When BACB ethical violations go unnoticed.

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By Emily Mandel, M.S., BCBA

bSci21 Contributing Writer

About a year ago, I worked with a high schooler diagnosed with high-functioning Autism. His mother requested that the primary focus of treatment be his social skills deficits, as he did not have many friends and often chose to be alone. I added two social skills goals to his treatment plan to target the domains I perceived to be the greatest areas of weakness based on a parent interview and direct observation.

One day during a session his mother left the room so that it was just the two of us. He turned to me and asked, “Why do you keep having me talk to the other kids in school? I don’t like them.” I must admit that it took me a minute to answer his question. After all, according to our ethical guidelines, the student’s needs always come first. So why did I not consult with him before speaking with his mother? I quickly scheduled a meeting with both the mother and the student, and we revised the treatment plan to satisfy the wants and needs of all parties involved in treatment.

Very often, behavior analysts do not even realize when they are violating ethical guidelines. After all, I was not abusing the student, violating HIPAA, or committing some other equally severe infraction. But this experience pushed me to revisit the BACB ethical guidelines website, and I realized just how many of these guidelines behavior analysts often do not consider in everyday practice. The following are four BACB ethical codes often overlooked by practitioners.

Code 1.06 – (a) Due to the potentially harmful effects of multiple relationships, behavior analysts avoid multiple relationships. (b) Behavior analysts must always be sensitive to the potentially harmful effects of multiple relationships. If behavior analysts find that, due to unforeseen factors, a multiple relationship has arisen, they seek to resolve it. Sometimes behavior analysts may cross boundaries without even realizing it. This can be as seemingly benign as accepting a gift or cup of coffee, or spending 15 minutes chatting with a parent on topics not relevant to treatment.

Code 4.02 – Behavior analysts involve the client in the planning of and consent for behavior-change programs. As with the scenario above, I did not consult the primary client, the student himself, and simply conducted a direct observation and parent interview. As clinicians, we must consider what the student wants, whenever possible.

Code 4.10 – Behavior analysts minimize the use of items as potential reinforcers that may be harmful to the health and development of the client, or that may require excessive motivating operations to be effective. Very often, we as practitioners often conduct reinforcer assessments, but do not consider potential harmful effects of specific reinforcers, as well as potential side effects of reinforcement (e.g. the use of unnecessary amounts of unhealthy edible reinforcers).

Code 5.06 – a) Behavior analysts design feedback and reinforcement systems in a way that improves supervisee performance. b) Behavior analysts provide documented, timely feedback regarding the performance of a supervisee on an ongoing basis. – Many behavior analysts do not employ reinforcement procedures for the staff they supervise, and instead use various means of aversive control. In addition, many behavior analysts neglect to provide consistent and frequent feedback at all.

Ethical violations are not always blatant or apparent. Very often, they go unnoticed. It is important that we as practitioners review our ethical code on a regular basis to ensure that we are practicing within ethical boundaries. To review the BACB’s Ethics Code, click here

Emily Mandel, M.S., BCBA, is a behavior clinician who works with children on the Autism Spectrum in the Greater Boston Area. She has over 3 years of experience delivering therapeutic services both in-home and in the public school system. Though she is predominantly focused on the utilization of Applied Behavior Analysis in treating individuals with disabilities, Emily enjoys examining topics such as religion, medicine, politics, and social constructs, through a behavioral lens. You can contact her at emandel90@gmail.com.

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15 Comments on "When BACB ethical violations go unnoticed."

  1. Clelia Sigaud | April 21, 2016 at 6:37 am | Reply

    So true! Thank you for this article, Emily.

  2. Fantastic points and well thought out examples! One word of clarification though: the article refers to “guidelines,” however, now it is an actual code, and violations are actionable.

  3. Debi Hoohuli-Rosa | April 21, 2016 at 11:37 pm | Reply

    Well written! Thank you for posting!

  4. Brian Hinchcliffe | April 22, 2016 at 8:32 am | Reply

    Hi Emily,

    Can you give some clarification regarding the first guideline (1.06) regarding the 15 minute conversation?

    • Emily Mandel | April 22, 2016 at 4:05 pm | Reply

      Thanks for the comment, Brian. Unfortunately, this and many other guidelines are relatively subjective. I have definitely had extended conversations with parents during the initial rapport-building phase. However, it becomes an issue when large amounts of regular sessions are taken up by small talk and other non-clinical activities. Again, though, since there is no real operational definition for “multiple relationships” within the context of the BACB guidelines, I can only offer up my own person interpretation. Hope this helps.

  5. Thank you for this article. I recently passed my exam last August and one of the first ethical dilemmas I faced was “to accept, or not accept” a bottle of water from a parent. Remembering a class discussion about how we should not accept anything as it may eventually be seen as a gift, I explained to the mother that I was unable to accept her benign gesture to give me water. She was initially offended but I was eventually able to win her over as ultimately the progress of her child outweighed me rejecting her bottle of water. Unfortunately, with other cultures, I found not accepting water to be even more difficult than just saying “no” (yes, being offered water turns out happens a lot more than I thought would have). In fact, I had one parent literally open the bottle of water for me and put it to very closely to my mouth. How would you work with families who’s culture differs and conflicts with our ethical standards? Do we risk developing a reputation of becoming culturally insensitive professionals?

    • I would just be straight with them and explain that it is due to our ethics code. If not, it can lead to more awkward situations in the future. This is a very common situation that I have encountered myself.

      Dr. W.

  6. Honestly John, just take the water, tea or coffee etc. Ethics are dynmaics and context is key. One could not honestly imagine a multiple relationship arising from a situation like this. Think of it this way, if you were providing training to a school or organisation and while waiting in the waiting room and the receptionist offered a drink from a watercooler, would you consider yourself to have received a gift that would give rise to multiple relationships?

    While we want to behave ethically, it is important not to become over-zealous or over-literal in our interpretation of the code. We don’t want to get into a situation where we end up reporting colleagues for taking a pen from an orgainsation they’re working with, offering a client coffee in their offices or not returning a Christmas card they’d received. It would probably be helpful if the code provided a definition of what constituted a gift.

    • Thank you for saying this. Sometimes I feel people just go overboard. Since when is accepting WATER a gift? People please use judgement. If you’re spending a half a day e with a client and you are explaning and doing program oversight… the LEAST the family can offer you is a glass of water. Your mouth gets dry…you didn’t have time to stop beforehand or you drank all the water your brought. It’s just a glass of water…

  7. A great antecedent intervention is to just bring your own water. I’ve been offered water hundreds of times while providing home-based services but since I travel with my own water bottle, I just hold it up and smile.

  8. Great reminder! Thanks!

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