BCBA Ethics Case Vignettes

BCBA Ethics Case Vignettes Marilyn is at a public event and Katie is not her client, a single mother of a child with autism. Katie saw Marilyn at a local event and had recently interviewed Marilyn as a potential service provider. Marilyn asked Katie at the event what happened with her decision and why she didn't choose her. Is this an ethics violation. - Yes. Even though it is not her clent Marilyn (the BCBA) is required to respect the privacy of others. Anthony (a BCBA) is using FC (facilitative communication) in his BA practice and a colleague has tried to talk to him about using evidence based interventions. The BACB discourages the use of FC & nearly a dozen scientific and professional organizations also discourage its use. Is Anthony choosing to use FC to guide his practice unethical? - Yes. Anthony could be reported to the board because he is not relying on scientific evidence based intervention and the school has already tried to dissuade him from using FC. A BCBA was asked by their supervisor to handle a case to which they did not feel comfortable handling. The client exhibit behaviors of pediophilia to which the BA did not have experience but is being pressured to do an assessment and provide treatment. What should they do? - A. Tell supervisor they are not comfortable handling the case. B. Ask to refer to someone who is qualified to take such dangerous & specialized clients. C. Mention the risk of the organization to litigation in the event treatment goes bad. D. All of the above. Answer is D Can training in mindfulness substitute for documented behavioral treatments? A BCBA is as encouraged to attend course but was not confident in its scientific based claims. They did not pay for the CEU course in mindfulness but want to include these hours for CEU for the year. Is this ethical? - While mindfulness could count for CEU hours you did not pay for the course and it would be better to not include these hours. If the course made negative claims about Behavior Analysis you should notify the board. A school agency has been billing under different client names for a child not receiving services because the other clients insurance provides unlimited hours. Is this ethical? - No. This is insurance fraud and the BCBA should report to insurance company in writing. Leaving employment with this agency would also be wise. You have an employee come to you about concerns of another co-worker having a drug problem. Should you report this to the board? - No, only those who have witnessed first hand the use of drugs can make the report. Encourage the person who did witness to approach the person directly. It may become appropriate for you to report to authorities or the board if through the process you do witness first hand or the person bringing the concern makes the call. BCBA Ethics Case Vignettes A BCBA hires a clients parent as an employee. What should they do? - A. If they go forward with firing the parent they should refer the client to another agency. Although not ideal. B. There is not a problem hiring them. C. They should terminate services without referring. A. B & C are not ethical. A BCBA was pressured by their client to accepted a gift. She resisted for a long time but eventually gave in and accepted the gift. Months later the parents had a falling out with the BCBA and filed a complaint with the agency that she accepted gifts against policy. What went wrong? - Even when friending clients and giving in to small features for good intentions can be turned in to a negative. The BCBA should not accept gifts. A BCBA is having individuals under them do ABA work they have not been trained properly to do. The BCBA has never seen the clients but signs off on the forms as though he is doing the work. Is this a violation? - Yes. BCBA's provide proper oversight and could be reported to the BACB. It is okay to begin dating a clients Mom because it is consensual? - False. You should address the concerns with this colleague and if they do not acknowledge as inappropriate you would file a complaint with the BACB. You are hired by a school to assess child and pressured to provide the report quickly to the school. The school may not hire you for more work if you do not follow through on this request. What should you do? - A. Quickly provide the report to the family so they have adequate time to prepare & possibly seek counsel. B. Operate in the best interest of the client which is the child, not the school. C. Both A & B. Answer is C A BCBA has concerns about her agency merging with a non evidenced based organization. She keeps working there and is this ethical? - The BCBA got the support of other BCBA's and expressed concerns. They slowed down the merger and were able to limit the use of non evidence based procedures. It's okay for a school to provide ABA services to a child without parents consent? - False. A BCBA is asked about children they work with by church members who see them at church. They should - A. Answer the questions about the kids. B. Tell them she can not discuss her work with her kids. C. Politely change the subject. D. B & C BCBA Ethics Case Vignettes Best answer is D. It's okay to bill for maximum hours even if you don't provide those amount of hours of actual service? - False. It is illegal & unethical. You are working with a child who's parents want to try a new miracle cure for autism. What should you do. A. Share concerns over evidence based research. Perhaps provide articles if the method has been shown to be invalid. B. Encourage parents to ask pediatrician for input. C. Both A & B. Best answer is C. - You are working with a family and both parents do not agree on treatment goals. The farther would not cooperate with goals & you want to terminate client. You provided cooperation clause & cindtions for program success as well as termination criteria and you set up a meeting to document & discuss issues. Both parents would attend. Is it ethical to terminate services? - Yes stating reason for terminating is due to lack of client improvement. Also refer to someone else for services. It is okay to terminate services abruptly without referrals? - False. BCBA should help the parent find an agency or solo BCBA who has the skill set to work competently with the child. Giving at least three referrals is ideal. A BCBA who completed some graduate work in clinical psych is using insurance funding for ABA services using assessments they are not qualified to use, psychological in nature and does not add information about the function, intensity and level of behavior. I discussed my concerns with this individual but they disagree. What other steps should be taken? - The individual should be reported to the BACB for activity outside the scope of behavioral practice. When ruling out medical reasons for a behavior a BCBA should encourage - A. Conduct a new FA and start the behavioral intervention. B. Wait for the results of the neurologist appointment and place antecedent manipulations in place to prevent any of the behavior from occurring. C. Keep the current intervention in place since it has worked in the past. B is the correct answer. BCBA's explain assessment results in a way that is understandable to the client - True. A parent does not want the assessment results shared with the child's school even the the BCBA is getting pressure from the school to share them. What should they do? - The BCBA must respect the wishes of the parent and they do not have their consent to share the results. BCBA Ethics Case Vignettes A BCBA has parents asking why we are not using FC. What should they do? - BCBAs do not have to be forced to use FC in ABA therapy. They can educate parents but ultimately can't do much if they are using FC in the home when the child is not at therapy. BA's involve the client in the planning of and consent for behavioral change programs before implementing. - True. You have two clients with similar behavioral targets which you've copied and pasted while a few are individualized to each person. Would this be an example of plagiarism? - No. Clients may often have similar programs and targets to each other which you've developed as the BCBA. Copy paste of program is appropriate when that target has been determined as bedded for their individual treatment plan. Copying an entire treatment program without considering the individual needs would be plagiarism. When fading services is imminent due to lack of family follow through the BCBA should: - A. Make a personal visit to both parents and explain the lack of agreement & follow bough on treatment plan. B. Recommend that Fading services would be best for child's safety. C.Draft a contract explicitly stating what is needed to continue services, involvement support follow through. D. All of the above are correct. A client was beginning food expansion therapy which a BCBA started force feeding sliced strawberries & the child was vomiting which was done by non certified staff. What should be done? - The BCBA with concerns should file a complaint with the BACB and act quickly to prevent harm to this child. They should approach the untrained supervisor & support staff and if necessary local authorities. A BCBA is using punishment first interventions. Is this ethical? - No. And the BACB should be notified in writing and letter to the BCBA or faculty using punishment first stating it is not in our ethical code to use punishment first techniques. A BCBA is not terminating services because they want the continued income even though the parents have expressed it is no loner needed. The supervisor is placing pressure & holding them to a notification contact. The colleague is aware of this & concerned whether this is an ethics concern. - The colleague should approach this BCBA & educate her about why this is unethical. If a client friendly resolution is not achieved this should be reported to the BACB. A BCBA is taking on more supervises than they are able to effectively manage. Pressure from her supervisor to do so. What should you do? - A. Encourage her to do the right thing & explain to her boss she can not effectively manage junior BA's. B. Immediately report to BACB.