Exam 1 Review Guide_MHS 4704 S24
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University of South Florida *
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Course
4704
Subject
Philosophy
Date
Apr 3, 2024
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docx
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5
Uploaded by GrandOctopus2447
Instructor: Bryon G. Miller, Ph.D., BCBA-D
MHS 4704:
Ethics in Applied Behavior Analysis
Exam 1 Review: Spring 2024
Exam 1 Ethics In ABA Review Guide
Introduction to Ethics (Lecture, Guided Notes, Study Objectives, B & B Ch. 1)
Be able to describe the differences between Behavior Therapy and Applied Behavior Analysis
Behavior therapy
is typically applied to clinical behavior
, with no universal codification
, and demarcated from psychotherapeutic techniques (focus more on individual’s behavior rather than cognitive thinking)
Applied Behavior Analysis
is applied to clinical and non-clinal behavior
, field has been universal
codified
, and practice is governed by certification and an ethical code of conduct.
Be able to identify/describe “Behavior Units” of the 1970s
They are residential units typically on old veterans’ or tuberculosis hospitals
to serve moderate to severe disabilities and severe problem behavior patients
.
They are institutional settings
. Behavior modifications promised to have dramatic results
and “behavior specialists” were told to “
be creative” (based on their personal opinion rather than base on science)
with their treatment (e.g.: use of restraint, no legal restriction). They have no code of ethics
and limited to no oversight.
Be able to identify/describe the conditions (e.g., staffing/training) that led to the Sunland Training Center, Miami Scandal
1. High staff turnover => understaffed facility and poorly trained
2. Allegations of resident abuse => people would visit loved ones and would see things that looked out of place; investigators looking into the supervising and behavior of the staff
3. Staff are college students
4. Lack of supervison => no feedbacks to improve
Be able to describe the practices and ethical/human rights concerns surrounding of the “Achievement Division” run by “Dr. E”
The practices surrounding the “achievement division” run by DR. E:
-
he presented himself as an expert in Behavior Modification providing “treatment.” o
emphasize “natural consequence of behavior”: if patient assaulted another person, they would get a physical consequence.
o
Unsupervised clients and holding self.
o
devise your own response to problem behavior be creative.
o
do not threaten, follow through on every contingency.
-
Ethic/human rights concerns surrounding of the “Achievement division”
o
He dehumanized and tortured the patients.
o
Forced public masturbation; sexual acts; public shaming.
o
Food and sleep deprivation
o
No privacy, no advocacy, no dignity
o
Soap in mouths
o
Beatings with wooden paddles
o
Forced to sleep with souled underwear.
o
No account of individual behavior
o
Supervisors condoned the “superb behavior modification program.”
Be able to identify/describe the Blue-Ribbon Panel Recommendations
-
Unannounced visits: to ensure places have high quality care.
-
Peer review of behavior programs: make sure behavioral plans are approved.
-
Experimental procedure review: research must be approved before conducted.
-
Prohibition of seclusion and “bizarre” punishment
Core Principles (Lecture, Guided Notes, Study Objectives, B & B Ch. 2)
Be able to identify/describe the 4 core principles
1.
Benefitting others
-
Behavior analysists have an obligation to maximize the benefits of their patient and do no harm to them.
2.
Treat others with compassion, dignity, and respect
-
Behavior analysist must behave towards other with compassion, dignity, and respect. 3.
Behave with integrity
-
Behavior analysts fullfill responsibilities to their scientific and professional communities, to society in general, and to the communities they serve by behaving in an honest and trustworthy manner. 4.
Ensure their competence
-
Behavior analysts should ensure their competence and increase their skills
Be able to provide an example of how each principle can be achieved in practice.
1.
Benefitting others
-
Protect the welfare and rights of clients above all others.
-
Focus on short-term and long-term effects of their professional activities.
-
Effectively and respectfully collaborating with others in the best interest of those with whom
they work and always placing clients’ interest first.
2.
Treat others with compassion, dignity, and respect
-
Treat others equitably, regardless their age, disability, ethnicity, or gender, …
-
Respect other privacy and confidentially
-
Respect and actively promote clients’ self-determination to the best of their abilities
3.
Behave with integrity
-
Behaver in an honest and trustworthy way
-
Not mispresenting themselves
-
Actively work to create to professional environments.
4.
Ensure their competence
-
Being aware of, working within, and continually evaluating the boundaries of their competence
-
Remaining knowledgeable and current about interventions that may exist in their practice areas
-
Remaining current and increasing their knowledge of the best practice
7-Step Model (Lecture, Guided Notes, Study Objectives, B & B CH. 4), 7-Step Model Activity)
What is 7-step model?
Seven-step model is:
o
Used to analyze complex (and not-so-complex) ethical issues.
o
Helps to identify pros/cons of alternative resolutions.
o
Provide a systematic approach in developing a plan of action.
o
Provide a framework for evaluating outcome.
o
Provide a mechanism for documenting ethical concerns related to behavioral services.
Be able to identify the steps involved in the 7-Step model and the purpose of its use.
Seven-step model includes:
o
Step 1: Is the incident covered by the Ethical Code?
Yes: identify relevant codes and proceed
No: discontinue the 7-step model process; caveat = advocate for yourself
o
Step 2: Who are the stakeholders?
BCBA or BCaBA or RBT
The client
The supervisor
The parents
The agency head
o
Step 3: Develop contingencies plans: plan A,B,C
Plans go from least (a) to most restrictive
Contingency plan is a thoughtful and strategic analysis of what to do in the event that your first action was unsuccessful
o
Step 4: Identify skills and clouts
Some skills that are required for dealing with ethical dilemas: assertiveness, leadership, interpersonal communications, client advocate, critical thinking, think function, handling difficult people, performance management, using shaping effectively.
Clout: the influence of position, power and authority to make things happen
o
Step 5: Identify the risk
Identify the risks to client, to yourself, and to all stakeholders
Will the client lose access to service? Could you lose your job?
o
Step 6: Implementation of contingency plan
Time and place to meet
Delivery of plan
Who will be present
Documentation: have in writing what will happen
o
Step 7: Evaluation
Evaluation of the implementation
Keep track of what was done by documenting the process and outcome
Be able to analyze
a provided ethical case or vignette using the 7-Step Model
. This will be similar to how we broke down the example during class and on the activity. This is to say, be
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able to read an ethical case and identify/provide the necessary information for a full analysis using the 7-Step Model
. Ethical Places to Work Part 1 (Lecture, Guided Notes, Study Objectives, B & B Ch. 14, Brodhead et al. (2018a))
Be able describe the importance of asking questions when searching for a new job
It’s important to ask questions when searching for a new job because:
o
You want your personal ethics to align with the company’s ethics.
o
Understanding about the ethics of the company would reduce the likelihood behavior analysts put themselves in a position of violating the BACB code.
o
The ABA organization is more likely to benefit from supporting the BACB Ethics Code
Be able to identify questions an interviewee should ask prior to accepting a new job.
Some example questions should ask prior to accepting a new job:
o
Ethics:
Do you have an ethics committee?
What are procedures for reporting an ethics violation?
o
Supervision:
How do you ensure supervisors are following the ethic code and provide high-
quality training?
o
Caseload:
How will my caseload be determined?
Will I receive support if I state that I am unable to take more cases?
o
Professional development:
Do you support continue education?
o
Evaluating employee performance:
What is the turnover among RBTs and BCBAs?
How do you handle poor performance?
o
Owner/management involvement
Is the owner of the company a BCBA?
o
Company policies and contracts:
Do you have HR department?
Would I have to sign a non-disclosure agreement?
Ethical Places to Work Part 2 (Lecture, Guided Notes, Study Objectives, CEPR (2023))
Be able describe how private equity funds can be both beneficial and detrimental to autism service companies
Private Equity Funds can be beneficial to autism service companies:
o
They want people that understand the system
Private Equity Funds can be detrimental to autism service companies:
o
The autism service companies are at risk in case of a fall out, not the PEs.
o
Increase debt for the autism service company
o
Degraded services
o
Layoffs
o
Furloughs
Be able to identify/describe why private equity firms have targeted autism service companies
Private equity firms have targeted autism service companies because:
o
The more intensive the service, the larger billing opportunities
o
Consolidation gives PE-owned provider organizations a large competitive advantage over for-profit and non-profit providers.
o
Consolidation gives PE firms more bargaining power to negotiate higher rates for themselves.
o
PE firms use financial leverage to extract higher reimbursement under threat of closing sites in less profitable states => “we are the only company left, if you don’t give us our rates, we will shut down all officers”
Be able to identify/describe the negative outcomes of PE firms buying out existing autism providers
Negative outcomes of PE Firms buying out existing autism providers:
o
Firms take control of training and care practices: they don’t know how to have client’s best interest in mind
o
Produce high turnover and ultimate departure from the industry: BCBA’s might burnout from case overload
o
Pressure to bill for more hours
o
Reduces access to services for consumers who require fewer billable service: they might say “you only require 8 hours, so we don wan you because we want someone with more
hours”
o
Reduce salaries for direct providers: to make more money but pay people less
o
Loads the company with massive debt: company will foreclose if debt is too large
o
Organizations will in turn shut down