1 Lorraine Becerra, M.A., BCBASPED 6780 Ethics Week 3 (9/24) Do not place text over the lines of an image (ie. The sidewalk.) Lorraine Becerra, M.A., BCBA

2 What’s Due What’s New Facilitated Discussion In Class Debates!Tyra’s Study What’s New

3 ROADMAP j ✓ 1.0 2.0 Everyday Ethical ChallengesIntroduction to the Compliance Code Responsible Conduct of Behavior Analysts Behavior Analysts’ Responsibility to Clients j ✓ 1.0 2.0

4 Everyday Ethical Challenges3 Everyday Ethical Challenges

5 Personal vs. Professional EthicsNon-Explicit Rules Culture Experiences Consequences Explicit Rules Determined by group Mismatched with Personal

6 FAVORS GOSSIP Erosion “WHITE LIES” APPRECIATION ADVICE RESPONSIBILITY

7 Strong Therapeutic RelationshipDO IT NOW Clear Compassion Discomfort Strong Therapeutic Relationship

8 BST for Supervisees/Staff/ParentsClear Instructions (spoken and written) Model Rehearse to Criterion Feedback Advanced Skills Moderate Skills New/Low-Level Skills Least Close In Supervision Moderate Close In Supervision Most Close in Supervision

9 Effective January 1, 2016

10 Related Codes BACB Code APA ABA CalABA FABA TxABA NASP NASW AERA

11 PROCESS Conduct Guidelines & Disciplinary StandardsInput Gathered Conduct Guidelines & Disciplinary Standards 2013 Ethics Workgroup Consolidate Into 1 Document & Expand Scope Streamline BACB’s Process PROCESS

12 WHAT’S DIFFERENT?

13 WHAT’S DIFFERENT? Compliance Code –single document Table of ContentsGlossary Code Compliance Committee & Disciplinary Review Committee -Reported w/in 6 months -On-line submissions Cross-Reference Guide Provided WHAT’S DIFFERENT?

14 MULTIPLE RELATIONSHIPSBEHAVIOR ANALYST SERVICES MULTIPLE RELATIONSHIPS GLOSSARY

15 Me? My Colleagues? My Supervisees? My Clients?FOCUS OF CODES

16 DEBATE (20 min) First Affirmative (5min)Cross Examination by Negative (2min) First Negative (5min) Cross Examination by Affirmative (2min) Conclusions (3 min)

17 DEBATE 1 SCENARIO: You are working in-home with a child with multiple disabilities who also engages in fairly aggressive behavior. The family is from India, and consists of the child’s mother and father, 4 younger siblings, and the child’s maternal grandmother. The parent’s speak English enough to effectively communicate information about programming, but the grandmother does not. The child’s aggression was most severe with the grandmother, but since services started 2 months ago you have implemented a successful intervention plan that has resulted in an 80% reduction of aggression and has increased the child’s functional communication. The grandmother does the majority of the cook, which smells great, which you have pointed out to the mother in the past. Upon leaving a session the grandmother presents you with a tinfoil packet of handmade samosas and a very large smile.

18 Break Do not place text over the lines of an image (ie. The sidewalk.)

19 Responsible Conduct of Behavior Analysts1.0 Responsible Conduct of Behavior Analysts …maintain the high standards of behavior of the profession.

20 WHAT ARE THE “HIGH” STANDARDS??Honesty Integrity Reliability Confidentiality Trustworthiness

21 1.01 Reliance on Scientific Knowledge 1.02 Boundaries of Competence 1.03 Maintaining Competence

22 1.04 INTEGRITY (a) Truthful & Honest (c) Follow Through & Commitments(b) Contingencies Leading to Fraudulent, Illegal, or Unethical Bx (c) Follow Through & Commitments (d) Follow Legal & Ethical Codes of Social & Professional Community (e) Commitment to Code and Actions to Resolve Conflicts

23 1.05 PROFESSIONAL & SCIENTIFIC RELATIONSHIPS(a) Services only in context of defined professional or scientific relationship (b) Use understandable language (conceptually systematic) -Info provided prior to services -Info provided about results & conclusions

24 1.05 PROFESSIONAL & SCIENTIFIC RELATIONSHIPS(c) When specific differences of the client or family significantly impact work > obtain training or refer (d) No discrimination (e) No purposeful harassment or demeaning of individuals (f) Recognize potential for personal problems and conflicts may influence > refrain if those compromise service delivery

25 1.06 MULTIPLE RELATIONSHIPS & CONFLICTS OF INTEREST(a) Avoid Multiple Relationships (b) Be Aware > Resolve (c) Recognize > Inform (d) Do not accept/give any gifts

26 1.07 EXPLOITATIVE RELATIONSHIPS(a) Do not exploit those you have authority over “unfairly use person for profit or advantage” (b) No sexual relationship with clients, students, or supervisees (c) No sexual relationships with clients, students, or supervisees for at least 2yrs following end of professional relationship (d) No bartering for services

27 Facilitated DiscussionRyan Brian

28 Behavior Analysts’ Responsibility to Clients2.0 Behavior Analysts’ Responsibility to Clients …operate in the best interest of clients.

29 Public/Private Org. Org. Rep Parent/Guardian Target Individual

30 Organizational Policies2.01 ACCEPTING CLIENTS Education Training Experience Available Resources Organizational Policies

31 2.01 ACCEPTING CLIENTS There is no one else. There are others, but...

32 2.02 RESPONSIBILITY All Parties affected by servicesMultiple parties as client? Establish hierarchy and communicate are outset Identify & Communicate Primary Beneficiary & Advocate for That Indiv

33 2.03 CONSULTATION (b) Cooperation With Others(a) Appropriate Consultation & Referral Based on Best Interest of Client -consent -”other relevant considerations” (b) Cooperation With Others -when indicated -manner consistent with philosophical assumptions & principles -purpose to effectively & appropriately serve client

34 2.04 THIRD-PARTY INVOLVEMENT IN SERVICES(a) Clarify natural of relationships at outset (each party and conflicts) (b) Foreseeable risk > clarify nature and direction of responsibilities, keep informed, resolve (c) Services to minors or protected classes > inform parent/guardian (d) Contraindicated Requirements > Client’s care above all others -Resolution -Termination

35 2.05 RIGHTS & PEROGATIVES OF CLIENTSClient’s rights paramount, provide support Credentials provided upon request Consent from client and staff for recording (different types) Informed of rights and complaint procedures Compliance with criminal background checks (a) (b) (c) (d) (e)

36 2.06 MAINTAINING CONFIDENTIALITY(a) Primary obligation to protect confidentiality (b) Discuss at outset and as appropriate/needed (c) Include only information relevant to communication (d) Discuss confidential information only for scientific/clinical purposes and only with appropriate individuals (e) Do not share identifying information about current clients within social media

37 (a) Maintain appropriate confidentiality in records2.07 MAINTATINING RECORDS (a) Maintain appropriate confidentiality in records (b) Maintain & dispose within requirements of laws, regs, policies, & Code

38 2.08 DISCLOSURES Disclosing Confidential Client Info W/O Consent, Unless Compelled or Permitted: -to provide needed professional services to client -to obtain appropriate professional consultation -to protect client or others from harm -to obtain payment (limited to necessary for purpose)

39 2.08 DISCLOSURES Consent for Disclosure at OutsetOngoing Consent for Disclosure as Need Arises

40 2.09(a) TREATMENT/INTERVENTION EFFICACYClients have right to effective treatment BA always obligated to advocate and educate: Scientifically Supported & Most-Effective Treatment Effective Treatment Validated As Producing Effects That Are: Short-Term & Long-Term

41 Client Context & Values Best Available EvidenceEffective Client Outcomes Client Context & Values Best Available Evidence Clinical Expertise

42 2.09(b) TREATMENT/INTERVENTION EFFICACYBA has responsibility to advocate for appropriate: AMOUNT LEVEL OVERSIGHT To Meet Goals

43 2.09(c) TREATMENT/INTERVENTION EFFICACYConsider additional factors, such as: efficiency cost-effectiveness risks/side effects preferences BA expertise & training When more than one scientifically support treatment is available:

44 2.09(d) TREATMENT/INTERVENTION EFFICACYReview & appraise effects of tx that might impact goals & possible impact on bx-change program

45 2.10 DOCUMENTING PROFESSIONAL WORK & RESEARCH(a) Document work to facilitate later work, ensure accountability, and comply with requirements of organization or law (b) Responsibility to create & maintain detail and accuracy consistent with best-practice & law

46 2.11 RECORDS & DATA (a) (b) … in accordance with…Retain records & data for at least 7yrs and as directed by law

47 2.12 CONTRACTS, FEES, & FINANCIAL ARRANGEMENTS(a) At Outset: signed contract outlining resp., scope, and obligations under Code (c) Fees are consistent with law and free of misrepresentation. Discuss service limitations due to funding limits up front (d) Changes in funding circumstances > revisit financial responsibilities and limits (b) As early as possible: agree to compensation & billing

48 2.13 ACCURACY IN BILLING REPORTSNature of Services Fees/Charges Identify of Provider Relevant Outcomes Other Required Descriptive Data

49 2.14 REFERRALS & FEES Must not receive or provide money, gifts or other enticements for any professional referrals. Referrals should include several options and based on need of client. Referrals include disclosure of relationship of parties.

50 2.15 INTERRUPTING OR DISCONTINUING SERVICES(a) Act in best interest of client to avoid interruption/disruption (b) Reasonable/timely efforts to facilitate continuation of services during unplanned interruptions (c) Upon contract > orderly and appropriate resolution –paramount consideration to welfare of client (d) Discontinuation: -no longer needs -no more benefit -harmed if continue -client request (e) Do not abandon. Discuss: -client’s views and needs -appropriate pre-termination -suggest alternate providers -reasonable other actions for timely transfer

51 Ethical Scenario 11 & 16 In groups of 3-4, you will review the scenario and write a one-page paper that includes the following: A brief and clear description of the specific ethical dilemma A minimum of 3 relevant codes A brief description of the relevant ethical principle/s A proposed primary and alternative solution, and A summary statement describing a similar experience or how this situation will be relevant to your future professional settings.

52 ! Next Class Read -Ethics Chapters 8 & 9Keep Looking into BCBAs to Interview and Post on Canvas Debate 2: Amy & Bayley Vs. Stephanie & Sandra Disc: Jason & Bayley Make time Every Day to Reflect on Ethics!