CHAPTER 4: MOST FREQUENT ETHICAL PROBLEMS Kelly Carlile
Caldwell College
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OVERVIEW Introduction Top 5 Ethical Concerns Top 10 Standards
Related to 6-10 Standards Related to Other Fields Ethical Concerns
for Other Fields Another Big Concern Related Codes of Ethics
Questions
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INTRODUCTION No official, systematic surveys of behavioral
practitioners to determine the most frequently occurring Based on
scenarios written by workshop attendees
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TOP 5 ETHICAL CONCERNS Ethical ConcernsEthical Standard 1 Right
to Effective Treatment2.10B 2 Responsibility to Recommend
Scientifically Supported and Most Effective Treatments 2.10A 3
Behavior Analysts Assessments are Sufficient to Provide Appropriate
Substantiation for their Findings 3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02
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RIGHT TO EFFECTIVE TREATMENT (2.10B) 2.10 Treatment Efficacy
(b) Clients have a right to effective treatment (i.e., based on the
research literature and adapted to the individual client)
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RIGHT TO EFFECTIVE TREATMENT (2.10B) Funding Unwillingness for
school districts to pay Difficult to get insurance companies to
reimburse Some still consider it experimental Not medically
necessary More public school programs being started Lack of
understanding of need Some states have age cut off and caps
lifetime expenditures
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RIGHT TO EFFECTIVE TREATMENT (2.10B) $35 billion (Ganz, 2008)
Direct Medical Costs Direct Non-Medical Costs Indirect Costs
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RIGHT TO EFFECTIVE TREATMENT (2.10B) Data Taking and Data
Faking Dont have time Know without the data Nonbehavioral
professionals are in leadership roles Fake data and present as
valid What are other reasons people may fake data?
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RIGHT TO EFFECTIVE TREATMENT (2.10B) Alternative Nonevidence
Based Treatments are Preferred Parents see as a choice More
available than ABA services Quick fix What document exists now to
assist with promotion of ABA?
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RIGHT TO EFFECTIVE TREATMENT (2.10B) Competing Lines of
Authority Working as a team, but under guidance of psychiatrist
Medication often chosen as treatment School district representative
overshadows parent and teacher
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RESPONSIBILITY TO RECOMMEND SCIENTIFICALLY SUPPORTED AND MOST
EFFECTIVE TREATMENTS (2.10A) 2.10 Treatment Efficacy (a) The
behavior analyst always has the responsibility to recommend
scientifically supported most effective treatments
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RESPONSIBILITY TO RECOMMEND SCIENTIFICALLY SUPPORTED AND MOST
EFFECTIVE TREATMENTS (2.10A) Choice Like having options, rather
than being told Want to do what is best Whats the harm in trying?
Want hope Bored Why dont we give parents a choice?
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RESPONSIBILITY TO RECOMMEND SCIENTIFICALLY SUPPORTED AND MOST
EFFECTIVE TREATMENTS (2.10A) Competing Professions and Their
Theories Importance of exercise Sensory diets Relaxation techniques
What do you do when you are asked to implement a sensory diet?
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BEHAVIOR ANALYSTS ASSESSMENTS ARE SUFFICIENT TO PROVIDE
APPROPRIATE SUBSTANTIATION FOR THEIR FINDINGS (3.0A) 3.0 Assessing
Behavior (a) Behavior analysts assessments, recommendations,
reports, and evaluative statements are based on information and
techniques sufficient to provide appropriate substantiation for
their findings
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BEHAVIOR ANALYSTS ASSESSMENTS ARE SUFFICIENT TO PROVIDE
APPROPRIATE SUBSTANTIATION FOR THEIR FINDINGS (3.0A) Start
intervention without assessment Recommend without seeing child
Decisions not based on data What do you do when you are asked
recommendations for a child you have never seen?
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DUAL RELATIONSHIPS AND CONFLICTS OF INTEREST (1.06A,B) 1.06
Dual Relationships and Conflicts of Interest (a) In many
communities and situations, it may not be feasible or reasonable
for behavior analysts to avoid social or other nonprofessional
contacts with persons such as clients, students, supervisees, or
research participants. Behavior analysts must always be sensitive
to the potential harmful effects of other contacts on their work
and on those persons with whom they deal. (b) A behavior analyst
refrains from entering into or promising a personal, scientific,
professional, financial, or other relationship with any such person
if it appears likely that such a relationship reasonably might
impair the behavior analysts objectivity or otherwise interfere
with the behavior analysts ability to effectively perform his or
her functions as a behavior analyst, or might harm or exploit the
other party.
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DUAL RELATIONSHIPS AND CONFLICTS OF INTEREST (1.06A,B) Dual
Relationships and Conflicts of Interest Any interaction with client
beyond role of therapist Accepting gifts or food Many deny this
effects judgment Also felt like they should cut family a break
financially What is too much? Is it less ethical to accept a gift
or to deny a gift? What should be done as a field to address
this?
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FUNCTIONAL ASSESSMENT (3.02) 3.02 Functional Assessment (a) The
behavior analyst conducts a functional assessment, as defined
below, to provide the necessary data to develop an effective
behavior change program. (b) Functional assessment includes a
variety of systematic information-gathering activities regarding
factors influencing the occurrence of a behavior (e.g.,
antecedents, consequences, setting events, or motivating
operations) including interview, direct observation, and
experimental analysis.
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FUNCTIONAL ASSESSMENT (3.02) Lack of resources Professional
judgment Descriptive assessments
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TOP 10 ETHICAL CONCERNS Ethical Standard 1 Treatment
Efficacy2.10B 2 Responsibility to Recommend Scientifically
Supported and Most Effective Treatments 2.10A 3 Assessing
Behavior3.0A 4 Dual Relationships and Conflicts1.06A,B 5 Functional
Assessment3.02 6 Least Restrictive Procedures4.10 7 Responsible for
Appraisal of Alternative Treatments 2.10c 8 Responsibility to All
Parties Affected by Behavioral Services 2.03 9
Reinforcement/Punishment4.05 10 Environmental Conditions that
Hamper Implementation 4.03
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STANDARDS RELATED TO 6-10 #StandardDescription 4.10 Least
Restrictive Procedures The behavior analyst reviews and appraises
the restrictiveness of alternative interventions and always
recommends the least restrictive procedures likely to be effective
in dealing with a behavior problem 2.10cTreatment Efficacy Behavior
analysts are responsible for review and appraisal of likely effects
of all alternative treatments, including those provided by other
disciplines and no intervention 2.03Responsibility The behavior
analysts responsibility is to all parties affected by behavioral
services. 4.05Reinforcement/Punishment The behavior analyst
recommends reinforcement rather than punishment whenever possible.
If punishment procedures are necessary, the behavior analyst always
includes reinforcement procedures for alternative behavior in the
program. 4.03 Environmental Conditions that Hamper Implementation
If environmental conditions hamper implementation of the behavior
analytic program, the behavior analyst seeks to eliminate the
environmental constraints, or identifies in writing the obstacles
to doing so.
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PT CODE OF ETHICS BACB Guidelines Treatment Efficacy (2.10A,B)
Assessing Behavior (3.0A) Dual Relationships and Conflicts of
Interest (1.06A,B) Functional Assessment (3.02) Least Restrictive
Procedures (4.10) Responsible for Appraisal of Alternative
Treatments (2.10C) Responsibility to All Parties Affected by
Behavioral Services (2.03) Reinforcement/Punishment (4.05)
Environmental Conditions that Hamper Implementation (4.03)
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OT CODE OF ETHICS
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Ethical Standard 1 Treatment Efficacy2.10B 2Responsibility to
Recommend Scientifically Supported and Most Effective Treatments
2.10A 3 Assessing Behavior3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02 6 Least Restrictive
Procedures4.10 7Responsible for Appraisal of Alternative Treatments
2.10c 8Responsibility to All Parties Affected by Behavioral
Services 2.03 9 Reinforcement/Punishment4.05 10Environmental
Conditions that Hamper Implementation 4.03
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ASHA CODE OF ETHICS
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Ethical Standard 1 Treatment Efficacy2.10B 2Responsibility to
Recommend Scientifically Supported and Most Effective Treatments
2.10A 3 Assessing Behavior3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02 6 Least Restrictive
Procedures4.10 7Responsible for Appraisal of Alternative Treatments
2.10c 8Responsibility to All Parties Affected by Behavioral
Services 2.03 9 Reinforcement/Punishment4.05 10Environmental
Conditions that Hamper Implementation 4.03 ASHA CODE OF ETHICS
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ART THERAPY CODE OF ETHICS
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Ethical Standard 1 Treatment Efficacy2.10B 2Responsibility to
Recommend Scientifically Supported and Most Effective Treatments
2.10A 3 Assessing Behavior3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02 6 Least Restrictive
Procedures4.10 7Responsible for Appraisal of Alternative Treatments
2.10c 8Responsibility to All Parties Affected by Behavioral
Services 2.03 9 Reinforcement/Punishment4.05 10Environmental
Conditions that Hamper Implementation 4.03 ART THERAPY CODE OF
ETHICS
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NEA CODE OF ETHICS Least detailed Do not address any of the
standards of the BACB guidelines Only address commitment to student
and commitment to self
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Ethical Standard 1 Treatment Efficacy2.10B 2Responsibility to
Recommend Scientifically Supported and Most Effective Treatments
2.10A 3 Assessing Behavior3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02 6 Least Restrictive
Procedures4.10 7Responsible for Appraisal of Alternative Treatments
2.10c 8Responsibility to All Parties Affected by Behavioral
Services 2.03 9 Reinforcement/Punishment4.05 10Environmental
Conditions that Hamper Implementation 4.03 NEA CODE OF ETHICS
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APA CODE OF ETHICS 2.04 Bases for Scientific and Professional
Judgments 3.05 Multiple Relationships 3.06 Conflict of Interest
3.10 Informed Consent 9.01 Bases for Assessments 9.02 Use of
Assessments
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Ethical Standard 1 Treatment Efficacy2.10B 2Responsibility to
Recommend Scientifically Supported and Most Effective Treatments
2.10A 3 Assessing Behavior3.0A 4 Dual Relationships and
Conflicts1.06A,B 5 Functional Assessment3.02 6 Least Restrictive
Procedures4.10 7Responsible for Appraisal of Alternative Treatments
2.10c 8Responsibility to All Parties Affected by Behavioral
Services 2.03 9 Reinforcement/Punishment4.05 10Environmental
Conditions that Hamper Implementation 4.03 APA CODE OF ETHICS
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ETHICAL ISSUES FOR OT/PT Recommendations not honored due to
budget Space to treat Group students
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ETHICAL ISSUES FOR SPEECH Told limited number of students they
can classify Told students will not be eligible, so do not assess
Back to back sessions reduce IEP times Forced to group
students
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ETHICAL ISSUES FOR TEACHERS Advocate for district first and
student second Asked to address issues outside expertise Given
behavior plans to implement with no training
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ETHICAL ISSUES FOR CST Told not to classify students with
specific diagnosis, even though meet criteria for it Parent
requests not always considered in team decision Public vs. Private
Programs General education teachers not in agreement and sabotage
placement if not in agreement or argue with parents unnecessarily
Hold back special education students Advance grade levels without
exposure to curriculum
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PROFESSIONAL ETHICS THAT RELATE TO TOP 10 CONCERNS Ethical
Standard 1 Treatment Efficacy2.10B 2 Responsibility to Recommend
Scientifically Supported and Most Effective Treatments 2.10A 3
Assessing Behavior3.0A 4 Dual Relationships and Conflicts1.06A,B 5
Functional Assessment3.02 6 Least Restrictive Procedures4.10 7
Responsible for Appraisal of Alternative Treatments 2.10c 8
Responsibility to All Parties Affected by Behavioral Services 2.03
9 Reinforcement/Punishment4.05 10 Environmental Conditions that
Hamper Implementation 4.03
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CAN YOU THINK OF AN EVEN BIGGER ETHICAL ISSUE NOT
MENTIONED??
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ETHICS AND TECHNOLOGY YouTube search revealed many Social Media
Ethic guidelines need to be updated to reflect new technological
advances.
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HOW TO HANDLE ETHICAL PROBLEMS To be continued... Chapter
17
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QUESTIONS?
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RELATED CODES OF ETHICS Art Therapy Code of Ethics Art Therapy
Code of Ethics APA Code of Ethics APA Code of Ethics OT Code of
Ethics OT Code of Ethics PT Code of Ethics PT Code of Ethics NEA
Code of Ethics NEA Code of Ethics