The Behavior Analyst’s Responsibility to Clients PRESENTED BY CHRISTINA SLATEN A Little History…. Early behavior analysts were responsible to the employer, sometimes the parents 1974 – Wyatt vs. Stickney Institutionalized mental patients had right to individualized treatment or to be discharged into the community Highlighted “client’s rights” Wyatt Standards Service delivery within a humane environment Sufficient qualified staff members Individualized treatment plans Least restricted environment Responsibility to all involved, with a focus on the person directly receiving the intervention to make sure no harm was done Responsibility to Clients Guideline 2: The behavior analyst has a responsibility to operate in the best interest of clients. Who is the client? (2.01) Anyone to whom services are provided Examples? Clear and detailed list of obligations that behavior analysts must adhere to when providing treatment involving behavioral procedures Always ask , “What is in the best interest of my client?” Definition of Client (2.01) Broad application Anyone to whom behavior analyst provides services Individual (service recipient) Parent/guardian of service recipient Institutional representative Public/private agency Firm/corporation Most vulnerable individuals in the chain of services are considered primary clients Accepting Clients (2.02) Only accept clients whose behavioral concerns are in line with behavior analyst’s education, training and experience • If outside expertise, must be under supervision/consultation of BCBA who has credentials with the particular situation Responsibility (2.03) Responsible to all parties effected by the behavioral services. Obligation to make sure that all principles of ethics extend to everyone involved Service recipient Parent/guardian Other people in the specific environment (e.g., other students in classroom) Consultation (2.04) Appropriate consults and referrals • Based on best interest of client • Appropriate consent • Subject t0 relevant considerations (e.g., applicable laws, contractual obligations) Cooperation with other professionals to provide effective and appropriate services • Recognize various ethical codes of other professions Third-Party Requests for Services (2.05) Clarify nature of relationship with each party at onset of service Role of behavior analyst Probable uses of services /information obtained Limits to confidentiality? If there are any risks of conflicting roles Clarify nature and direction of responsibilities Keep all parities informed Resolve situation according to Guidelines Rights and Prerogatives of Clients (2.06) Supports individual rights under the law Provide client with accurate credentials Inform clients of rights and procedures to complain about professional practices Secure permission (for each use of) electronic recording of interviews/service delivery sessions Meet requirements for criminal background checks Maintaining Confidentiality (2.07) Primary obligation to take reasonable precautions to respect confidentiality Law, institutional rules, professional, and/or professional/scientific relationships Clients have a right to confidentiality – should be discussed at onset of relationship and ongoing as needed Unless not feasible or contraindicated Examples? Include only pertinent information in written or oral communication Discuss confidential information only for appropriate scientific/professional purposes and with people clearly concerned with info Maintaining Records (2.08) Review current Health Insurance Portability and Accountability Act (HIPPA, 2003) legislation Creating Maintain and dispose of records in accordance to applicable laws, regulations or corporate policy AND in a manner that complies with the BCBA guidelines. Transferring Maintain appropriate confidentiality Accessing Storing/Disposing Disclosures (2.09) A.) Disclose confidential information without consent of the individuals only as mandated/permitted by law for a valid purpose To provide professional services to client Obtain professional consultations To protect client/others from harm To obtain payment for services B.) Disclose confidential information with appropriate consent Examples of appropriate consent? Treatment Efficacy (2.10) Responsible to recommend scientifically supported most effective treatment procedures Both long and short term benefits to clients and society Right to effective treatment Based on research literature Adapted to individual client Responsible for review and assessment of likely effects of all alternative treatments Including those provided by other disciplines and no intervention Consideration of multiple, scientifically-supported treatments, may include, but not limited to… Efficiency Cost-effectiveness Risks/side-effects Client preference Practitioner experience/training Documenting Professional and Scientific Work (2.11) Appropriately document to facilitation replication, ensure accountability & meet requirements of institution/law If used in legal proceedings, must create and maintain documentation that would be consistent with the quality consistent with reasonable scrutiny in a judicial forum Good idea to imagine all documentation WILL be used in legal proceedings Always obtain and document Institutional Review Board (IRB) or local Human Research committees Confirmation of compliance with institutional requirements Records and Data (2.12) maintain Dispose disseminate Compliance with guidelines and applicable laws or regulations Retain Store store create Fees, Financial Arrangements and Terms of Consultation (2.13) Agreement reached re: detailing compensation and billing arrangements as early in professional/scientific relationship as possible Fees consistent with law Limitations of service due to financing discussed as early as possible Do not misrepresent fees Provide term of consultation, specific requirements for providing services & responsibilities of all parties Prior to implementation of services Contract or Declaration of Professional Services Accuracy in Reports to Those Who Pay for Services (2.14) Accurately state Nature of service/research Fees or charges Identity of provider Findings Other required descriptive data Examples? Referrals and Fees (2.15) Disclose if there is payment received or fees divided with another professional (other than employer – employee relationship Interrupting or Terminating Services (2.16) Make reasonable efforts to plan for continuing service in the event there will be an interruption of service Include resolution of services in contract Do not abandon client – end service when it is reasonably apparent client no longer needs services Pre-termination services Suggest other service providers Transfer responsibility to other providers if necessary Questions? References Bailey, J.S., &Burch, M.R. (2001). Ethics for behavior analysts (2nd Expanded Edition). Routledge.