Teamwork, Collaboration, and the Pesky Issue of Ethics

Shelley McLean, M.Ed, BCBA

bSci21 Contributing Writer

Sometimes I wonder if it’s just me . . .

One of my favorite authors, leadership experts, and public speakers, Simon Sinek, recently wrote a great little book called Together is Better.  It’s a picture book created around a series of powerful quotes about leadership and teamwork.  The book is brilliant in its simplicity, yet it carries a profound message.  One statement in the book caused me to stop, put the book down, and push my chair back from my desk: “Bad teams work in the same place. Good teams work together” (Sinek, 2016).  I think the reason those two short sentences, situated inconspicuously in the middle of a book packed full of equally-meaningful quotes, made such an impact on me is that for a while now I’ve been engaging in a high rate of a covert verbal behavior – “thinking” – about collaboration and teamwork.  In particular, I’ve been wondering how I, as a Board Certified Behavior Analyst (BCBA) can consistently and professionally collaborate successfully with nonbehavioral partner professionals, and also be sure that I am following the ethical requirements outlined in the Behavior Analyst Certification Board’s (BACB) Professional and Ethical Compliance Code for Behavior Analysts.  Then I started to wonder if other behavior analysts face this conundrum, or if I’m the only one who finds these situations tricky to navigate.

Let me take a step back and tell you a bit about how my ethical dilemma started.  For a number of years, I provided consultation to school teams working with learners with Autism Spectrum Disorder (ASD) and/or with challenging behavior. Like many consultants, I’m sure, I can’t begin to count the number of program-planning meetings, problem-solving meetings, and transition meetings I have attended over the years.  At nearly all of those meetings I was the only educator who was also a BCBA, particularly since there were very few behavior analysts in my area at that time.  It was quite common to have other teachers (special educators, classroom teachers), administrators, and speech-language pathologists, and sometimes an occupational therapist, physical therapist, psychologist, or other professional involved in the meetings, and each person at the table brought his or her unique training, experience, and expertise.  While we were all there to work in the best interest of the learner on whose behalf we were meeting, one challenge that arose was that sometimes we had different ideas about what intervention or strategy was in the best interest of the learner.

As a newly-minted BCBA, I knew that I had a professional and ethical obligation to comply with the BACB’s Professional and Ethical Compliance Code for Behavior Analysts (at that time the Guidelines for Responsible Conduct for Behavior Analysts).  I knew about the learner’s “right to effective treatment” (BACB, 2014, section 2.09; Van Houten et al., 1988) and that under the Code, I was expected to “advocate for . . . scientifically supported, most-effective treatment procedures” (BACB, 2014, section 2.09).  But some of the interventions suggested by the interdisciplinary professionals at a number of the meetings left me conflicted.  In some cases, recommendations were based on behavioral principles, and I could easily get on board.  At other times, I wasn’t at all familiar with the intervention being recommended, and didn’t know whether I should support it or not.  And then there were the situations when the recommendation being made was not based on the science that I had been trained in at all.  When those situations arose, I wasn’t sure how to respond as I sat around the table with my colleagues.  I knew that ethical practice included collaborating with nonbehavioral service providers (BACB, 2014, section 2.03), and my own learning history had taught me that questioning, debating with, and potentially alienating, partner professionals would probably not be an effective approach.  However, I often did not know for sure how to respond in those situations, and I did not always handle them well.

A research study undertaken by Amy Kelly and Matt Tincani suggests that my experience may not be as unique as I thought at the time.  The investigators surveyed more than three hundred behavioral professionals and found that, while the majority of the respondents indicated that collaboration with interdisciplinary professionals was an important and valuable aspect of their work, and 85% reported that they collaborated with partner professionals representing various disciplines on a daily or weekly basis, very few had any formal training on how to participate effectively in these collaborations (Kelly & Tincani, 2013).  Apparently I wasn’t alone in feeling like I needed more training and support to know how to navigate these situations successfully. However, while this knowledge may have been reassuring, it was not necessarily helpful.

Fortunately, a recent article written by Matthew Brodhead and published in Behavior Analysis in Practice has provided some helpful advice and direction.  Brodhead has developed a model and process to help behavior analysts assess “nonbehavioral treatments while maintaining an ethical balance between professional relationships and the well-being and safety of the individual with ASD” (Brodhead, 2015).   He suggests the following:

• Once it has been determined that the proposed intervention is indeed nonbehavioral, it is critical to assess any potential risks to the safety of the learner, as the safety and dignity of the individual should always be primary considerations.
• If the behavior analyst is not familiar with the treatment being proposed, Brodhead recommends thoroughly researching the intervention before making any decisions or recommendations for or against it.  He calls this conducting a “skeptical appraisal.”
• The next question in the decision-making process may be very helpful for behavior analysts: Can the proposed treatment be translated into behavioral principles, and if so, is it possible that the intervention may be successful when considered in those terms?  Different professionals may use different terminology, and some interventions may even be marketed under catchy names, but they may still be based on behavioral principles and research may support their effectiveness in similar contexts.
• He then recommends asking whether or not the proposed intervention will interfere with the learner’s overall program goals, and he provides a user-friendly checklist to assist in determining the extent to which the intervention may interfere. 
• As a final step, Brodhead suggests that behavior analysts consider whether the potential impacts of the intervention on the learner are significant enough to justify possibly jeopardizing the relationship with the partner professional(s) involved. 

The process outlined by Matthew Brodhead may be helpful to behavior analysts who find themselves navigating tricky ethical situations when working collaboratively with interdisciplinary teams.  More detail and the complete decision-making flowchart can be found in the full article.  As Kelly and Tincani point out, additional pre-service or in-service training for BCBAs in this area would also be very valuable, since most would agree that collaboration among interdisciplinary professionals is an essential ingredient as we seek to provide the best possible support to our learners with ASD and behavior challenges, and build teams that do more than just work in the same place.

References:

Behavior Analyst Certification Board (BACB). (2014).  Professional and ethical compliance code for behavior analysts. http://bacb.com/wp-content/uploads/2016/03/160321-compliance-code-english.pdf

Brodhead, M. T. (2015).  Maintaining professional relationships in an interdisciplinary setting: Strategies for navigating nonbehavioral treatment recommendations for individuals with autism.  Behavior Analysis in Practice, 8(1), 70-78.

Kelly, A., & Tincani, M. (2013). Collaborative training and practice among applied behavior analysts who support individuals with autism spectrum disorder.  Education and Training in Autism and Developmental Disabilities, 48(1), 120-131.

Sinek, S. (2016). Together is Better.  New York, NY:  Penguin Random House LLC.

Van Houten, R., Axelrod, S., Bailey, J., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I. (1988).  The right to effective behavioral treatment.  Journal of Applied Behavior Analysis, 21(4), 381-384.

Shelley McLean, M.Ed, BCBA is passionate about empowering educators with an understanding of behavioural principles to give them the tools and the confidence to ignite the potential in all of their learners.  She is the Coordinator of the interprovincial Autism in Education (AIE) Partnership for the Atlantic Provinces Special Education Authority (APSEA) in Halifax, Nova Scotia, Canada.  Shelley has worked as a classroom teacher, guidance counselor, high school administrator, itinerant ASD consultant, and provincial Learning Specialist for ASD and Complex Cases during her career in education, which spans more than 17 years.  She has also served as a part-time instructor for ABA courses at the University of New Brunswick and Western University in Ontario.  Shelley holds Bachelor degrees in Arts and Education, and a Master of Education degree in Counseling Psychology.  She completed a Graduate Academic Certificate in Applied Behavior Analysis from the University of North Texas and has been a Board Certified Behavior Analyst (BCBA) since 2010.  You can contact her at [email protected]