PRESENTED BY CHRISTINA SLATEN

The Behavior Analyst’s Responsibility to Clients

A Little History….

Early behavior analysts were responsible to the employer, sometimes the parents

1974 – Wyatt vs. Stickney Institutionalized mental patients had right to

individualized treatment or to be discharged into the community

Highlighted “client’s rights” Wyatt Standards

Service delivery within a humane environment Sufficient qualified staff members Individualized treatment plans Least restricted environment

Responsibility to all involved, with a focus on the person directly receiving the intervention to make sure no harm was done

Responsibility to Clients

Guideline 2: The behavior analyst has a responsibility to operate in the best interest of clients. Who is the client? (2.01)

Anyone to whom services are provided Examples?

Clear and detailed list of obligations that behavior analysts must adhere to when providing treatment involving behavioral procedures

Always ask , “What is in the best interest of my client?”

Definition of Client (2.01)

Broad application

Anyone to whom behavior analyst provides services Individual (service recipient) Parent/guardian of service recipient Institutional representative Public/private agency Firm/corporation

Most vulnerable individuals in the chain of services are considered primary clients

Accepting Clients (2.02)

Only accept clients whose behavioral concerns are in line with behavior analyst’s education, training and experience

• If outside expertise, must be under supervision/consultation of BCBA who has credentials with the particular situation

Responsibility (2.03)

Responsible to all parties effected by the behavioral services.

Obligation to make sure that all principles of ethics extend to everyone involved Service recipient Parent/guardian Other people in the specific environment (e.g., other

students in classroom)

Consultation (2.04)

Appropriate consults and referrals• Based on best interest of

client• Appropriate consent• Subject t0 relevant

considerations (e.g., applicable laws, contractual obligations)

Cooperation with other professionals to provide effective and appropriate services• Recognize various ethical

codes of other professions

Third-Party Requests for Services (2.05)

Clarify nature of relationship with each party at onset of service Role of behavior analyst Probable uses of services /information obtained Limits to confidentiality?

If there are any risks of conflicting roles Clarify nature and direction of responsibilities Keep all parities informed Resolve situation according to Guidelines

Rights and Prerogatives of Clients (2.06)

Supports individual rights under the law

Secure permission (for each use of) electronic

recording of interviews/service delivery sessions

Meet requirements for

criminal background

checks

Inform clients of rights and procedures to

complain about professional practices

Provide client with accurate credentials

Maintaining Confidentiality (2.07)

Primary obligation to take reasonable precautions to respect confidentiality Law, institutional rules, professional, and/or professional/scientific

relationshipsClients have a right to confidentiality – should be

discussed at onset of relationship and ongoing as needed Unless not feasible or contraindicated

Examples?

Include only pertinent information in written or oral communication

Discuss confidential information only for appropriate scientific/professional purposes and with people clearly concerned with info

Maintaining Records (2.08)

Maintain appropriate

confidentiality

Creating

Storing/Disposing

Accessing

Transferring

Maintain and dispose of records in accordance to applicable laws, regulations or corporate policy AND in a manner that complies with the BCBA guidelines.

Review current Health Insurance Portability and Accountability Act (HIPPA, 2003) legislation

Disclosures (2.09)

A.) Disclose confidential information without consent of the individuals only as mandated/permitted by law for a valid purpose To provide professional

services to client Obtain professional

consultations To protect client/others

from harm To obtain payment for

services

B.) Disclose confidential information with appropriate consent Examples of

appropriate consent?

Treatment Efficacy (2.10)

Responsible to recommend scientifically supported most effective treatment procedures Both long and short term benefits to clients and society

Right to effective treatment Based on research literature Adapted to individual client

Responsible for review and assessment of likely effects of all alternative treatments Including those provided by other disciplines and no intervention

Consideration of multiple, scientifically-supported treatments, may include, but not limited to… Efficiency Cost-effectiveness Risks/side-effects Client preference Practitioner experience/training

Documenting Professional and Scientific Work (2.11)

Appropriately document to facilitation replication, ensure accountability & meet requirements of institution/law

If used in legal proceedings, must create and maintain documentation that would be consistent with the quality consistent with reasonable scrutiny in a judicial forum Good idea to imagine all documentation WILL be used in legal

proceedingsAlways obtain and document

Institutional Review Board (IRB) or local Human Research committees

Confirmation of compliance with institutional requirements

Records and Data (2.12)

Compliance with guidelines and applicable laws or regulations

Fees, Financial Arrangements and Terms of Consultation (2.13)

Agreement reached re: detailing compensation and billing arrangements as early in professional/scientific relationship as possible

Fees consistent with law Limitations of service due to financing discussed as early as

possible Do not misrepresent fees

Provide term of consultation, specific requirements for providing services & responsibilities of all parties Prior to implementation of services Contract or Declaration of Professional Services

Accuracy in Reports to Those Who Pay for Services (2.14)

Accurately state Nature of service/research Fees or charges Identity of provider Findings Other required descriptive data

Examples?

Referrals and Fees (2.15)

Disclose if there is payment received or fees divided with another professional (other than employer – employee relationship

Interrupting or Terminating Services (2.16)

Make reasonable efforts to plan for continuing service in the event there will be an interruption of service

Include resolution of services in contractDo not abandon client – end service when it is

reasonably apparent client no longer needs services

Pre-termination services Suggest other service providers Transfer responsibility to other providers if necessary

Questions?

References

Bailey, J.S., &Burch, M.R. (2001). Ethics for behavior analysts (2nd Expanded

Edition). Routledge.