Association for Behavior Analysis International

Often times, Board Certified Behavior Analysts (BCBAs) are asked to treat adults with both behavioral and medical complications. These BCBAs work within interdisciplinary teams that include medical practitioners, psychiatrists, and a smorgasbord of other professionals. The work of these teams is subject to significant organizational pressures and regulatory constraints. Working within such settings can pressure BCBAs to act beyond the purview of their certifications, and complicate the implementation of effective and sustainable treatment. The presenter will discuss a specific case of the ethical concerns faced by a BCBA working under such conditions. This BCBA served an individual in a residential setting with developmental disabilities, comorbid psychiatric diagnoses, and severe medical conditions. The discussion will cover the implementation of interventions while minimizing personal rights restrictions, evaluating appropriate treatment strategies, and working alongside professionals from other disciplines who have different sets of clinical objectives and ethical requirements. Strategies for navigating these interactions will be discussed.

The title of this talk reflects one of many prevalent, alarming, and real life student-generated scenarios provided to the author and instructor during a certification-board approved online course sequence in behavior analysis. Recent growth in online programs reflects an influx of non-behavior analysts to the field hired, in many cases, faster than certification (and training) programs can keep up. In the wake of fluctuating funding streams and new legislation, how can the community of behavior analysts plan to protect against ethical drift and prepare for new challenges? In order to explore this growing concern, we will review issues from the past 5 years of practice in diverse settings in Colorado, a state relatively new to behavior analysis and to insurance-mandated behavior analysis. Case studies and sets of potential solutions will be presented from several distinct practice contexts, including: Instructing new behavior analysis students with varying previous experiences and advanced degrees; supervision in clinical settings new to behavior analysis; and community behavior analysis settings supporting learners with autism, developmental disabilities, or needs addressed by state-reimbursed early intervention programs. Some implications are discussed for each area of practice, ending with a call to action.