Addressing Non-Compliance and Ethical Considerations in ABA Services

QUESTION

You are a BCBA or BCaBA who provides services to Jenna, an adolescent who is diagnosed with an intellectual disability. Unfortunately, Jenna’s mother (who is a single mom) has not been implementing any of your recommendations. Your RBT reports that Jenna is often in diapers at the start of the session, even though you have trained her mother on the toilet-training protocol and have recommended she be in underwear. Your RBT also reports that Jenna seems to have full access to her tablet prior to sessions after her mother agreed that the tablet would be a contingent reinforcer. Your RBT recommends no longer providing services to this family and referring to another agency.

In Scenario 1, what would you do? Please list what actions you would take and explain why.

list the main ethical codes.

ANSWER

Addressing Non-Compliance and Ethical Considerations in ABA Services

Introduction

As a Board Certified Behavior Analyst (BCBA) or Board Certified Assistant Behavior Analyst (BCaBA), providing services to individuals with developmental disabilities requires addressing challenges related to non-compliance by caregivers and potential ethical concerns. This essay outlines the actions I would take in Scenario 1, where a client’s caregiver is not implementing recommendations, and discusses the relevant ethical codes that guide my decision-making.

Actions to Take

Open Communication: I would initiate open and honest communication with Jenna’s mother. I would express my concerns about the discrepancies between the recommendations provided, the mother’s implementation, and the observed behaviors during sessions. I would emphasize the importance of consistency and collaboration in achieving the best outcomes for Jenna.

Re-Evaluation and Training: I would re-evaluate the strategies and recommendations given to ensure they are feasible and align with the family’s dynamics and resources. If necessary, I would modify the interventions and retrain Jenna’s mother to ensure her understanding and comfort in implementing them effectively.

Individualized Solutions: Recognizing that each family has unique circumstances, I would work with Jenna’s mother to develop individualized solutions that address potential barriers to implementation. This might involve adjusting the toilet-training protocol or exploring alternative reinforcers that are more motivating for Jenna.

Collaboration: I would collaborate with other professionals involved in Jenna’s care, such as educators, therapists, and medical professionals. A collaborative approach ensures a comprehensive understanding of Jenna’s needs and enables coordinated efforts to address challenges.

Behavioral Contracting: If non-compliance persists, I would consider implementing a behavioral contract with Jenna’s mother. This contract would outline clear expectations, consequences for non-compliance, and rewards for successful implementation. The contract fosters accountability and commitment to the intervention plan.

Supervision and Support: I would provide ongoing supervision and support to the Registered Behavior Technician (RBT) working with Jenna. Regular meetings and updates would ensure that the RBT is implementing interventions correctly and addressing any concerns promptly.

Ethical Codes: Several ethical codes guide my decisions and actions in this scenario

Beneficence and Nonmaleficence: As per the ethical code, I am committed to promoting the well-being of Jenna and ensuring that my interventions are in her best interests. This includes addressing non-compliance to enhance the effectiveness of the intervention plan.

Responsibility: I am responsible for ensuring that interventions are implemented correctly and ethically. This includes monitoring the RBT’s reports, addressing non-compliance, and providing appropriate training and supervision.

Integrity: Upholding integrity requires transparent communication with Jenna’s mother about concerns related to implementation. Open communication fosters trust and allows for collaborative problem-solving.

Professional and Scientific Responsibility: It is my duty to apply evidence-based practices and collaborate with caregivers to ensure the highest quality of care for Jenna. Modifying interventions and strategies based on the caregiver’s feedback and needs is in line with this responsibility.

Conclusion: In Scenario 1, the key is to address non-compliance through open communication, re-evaluation, individualized solutions, collaboration, and potentially behavioral contracting. Ethical codes play a crucial role in guiding these actions to ensure the well-being of the client and the integrity of the interventions. By adhering to ethical principles and taking appropriate steps, I aim to facilitate positive changes in Jenna’s behavior and promote a collaborative and effective therapeutic process.