SPED 6780 Ethics Week 3 924 Lorraine Becerra

SPED 6780 Ethics Week 3 (9/24) Lorraine Becerra, M. A. , BCBA

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

ROADMAP j ✓ Everyday Ethical Challenges 1. 0 Introduction to the Compliance Code Responsible Conduct of Behavior Analysts 2. 0 Behavior Analysts’ Responsibility to Clients

3 Everyday Ethical Challenges

Personal vs. Professional Ethics Non-Explicit Rules • Culture • Experiences • Consequences • Determined by group • Mismatched with Personal

E s n r i o o FAVORS GOSSIP “WHITE LIES” APPRECIATION ADVICE RESPONSIBILITY

DO IT NOW Clear Compassion Discomfort Strong Therapeutic Relationship

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

Effective January 1, 2016

Related Codes FABA Tx. ABA Cal. ABA NASP ABA APA NASW BACB Code AERA

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

WHAT’S

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

BEHAVIOR ANALYST SERVICES MULTIPLE RELATIONSHIPS GLOSSARY

y M Me? gues? a e l l Co My s? e e is v r ? e s t p n Su Clie My FOCUS OF CODES

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

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.

Break

1. 0 Responsible Conduct of Behavior Analysts …maintain the high standards of behavior of the profession.

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

1. 01 Reliance on Scientific Knowledge 1. 02 Boundaries of Competence 1. 03 Maintaining Competence

1. 04 INTEGRITY (e) (a) Commitment to Code and Actions to Resolve Conflicts (d) Follow Legal & Ethical Codes of Social & Professional Community Truthful & Honest (b) Contingencies Leading to Fraudulent, Illegal, or Unethical Bx (c) Follow Through & Commitments

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

1. 05 PROFESSIONAL & SCIENTIFIC RELATIONSHIPS (c) When specific differences of the client or family significantly impact work > obtain training or refer (e) No purposeful harassment or demeaning of individuals (d) No discrimination (f) Recognize potential for personal problems and conflicts may influence > refrain if those compromise service delivery

1. 06 MULTIPLE RELATIONSHIPS & CONFLICTS OF INTEREST (a) Avoid Multiple Relationships (b) Be Aware > Resolve (c) Recognize > Inform (d) Do not accept/giv e any gifts

(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 1. 07 EXPLOITATIV E RELATIONSHI PS (c) No sexual relationships with clients, students, or supervisees for at least 2 yrs following end of professional relationship (d) No bartering for services

Facilitated Discussion Ryan Brian

2. 0 Behavior Analysts’ Responsibility to Clients …operate in the best interest of clients.

Public/Pri vate Org. Rep Parent/Gu ardian Target Individual

2. 01 ACCEPTING CLIENTS Education Training Experience Available Resources Organizational Policies

2. 01 ACCEPTING CLIENTS There is no one else. There are others, but. . .

2. 02 RESPONSIBILITY All Parties affected by services Multiple parties as client? Establish hierarchy and communicate are outset Identify & Communicate Primary Beneficiary & Advocate for That Indiv

2. 03 CONSULTATION (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

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

2. 05 RIGHTS & PEROGATIVES OF CLIENTS (a) Client’s rights paramount, provide support (b) Credentials provided upon request (c) Consent from client and staff for recording (different types) (d) Informed of rights and complaint procedures (e) Compliance with criminal background checks

2. 06 MAINTAINING CONFIDENTIALITY (a) Primary obligation to protect confidentiality (b) Discuss at outset and as appropriate/needed (d) Discuss confidential information only for scientific/clinical purposes and only with appropriate individuals (c) Include only information relevant to communication (e) Do not share identifying information about current clients within social media

2. 07 MAINTATINING RECORDS (a) Maintain appropriate confidentiality in records (b) Maintain & dispose within requirements of laws, regs, policies, & Code

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)

2. 08 DISCLOSURES Consent for Disclosure at Outset Ongoing Consent for Disclosure as Need Arises

2. 09(a) TREATMENT/INTERVENTION EFFICACY Clients have right to effective treatment BA always obligated to advocate and educate: Scientifically Supported & Most-Effective Treatment Validated As Producing Effects That Are: Short-Term & Long-Term

Best Available Evidence Client Context & Values Clinical Expertise Effective Client Outcomes

2. 09(b) TREATMENT/INTERVENTION EFFICACY BA has responsibility to advocate for appropriate: AMOUNT LEVEL OVERSIGH T To Meet Goals

2. 09(c) TREATMENT/INTERVENTION EFFICACY When more than one scientifically support treatment is available: Consider additional factors, such as: efficiency costeffectiveness risks/side effects preferences BA expertise & training

2. 09(d) TREATMENT/INTERVENTION EFFICACY Review & appraise effects of tx that might impact goals & possible impact on bx-change program

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 bestpractice & law

2. 11 RECORDS & DATA (a) … in accordance with… (b) Retain records & data for at least 7 yrs and as directed by law

2. 12 CONTRACTS, FEES, & FINANCIAL ARRANGEMENTS (a) At Outset: signed contract outlining resp. , scope, and obligations under Code (b) As early as possible: agree to compensation & billing (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

2. 13 ACCURACY IN BILLING REPORTS Nature of Services Other Required Descriptive Data Billing Report Relevant Outcomes Fees/Charge s Identify of Provider

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.

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 (d) Discontinuation: -no longer needs -no more benefit -harmed if continue -client request (c) Upon contract > orderly and appropriate resolution –paramount consideration to welfare of client (e) Do not abandon. Discuss: -client’s views and needs -appropriate pre-termination -suggest alternate providers -reasonable other actions for timely transfer

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.

Next Class ! Read -Ethics Chapters 8 &9 Keep 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!