SPE_567_Discussion_Summary_2

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Owens, S.-CS1 Team Members: Patrick Tyler, Shannon Burress, Stephanie Owens, James Blackman CASE STUDY Number: 2 Ethical Guideline(s) Addressed in this Case: Dilemma #18 (p.338). A. 1.01 Reliance on Scientific Knowledge: “Behavior analysts rely on scientifically and professionally derived knowledge when making scientific or professional judgments in human service provision, or when engaging in scholarly or professional endeavors.” (p. 58) B. 2.04b Consultation: “When indicated and professionally appropriate, behavior analysts cooperate with other professionals in order to serve their clients effectively and appropriately. Behavior analysts recognize that other professions have ethical codes that may differ in their specific requirements from these Guidelines.” (p. 79) C. 2.10a,b, and c Treatment Efficacy: a)”The behavior analyst always has the responsibility to recommend 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” (p. 87) b) “Clients have a right to effective treatment (i.e., based on the research literature and adapted to the individual client).” (p. 87) c) “Behavior analysts are responsible for review and appraisal of likely effects of all alternative treatments, including those provided by other disciplines and no intervention.” (p. 87) D. 4.03 Environmental Conditions that Hamper Implementation: “If environmental conditions hamper implementation of the behavior analytic program, the behavior analyst seeks to eliminate the environmental constraints, or identifies in writing the obstacles to doing so.” (p. 122) E. 4.08 Program Modifications: “The behavior analyst modifies the program on the basis of data.” (p. 126) Resolution: In this case, a 10-year-old girl has been demonstrating multiple behavior problems within her school environment. Her parents took her to a well respected psychologist, who counseled with her outside of school. As a result of the visit, the psychologist has suggested a “point sheet” to motivate the young girl to improve her behavior at school. However, the point system has had minimal effect in motivating her

to act appropriately within the classroom. This is an example of how the environment or a change of environment affects behavior (Steg, 2013). Some intervention strategies may prove to be ineffective in the school setting, yet very effective in the home or a divergent setting (i.e. psychologist’s office) or vice versa. A keen behavior analyst acknowledges these behavior changes and modifies his or her treatment plan with the assistance of parents, teacher, administration, and support staff. Collaborating with professionals trained outside of the behavior analyst realm may be wearisome; however, communication should be conducted humbly, considering the other disciplines, to maximize client benefits. In this case, the behavior analyst should conduct research regarding similar cases and respectfully present the data to the psychologist and the others involved. After observing the client and recording data to determine the effectiveness of the psychologist’s point sheet, the BA should collaborate with the psychologist to determine if the treatment is, in fact, effective. Upon reviewing the results of the study, further discussion between the psychologist and BA should be conducted to reach a mutual agreement on a behavior plan. This example of teamwork will positively affect the client’s family. Being that the family has an established relationship with the psychologist, his/her opinion will be paramount in determining current and future behavior plans. Ethical Guideline(s) Addressed in this Case: Dilemma #21 1.04 Integrity: (a) Behavior analysts are truthful and honest. The behavior analyst follows through on obligations and professional commitments with high quality work and refrains from making professional commitments that he/she cannot keep. (p. 60) 2.02 Accepting Clients: The behavior analyst accepts as clients only those individuals or entities (agencies, firms, etc.) whose behavior problems or requested service are commensurate with the behavior analyst’s education, training, and experience. In lieu of these conditions, the behavior analyst must function under the supervision of or in consultation with a behavior analyst whose credentials permit working with such behavior problems or services. (p. 76) 2.03 Responsibility: The behavior analyst’s responsibility is to all parties affected by behavioral services. (p. 77) 2.04 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. (p. 78) (b) When indicated and professionally appropriate, behavior analysts cooperate with other professionals in order to serve their clients effectively and appropriately. Behavior analysts recognize that other professions have ethical codes that may differ in their specific requirements from these Guidelines. (p.79) 2.10 Treatment Efficacy: (a) The behavior analyst always has the responsibility to recommend 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. (p.87) (b) Clients have a right to effective treatment (i.e., based on the research literature and adapted to the individual client). (p. 87) (c) Behavior analysts are responsible for review and appraisal of likely effects of all alternative treatments, including those provided by other disciplines and no intervention. (p.87) 3.02 Functional Assessment: (a) The behavior analyst conducts a functional assessment, as defined below, to provide the necessary data to develop an effective behavior change program. (p. 112) (b) Functional assessment includes a variety of systematic information-gathering activities regarding factors influencing the occurrence of a behavior (e.g., antecedents, consequences, setting events, or motivating operations) including interview, direct observation, and experimental analysis. (p. 112) 3.03 Explaining Assessment Results: Unless the nature of the relationship is clearly explained to the person being assessed in advance and precludes provision of an explanation of results (such as in some organizational consultation, some screenings, and forensic evaluations), behavior analysts ensure that an explanation of the results is provided using language that is

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reasonably understandable to the person assessed or to another legally authorized person on behalf of the client. Regardless of whether the interpretation is done by the behavior analyst, by assistants, or others, behavior analysts take reasonable steps to ensure that appropriate explanations of results are given. (p. 113) 3.05 Describing Program Objectives: The behavior analyst describes, in writing, the objectives of the behavior change program to the client or client-surrogate (see below) before attempting to implement the program. And to the extent possible, a risk-benefit analysis should be conducted on the procedures to be implemented to reach the objective. (p. 114) 4.01 Describing Conditions for Program Success: The behavior analyst describes to the client or client-surrogate the environmental conditions that are necessary for the program to be effective. (p. 121) 4.02 Environmental Conditions that Preclude Implementation: If environmental conditions preclude implementation of a behavior analytic program, the behavior analyst recommends that other professional assistance (i.e., assessment, consultation or therapeutic intervention by other professionals) be sought. (p. 121) 4.03 Environmental Conditions that Hamper Implementation: If environmental conditions hamper implementation of the behavior analytic program, the behavior analyst seeks to eliminate the environmental constraints, or identifies in writing the obstacles to doing so. (p. 122) 4.07 On-Going Data Collection: The behavior analyst collects data, or asks the client, client-surrogate, or designated others to collect data needed to assess progress within the program. (p. 125) Resolution: Lacking adequate hours to approach services for a child demonstrating several significant challenges is laborious; however, is not an excuse for denying services. The BACB guidelines (2010) makes a BA’s obligation to assist very clear. To ensure the client is receiving the most appropriate form of therapy, the BA will address the child's behaviors one at a time, for the start, and the foreseeable future.

First, the BA will observe, establish baselines, write an FBA, and fulfill all necessary procedures. With the limit of two hours each week, a pro bono assessment may be an option for the BA consider, along with video recording, and other forms of indirect assessment. If the parent(s) or guardian(s) are willing and capable of observation, collecting data, and implementing therapy, they may become a great asset to the program as a whole. Parent / guardian training is essential in maximizing a treatment program stemming from two hours each week for service. One may consider suggesting the use of web resources for training such as the National Professional Development Center on Autism, at http://autismpdc.fpg.unc.edu/node/19. (2015). The BA may refer the client surrogates to state funded training programs or free programs that have become available through local school districts. Along with the parents, and any other interested parties, it may be necessary to research options that would increase the number of hours approved by insurance, or to utilize additional funding sources, such as grant funds, or donations from private sources. Perhaps, other professionals would be willing to contribute their time and services, as well. BCBAs cannot, as a matter of professional ethics, or likely through a personal sense of responsibility, discontinue services. Though the environmental restrictions may prove to be unfeasible, one must consider the potential to improve the lives of their client and his or her family. References: BACB guidelines for responsible conduct for behavior analysts . (2010, June). Retrieved June 3, 2015, from Behavior Analyst Certification Board: http://www.bacb.com/index.php?page=57#2 Steg, L. (2013). Environmental psychology: An introduction . Hoboken, NJ: Wiley- Blackwell. Evidence Based Practices. Retrieved June 4, 2015, from National Professional Development Center on Autism: http://autismpdc.fpg.unc.edu/node/19

SPE_567_Discussion_Summary_2

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