that address three fundamental questions that guide how you conduct yourself to help others improve their physical, social, psychological, familial, or personal condition
- Ethics is important for furthering the welfare of the client
- 3 Fundamental of Questions of Ethical Pracitce
- 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?
(one of the three fundamental ethical questions)
- considerations related to cultural practices–what may be acceptable in one culture may not be in another
- differences across time–what was acceptable 20 years ago has changed
- Three things to guide you in the decision making process:
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Professional Training and Experience
- your decision making should be based on your clinical/professional training–NOT your personal history
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Personal History
- your indvidual cultural, religious, or social background that should NOT influence your decisions
- you must recognize your personal history may lead to inappropriate solutions– if so, get help from a supervisor OR excuse yourself from the case
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The Context of Practice
- refers to where you practice and the specific nature of the job
- context determines what is legal vs. illegal and ethical vs. unethical
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Professional Training and Experience
Ethics vs. Legality
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 is both illegal and unethical?
- misrepresenting promised services or skills
- stealing from clients
- abuse
- consexual sex under 18
Ethical Codes are:
- 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?
(one of the three fundamental ethical questions)
- Addresses the goals and objectives of practice and focues us to ask the questions:
- what are we trying to accomplish?
- How are we trying to accomplish it?
- is the objective socially valid?
- 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, behavior analyst, and society
- not every skill has social validity
- Ex. teaching a child who cannot see or walk the skills of traffic safety is not socially valid
- ex. teaching an adult with disabilities to play with children’s coloring books is not socially valid
2 Ways to Assess Social Validity
- Social Comparison
- comparison to an equivalent or typically developing group
- limitation- normative data may not be 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- evaluation may be too subjective and not tell us about the success of the interention
What does it mean to be a good behavior analyst?
(one of the three fundamental ethical questions)
- following professional codes of conduct
- keeping the client’s welfare in your ideas
- following the golden rule: do unto others as you would have them do unto you
- a good practitioner is self regulating- seeks ways to calibrate decisions over time to ensure that values, contingencies, and rights and responsibilties are integrated and an informed combination of these is considered
3 Reasons why we abide by ethics
MHS- My hairy sister
- to produce meaningful behavior change of social significance to the client
- to reduce/eliminate harm (e.g. poor treatments, SIB, etc)
- To conform to the ethical standards of learned societies and professional organizations
What are professional standards?
- standards are an umbrella term for everything
- standards are written guidelines that provide a direction for conducting the practices associated with an organization
BACB and the Association for Behavior Analysis
BACB- certifies individual practitioners
Association for Behavior Analysis- accredits university programs
5 Documents Describing Standards of Professional Conduct and Ethical Practice for ABA
TLCEPBT- TLC Eating Peanut Butter Together
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TL - 4th Edition Task List 2015
- describes knowledge, skills, and attributes expected of a BCBA divided into 3 sections
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C - Professional and Ethical Compliance CODE for Behavior Analysts 2016
- replaced The Professional Disciplinary and Ethical Standards AND The Guidelines for Responsible Conduct for Behavior Analysts
- E - The Right to Effective EDUCATION (Association for Behavior Analysis) 1990
- P - Ethical Principles of PSYCHOLOGISTS and Code of Conduct (APA) 2010
- BT- The Right to Effective BEHAVIORAL TREATMENT (Association for Behavior Analysis) 1989
1.0 Responsible Conduct of Behavior Analysts
“Behavior analysts maintain the high standards of behaivor of the profession”
- 01 Reliance on Scientific Knowledge
- 02 Boundaries of Competence
- 03 Maintaining Competence through Professional Development
- 04 Integrity
- 05 Professional and Scientific Relationships
- 06 Multiple Relationships and Conflicts of Interest
- 07 Exploitative Relationships
A behavior analyst refers to an individual who holds the BCBA or BCaBA credential, an individual authorized by the BACB to provide supervison, or a coordinator of a BACB Approved Course Sequence. Where Code elemetns are deemed relevant to the practice of an RBT, the term behavior analyst includes the behavior technician.
1.01 Reliance on Scientific Knowledge
Behavior analysts rely on professionally derived knowledge based on science and behavior analysis when making scientific or professional judgments in human service provision, or when engaging in scholarly or professional endeavors.
1.02 Boundaries of Competence
(a) All behavior analysts provide services, teach, and conduct research only within the boundaries of their competence, defined as being commensurate with their education, training, and supervised experience.
(b) Behavior analysts provide services, teach, or conduct research in new areas (e.g., populations, techniques, behaviors) only after first undertaking appropriate study, training, supervision, and/or consultation from persons who are competent in those areas.
1.03 Maintaining Competence through Professional Development
Behavior analysts maintain knowledge of current scientific and professional information in their areas of practice and undertake ongoing efforts to maintain competence in the skills they use by: reading the appropriate literature, attending conferences and conventions, participating in workshops, obtaining additional coursework, and/or obtaining and maintaining appropriate professional credentials.
CLAC
- C- CEUs
- L- read literature
- A- additional coursework
- C- Conferences/workshops
1.04 Integrity
(a) Behavior analysts are truthful and honest and arrange the environment to promote truthful and honest behavior in others.
(b) Behavior analysts do not implement contingencies that would cause others to engage in fraudulent, illegal, or unethical conduct.
(c) Behavior analysts follow through on obligations, and contractual and professional commitments with high quality work and refrain from making professional commitments they cannot keep.
(d) Behavior analysts’ behavior conforms to the legal and ethical codes of the social and professional community of which they are members.
(e) If behavior analysts’ ethical responsibilities conflict with law or any policy of an organization with which they are affiliated, behavior analysts make known their commitment to this Code and take steps to resolve the conflict in a responsible manner in accordance with law.
1.05 Professional and Scientific Relationships
(a) Behavior analysts provide behavior-analytic services only in the context of a defined, professional, or scientific relationship or role.
(b) When behavior analysts provide behavior-analytic services, they use language that is fully understandable to the recipient of those services while remaining conceptually systematic with the profession of behavior analysis. They provide appropriate information prior to service delivery about the nature of such services and appropriate information later about results and conclusions.
(c) Where differences of age, gender, race, culture, ethnicity, national origin, religion, sexual orientation, disability, language, or socioeconomic status significantly affect behavior analysts’ work concerning particular individuals or groups, behavior analysts obtain the training, experience, consultation, and/or supervision necessary to ensure the competence of their services, or they make appropriate referrals.
(d) In their work-related activities, behavior analysts 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.
(e) Behavior analysts do not knowingly engage in behavior that is harassing or demeaning to persons with whom they interact in their 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.
(f) Behavior analysts recognize that their personal problems and conflicts may interfere with their effectiveness. Behavior analysts refrain from providing services when their personal circumstances may compromise delivering services to the best of their abilities.
1.06 Multiple (Dual) Relationships and COnflicts of Interest
(a) Due to the potentially harmful effects of multiple relationships, behavior analysts avoid multiple relationships.
(b) Behavior analysts must always be sensitive to the potentially harmful effects of multiple relationships. If behavior analysts find that, due to unforeseen factors, a multiple relationship has arisen, they seek to resolve it.
(c) Behavior analysts recognize and inform clients and supervisees about the potential harmful effects of multiple relationships.
(d) Behavior analysts do not accept any gifts from or give any gifts to clients because this constitutes a multiple relationship.
Definition of Multiple Relationship:
one in which a behavior analyst is in both a behavior analytic role and non behavior analytic role simultaneously with a client or someone closely associated with or related to the client
Information on Conflicts of Interest
- 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 unsolicted gifts or invitations to parties
- You must guard against crossing any personal or professional boundaries
- General Rule- when in doubt if a boundary was crossed, consult a supervisor or experienced confidante
1.07 Exploitative Relationships
(a) Behavior analysts do not exploit persons over whom they have supervisory, evaluative, or other authority such as students, supervisees, employees, research participants, and clients.
(b) Behavior analysts do not engage in sexual relationships with clients, students, or supervisees, because such relationships easily impair judgment or become exploitative.
(c) Behavior analysts refrain from any sexual relationships with clients, students, or supervisees, for at least two years after the date the professional relationship has formally ended.
(d) Behavior analysts do not barter for services, unless a written agreement is in place for the barter that is (1) requested by the client or supervisee; (2) customary to the area where services are provided; and (3) fair and commensurate with the value of behavior-analytic services provided.
Definition of a Client
- The term client refers to any recipient or beneficiary of the professional services provided by a behaivor analyst.
- It includes, but is not limited to
- the direct recipient of services
- the parent, relative, legal representative, or legal guardian of the recipient of services
- the employer, agency representattive, institutional representative, or third party contractor for services of the behavior analyst, and/or
- any other individual or entitiy that is a known beneficiary of services or who would normally be construed as a client or client surrogate
- It does NOT include
- third party insurers or payers unless you are hired directly under contract by the third party insurer or payer
2.0 Behavior Analysts’ Responsibility to Clients
Behavior analysts have a responsibility to operate in the best interest of clients.
The term client as used here is broadly applicable to whomever behavior analysts provide services, whether an individual person (service recipient), a parent or guardian of a service recipient, an organizational representative, a public or private organization, a firm, or a corporation.
- 01 Accepting Clients
- 02 Responsibility
- 03 Consultation
- 04 Third-Party Involvement in Services
- 05 Rights and Prerogatives of Clients
- 06 Maintaining Confidentiality
- 07 Maintaining Records
- 08 Disclosures
- 09 Treatment/Intervention Efficacy
- 10 Documenting Professional Work and Research
- 11 Records and Data
- 12 Contracts, Fees, and Financial Arrangements
- 13 Accuracy in Billing Reports
- 14 Referrals and Fees
- 15 Interrupting or Discontinuing Services
2.01 Accepting Clients
Behavior analysts accept as clients only those individuals or entities whose requested services are commensurate with the behavior analysts’ education, training, experience, available resources,
and organizational policies. In lieu of these conditions, behavior analysts must function under the supervision of or in consultation with a behavior analyst whose credentials permit performing such services.
2.02 Responsibility
Behavior analysts’ responsibility is to all parties affected by behavior-analytic services. When multiple parties are involved and could be defined as a client, a hierarchy of parties must be established and communicated from the outset of the defined relationship. Behavior analysts identify and communicate who the primary ultimate beneficiary of services is in any given situation and advocate for his or her best interests.
2.03 Consultation
(a) Behavior analysts arrange for appropriate consultations and referrals based principally on the best interests of their clients, with appropriate consent, and subject to other relevant considerations, including applicable law and contractual obligations.
(b) When indicated and professionally appropriate, behavior analysts 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 their clients.
How to get appropriate consent to make a referral
- inform your client of the referral process
- inform them about the other provider’s qualifications
- provide your client 2 to 3 referrals for them to choose from
2.04 Third Party Involvement in Services
(a) When behavior analysts agree to provide services to a person or entity at the request of a third party, behavior analysts clarify, to the extent feasible and at the outset of the service, the nature of the relationship with each party and any potential conflicts. This clarification includes the role of the behavior analyst (such as therapist, organizational consultant, or expert witness), the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality.
(b) If there is a foreseeable risk of behavior analysts being called upon to perform conflicting roles because of the involvement of a third party, behavior analysts clarify the nature and direction of their responsibilities, keep all parties appropriately informed as matters develop, and resolve the situation in accordance with this Code.
(c) When providing services to a minor or individual who is a member of a protected population at the request of a third party, behavior analysts ensure that the parent or client-surrogate of the ultimate recipient of services is informed of the nature and scope of services to be provided, as well as their right to all service records and data.
(d) Behavior analysts put the client’s care above all others and, should the third party make requirements for services that are contraindicated by the behavior analyst’s recommendations, behavior analysts are obligated to resolve such conflicts in the best interest of the client. If said conflict cannot be resolved, that behavior analyst’s services to the client may be discontinued following appropriate transition.
2.05 Rights and Perogatives of Clients
(a) The rights of the client are paramount and behavior analysts support clients’ legal rights and prerogatives.
(b) Clients and supervisees must be provided, on request, an accurate and current set of the behavior analyst’s credentials.
(c) Permission for electronic recording of interviews and service delivery sessions is secured from clients and relevant staff in all relevant settings. Consent for different uses must be obtained specifically and separately.
(d) Clients and supervisees must be informed of their rights and about procedures to lodge complaints about professional practices of behavior analysts with the employer, appropriate authorities, and the BACB.
(e) Behavior analysts comply with any requirements for criminal background checks.
2.06 Maintaining Confidentiality
(a) Behavior analysts have a primary obligation and take reasonable precautions to protect the confidentiality of those with whom they work or consult, recognizing that confidentiality may be established by law, organizational rules, or professional or scientific relationships.
(b) Behavior analysts discuss confidentiality at the outset of the relationship and thereafter as new circumstances may warrant.
(c) In order to minimize intrusions on privacy, behavior analysts include only information germane to the purpose for which the communication is made in written, oral, and electronic reports, consultations, and other avenues.
(d) Behavior analysts 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.
(e) Behavior analysts must not share or create situations likely to result in the sharing of any identifying information (written, photographic, or video) about current clients and supervisees within social media contexts.
2.07 Maintaining Records
(a) Behavior analysts maintain appropriate confidentiality in creating, storing, accessing, transferring, and disposing of records under their control, whether these are written, automated, electronic, or in any other medium.
(b) Behavior analysts maintain and dispose of records in accordance with applicable laws, regulations, corporate policies, and organizational policies, and in a manner that permits compliance with the requirements of this Code.
2.08 Disclosures
Behavior analysts never disclose confidential information without the consent of the client, except as mandated by law, or where permitted by law for a valid purpose, such as (1) to provide needed professional services to the client, (2) to obtain appropriate professional consultations, (3) to protect the client or others from harm, or (4) to obtain payment for services, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose. Behavior analysts recognize that parameters of consent for disclosure should be acquired at the outset of any defined relationship and is an ongoing procedure throughout the duration of the professional relationship.
CPPS
- Consultation
- Protection
- Payment
- Services
2.09 Treatment/Intervention Efficacy
(a) Clients have a right to effective treatment (i.e., based on the research literature and adapted to the individual client). Behavior analysts 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.
(b) Behavior analysts have the responsibility to advocate for the appropriate amount and level of service provision and oversight required to meet the defined behavior-change program goals.
(c) In those instances where more than one scientifically supported treatment has been established, additional factors may be considered in selecting interventions, including, but not limited to, efficiency and cost-effectiveness, risks and side-effects of the interventions, client preference, and practitioner experience and training.
(d) Behavior analysts review and appraise the effects of any treatments about which they are aware that might impact the goals of the behavior-change program, and their possible impact on the behavior- change program, to the extent possible.
2.10 Documenting Professional Work and Research
(a) Behavior analysts appropriately document their professional work in order to facilitate provision of services later by them or by other professionals, to ensure accountability, and to meet other requirements of organizations or the law.
(b) Behavior analysts have a responsibility to create and maintain documentation in the kind of detail and quality that would be consistent with best practices and the law.
2.11 Records and Data
(a) Behavior analysts create, maintain, disseminate, store, retain, and dispose of records and data relating to their research, practice, and other work in accordance with applicable laws, regulations, and policies; in a manner that permits compliance with the requirements of this Code; and in a manner that allows for appropriate transition of service oversight at any moment in time.
(b) Behavior analysts must retain records and data for at least seven (7) years and as otherwise required by law.
Extra Information on Maintaining Records
- According to the APA Ethical Principles of Pyschologists and Code of Conduct
- 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 fture research, and comply with legal requirements
- a release must be obtained to attain or give records
- record disposal should be complete (shredding)
- According to HIPAA, electronic transmission of confidential records across any unsecured medium is prohibited
2.12 Contracts, Fees, and Financial Arrangements
(a) Prior to the implementation of services, behavior analysts ensure that there is in place a signed contract outlining the responsibilities of all parties, the scope of behavior-analytic services to be provided, and behavior analysts’ obligations under this Code.
(b) As early as is feasible in a professional or scientific relationship, behavior analysts reach an agreement with their clients specifying compensation and billing arrangements.
(c) Behavior analysts’ fee practices are consistent with law and behavior analysts do not misrepresent their fees. If limitations to services can be anticipated because of limitations in funding, this is discussed with the client as early as is feasible.
(d) When funding circumstances change, the financial responsibilities and limits must be revisited with the client.
2.13 Accuracy in Billing Reports
Behavior analysts accurately state the nature of the services provided, the fees or charges, the identity of the provider, relevant outcomes, and other required descriptive data.
2.14 Referrals and Fees
Behavior analysts must not receive or provide money, gifts, or other enticements for any professional referrals. Referrals should include multiple options and be made based on objective determination of the client need and subsequent alignment with the repertoire of the referee. When providing or receiving a referral, the extent of any relationship between the two parties is disclosed to the client.
2.15 Interrupting or Discontinuing Services
(a) Behavior analysts act in the best interests of the client and supervisee to avoid interruption or disruption of service.
(b) Behavior analysts make reasonable and timely efforts for facilitating the continuation of behavior- analytic services in the event of unplanned interruptions (e.g., due to illness, impairment, unavailability, relocation, disruption of funding, disaster).
(c) When entering into employment or contractual relationships, behavior analysts provide for orderly and appropriate resolution of responsibility for services in the event that the employment or contractual relationship ends, with paramount consideration given to the welfare of the ultimate beneficiary of services.
(d) Discontinuation only occurs after efforts to transition have been made. Behavior analysts discontinue a professional relationship in a timely manner when the client:
- (1) no longer needs the service,
- (2) is not benefiting from the service,
- (3) is being harmed by continued service, or
- (4) when the client requests discontinuation.
(e) Behavior analysts do not abandon clients and supervisees. Prior to discontinuation, for whatever reason, behavior analysts:
- discuss service needs,
- provide appropriate pre-termination services,
- suggest alternative service providers as appropriate, and,
- upon consent, take other reasonable steps to facilitate timely transfer of responsibility to another provider.
3.0 Assessing Behavior
Behavior analysts using behavior-analytic assessment techniques do so for purposes that are appropriate given current research.
- 01 Behavior-Analytic Assessment
- 02 Medical Consultation
- 03 Behavior-Analytic Assessment Consent
- 04 Explaining Assessment Results
- 05 Consent-Client Records
3.01 Behavior-Analytic Assessment
(a) Behavior analysts conduct current assessments prior to making recommendations or developing behavior-change programs. The type of assessment used is determined by client’s needs and consent, environmental parameters, and other contextual variables. When behavior analysts are developing a behavior-reduction program, they must first conduct a functional assessment.
(b) Behavior analysts have an obligation to collect and graphically display data, using behavior-analytic conventions, in a manner that allows for decisions and recommendations for behavior-change program development.
3.02 Medical Consultation
Behavior analysts recommend seeking a medical consultation if there is any reasonable possibility that a referred behavior is influenced by medical or biological variables.
3.03 Behavior-Analytic Assessment Consent
(a) Prior to conducting an assessment, behavior analysts must explain to the client the procedure(s) to be used, who will participate, and how the resulting information will be used.
(b) Behavior analysts must obtain the client’s written approval of the assessment procedures before implementing them.
3.04 Explaining Assessment Results
Behavior analysts explain assessment results using language and graphic displays of data that are reasonably understandable to the client.