Oluwadamilola_Adekunle_Psy7710

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1 Risk and Benefits Analysis. Oluwadamilola Adekunle Capella University PSY. 7710 SEP. 2023.

2 To the family of Juan, I hope this letter finds you well. I am writing to discuss the current situation involving your grandfather, Juan, who is residing in the nursing home and is diagnosed with Alzheimer's disease. I have been consulted regarding his care and the challenging behaviors he has been exhibiting. I have conducted a thorough analysis using Bailey and Burch's (2016) risk-benefit analysis model to assess the proposed behavior analytic procedure and provide recommendations. Attached to this letter, you will find a copy of the Risk-Benefit Analysis Worksheet I used to guide my assessment. The purpose of the risk assessment is to examine the risks and benefits of a specific applied behavior analysis procedure. The applied behavior analysis procedure that was decided to be used is the Differential Reinforcement of other behavior, also referred to as DRO. Differential Reinforcement of Other Behavior (DRO) is a behavior modification technique that involves reinforcing or rewarding any behavior other than the target behavior you want to reduce or eliminate. It aims to decrease the occurrence of the undesired behavior by reinforcing alternative, desirable behaviors. (Cooper et al. (2020) In hopes that Juan can display alternate behaviors, he will be reinforced with rewards for his positive actions. This will hopefully lead to a decrease in the target. As a Board-Certified Behavior Analyst, I recommend conducting a Functional Behavior Assessment on Juan before beginning this ABA procedure. With every fresh start, certain apprehensions naturally arise. My purpose is to address these concerns and assure you that both our team and the facility are fully committed to providing the highest standards of care for Juan. According to the Behavior Analyst Certification Board, also known as the BACB, there are several ethical codes that I want to emphasize our commitment to as Juan's family. These

3 ethical codes are essential for ensuring Juan's well-being and proper treatment. I'd like to highlight some of the most crucial ones, even though there are more than these. Firstly, I want to draw your attention to ethics code 2.01, which pertains to providing effective treatment. Currently, I believe that Juan may not be receiving the most effective treatment for his situation. I want to emphasize that this is not a reflection on the facility's efforts. I believe that conducting a functional behavior assessment and subsequently implementing a DROs procedure will greatly enhance Juan's behavior. The next important code is 2.11, which addresses obtaining informed consent. This code underscores your role as Juan's family in ensuring that you are well-informed about everything related to Juan's care. Following that, we have codes 2.13, which relates to selecting, designing, and implementing assessments, and 2.14, which pertains to selecting, designing, and implementing behavior change interventions. Code 2.13 is relevant to the need for a functional behavior assessment for Juan, while code 2.14 covers the specific interventions, such as DROs, that we wish to employ for Juan's care. Lastly, code 3.01, which concerns our responsibility to the client (Juan), underscores our commitment to acting in Juan's best interests. If the outlined procedure is not yielding the desired results, it is our ethical responsibility to consider alternative approaches that better serve Juan's well-being.

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4 Risk-Benefit Worksheet ABA Procedure The ABA procedure I recommend for Juan's case is "Differential Reinforcement of Other Behavior (DRO)." This procedure involves reinforcing behaviors that are incompatible with the problem behavior while withholding reinforcement for the problem behavior. Special Methods In this context, we will implement DRO by reinforcing Juan's engagement in positive and pro- social activities, such as participating in therapeutic sessions, socializing with other residents, and engaging in meaningful activities that cater to his interests. We will also ensure that he receives continuous support and supervision to prevent elopement. Risks Risk Number Risks Notes 1 Isolation Restricting Juan to his room for extended periods may lead to social isolation, reduced engagement in meaningful activities, and a diminished quality of life (BACB Code 2.09). 2 Emotional and Psychological Impact This restriction may exacerbate Juan's frustration and agitation, leading to further verbal aggression (BACB Code 3.04). 3 Violation of Autonomy Restricting Juan's access to common areas may infringe upon his right to make choices regarding his daily activities (BACB Code 2.02). 4 Negative Impact on health Prolonged confinement to his room may negatively affect Juan's physical and mental

5 Risk Number Risks Notes health, potentially worsening his condition (BACB Code 3.02). Benefits List at least four benefits of using the ABA procedure. As this is just a list, it can be brief. The notes section is for elaboration. Note why/how each benefit listed is helpful to the client/situation (you can cite ethics codes or research to support here). Benefit Number Benefit Notes 1 Behavior Reduction Implementing DRO can be effective in reducing elopement and verbal aggression, promoting a safer environment for Juan and others (BACB Code 2.09). 2 Improved Social Engagement By encouraging positive behaviors and providing support, we aim to enhance Juan's social interactions and overall well-being (BACB Code 2.09). 3 Respect for Autonomy We will actively involve Juan in the decision-making process regarding his daily activities, respecting his autonomy (BACB Code 2.02). 4 Enhances the quality of life The successful reduction of problem behaviors can lead to an improved quality of life for Juan and other residents (BACB Code 2.09). Summary of Risks vs Benefits After a thorough risk-benefit analysis, it is evident that implementing a DRO procedure offers significant advantages in reducing problem behaviors, enhancing safety, and improving Juan's quality of life. While there are risks associated with any intervention, we can mitigate

6 them through ongoing monitoring, assessment, and adjustments to the intervention plan. It is crucial to emphasize that the proposed use of chemical restraints should be avoided due to ethical concerns (BACB Code 4.08) and potential negative consequences for Juan's well-being. Based on the analysis, I recommend proceeding with the implementation of the Differential Reinforcement of Other Behavior (DRO) procedure, which focuses on reinforcing Juan's appropriate behaviors and systematically reducing his elopement and verbal aggression. I will closely monitor Juan's progress, regularly review the intervention plan, and make necessary adjustments to ensure its effectiveness. I appreciate your trust in my expertise and commitment to Juan's well-being. If you have any questions or concerns, please do not hesitate to reach out. Additionally, I have included a copy of the completed risk-benefit analysis worksheet for your reference. Yours Sincerely, Oluwadamilola Adekunle. References Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts (3rd ed.) . Routledge. Behavior Analyst Certification Board. (2020).

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7 Ethics code for behavior analysts. https://bacb.com/wp- content/ethics-code-for- behavior-analysts/ Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis (3rd ed.). Pearson Education (US). https://capella.vitalsource.c om/books/9780134798783 6 Cooper, J. O., Heron, T. E., & Heward, W. L. (2019).

8 Applied Behavior Analysis (3rd ed.). Pearson Education (US). https://capella.vitalsource.c om/books/9780134798783 6 Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis (3rd ed.). Pearson Education (US). https://capella.vitalsource.c om/books/9780134798783 6 Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis (3rd ed.).

9 Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts.

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