Review the “Ethical Dilemmas Worksheet” in the Learning Resources, which contains ethical dilemmas a professional behavior analyst might face. Prepare to analyze and respond to the ethical dilemmas.

For each of the 5 dilemmas on the “Ethical Dilemmas Worksheet,” answer the following questions:

• What is the problem?
• Which ethical code(s) pertain to the problem?
• How would you handle this dilemma and why?

1. Laura has been working as Josh’s behavior analyst for many years. During the past six
months, Josh has developed some moderate to severe self-injurious behaviors (SIBs). He
now has a lump on his forehead from head-banging and open sores on his arms from
scratching. Laura has followed all the procedures for best practice, beginning with a
medical assessment, a functional analysis, and a function-based approached to treatment.
However, Josh’s behaviors have increased in rate and intensity. Laura has re-assessed and
made modifications to the behavior intervention plan several times, but no intervention
seems to be working. Laura is feeling unsure about what to do next with Josh and is
considering the use of aversive procedures, including the possibility of using electric
shock.

2. Susan is a behavior analyst who works with children diagnosed with autism spectrum
disorder (ASD). Her best friend has a four-year-old child recently diagnosed with ASD.
The friend has sought help from a local therapist who advertises herself as an autism
expert. The therapist does not have a background in behavior analysis and her methods
are not validated by research. Susan has tried to explain this to her friend, but the friend
has been told by a parent at her child’s preschool that this therapist is great and has a
100% success rate. After being told by her friend how the therapist is misguiding the
child’s treatment, Susan has had enough and begins giving the friend her professional
opinion. The friend is open to Susan’s advice and begins to call on her more to consult.
Susan realizes her friend needs more than just advice and considers developing a home-
based program for the child. A colleague warns Susan to consider the ethics of what she
is doing with her friend.

3. Matt works for a public school as a behavior analyst. The school employs several
behavior analysts and has ASD classrooms for children who would otherwise require a
more restrictive environment. Many students at the school engage in dangerous
behaviors, including aggression and SIB. It is not uncommon for students to be held in
restraints or placed in seclusion. The school has provided training for these procedures
and oversees their use with the required documentation and reporting per the state laws.
Matt recently observed a student (not one of his clients) placed in seclusion without
continual visual monitoring. He approached the student’s behavior analyst about it and
was told the monitor was called away to another crisis. Matt responded that he was
uncomfortable that students may hurt themselves in seclusion if they are not visually
monitored at all times. The behavior analyst said it was out of her control. Matt then went
to the school administration, and they said there was nothing they could do—it was a
staffing issue that will not be resolved for several months.

4. Mona is a behavior analyst in training and is seeking supervision for her fieldwork at her
place of employment. She is told that all supervisors are maxed out with supervision and
have no available slots. She approaches Kathy, a board-certified behavior analyst
(BCBA) with whom she works closely and asks if there is any way an exception to the
caseload max could be made so that she could take her on. Kathy says she can make an
exception under one condition—Mona would have to serve as her Saturday night
babysitter for the duration of supervision.

5. Carolyn, a BCBA working in a practice with several other behavior analysts, all BCBAs
or BCBADs, has a client whose parents are going through a nasty divorce. She learns that
another BCBA in the practice has accessed the records for this client and released
confidential information about a client to an attorney working with one parent without a
signed release or court order. After the psychologist reviews the information presented, it
is clear to the treating psychologist that the other psychologist breached confidentiality.
What should Carolyn do?

ANSWER

Ethical Dilemmas Worksheet.”

Dilemma 1: Laura’s Use of Aversive Procedures

Problem: Laura is faced with the challenge of managing severe self-injurious behaviors in her client, Josh. Despite employing best practices and modifying the behavior intervention plan, the behaviors have escalated. Laura is considering using aversive procedures, including electric shock, which raises ethical concerns.

Ethical Code(s): This dilemma implicates several ethical codes, such as the Behavior Analyst Certification Board’s Professional and Ethical Compliance Code for Behavior Analysts. Notably, Code 2.09 states that behavior analysts must always prioritize the welfare of their clients and avoid using interventions that may cause harm.

Response: Laura should approach this situation with the utmost care and adherence to ethical guidelines. Rather than resorting to aversive procedures immediately, she should continue exploring alternative interventions, consulting with colleagues, and seeking supervision. Engaging in interdisciplinary collaboration, such as consulting with medical professionals, psychologists, and educators, can provide valuable insights. If all non-aversive interventions have been exhausted and there is clear evidence that aversive procedures are the last resort, Laura should ensure she obtains informed consent from the client’s legal guardians after presenting all available options, potential risks, and benefits.

Dilemma 2: Susan’s Involvement in Friend’s Child’s Treatment

Problem: Susan faces a situation where her personal and professional lives intersect. Her friend seeks help for her child’s autism from a therapist with questionable methods. Susan offers her professional opinion and later considers developing a home-based program, which blurs the boundaries of their personal and professional relationships.

Ethical Code(s): The Behavior Analyst Certification Board’s Code 2.01 emphasizes that behavior analysts must maintain professional boundaries and avoid multiple relationships that could impair objectivity and effectiveness.

Response: Susan should prioritize maintaining professional boundaries while offering support to her friend. She should continue providing evidence-based information about autism interventions and advocate for validated methods. If her friend desires further assistance, Susan should consider connecting her friend with other qualified professionals who can provide the necessary support without compromising ethical principles.

Dilemma 3: Matt’s Concerns about Student Seclusion

Problem: Matt observes a school’s use of seclusion and restraint procedures for students with dangerous behaviors, which raises concerns about safety and ethical compliance.

Ethical Code(s): The Behavior Analyst Certification Board’s Code 2.09 underscores the importance of using interventions that prioritize the safety and well-being of clients and minimize harm.

Response: Matt should continue advocating for the safety of students. He should document his concerns and discussions with colleagues and administrators. He can collaborate with his colleagues to gather information, potentially involving other behavior analysts in addressing this issue. Matt could also explore external resources, such as state regulatory bodies or professional organizations, to ensure the school’s practices align with ethical and legal standards.

Dilemma 4: Mona’s Supervision Arrangement

Problem: Mona seeks supervision from Kathy and is offered a spot with the condition that she serves as Kathy’s babysitter.

Ethical Code(s): The Behavior Analyst Certification Board’s Code 3.04 states that behavior analysts should not exploit relationships with supervisees for personal, sexual, or financial gain.

Response: Mona should decline the supervision arrangement proposed by Kathy, as it crosses ethical boundaries. She can seek supervision from other available supervisors who do not request personal favors in exchange for professional services. If none are available, Mona should escalate the situation to higher management or regulatory bodies, as appropriate, to ensure her access to ethical supervision.

Dilemma 5: Carolyn’s Response to Breach of ConfidentialityProblem: Carolyn discovers that a colleague in her practice has released confidential information about a client involved in a divorce case without proper authorization.

Ethical Code(s): The Behavior Analyst Certification Board’s Code 4.07 emphasizes maintaining client confidentiality and safeguarding their information.

Response: Carolyn should promptly address this ethical breach. She can communicate her concerns with the colleague involved, expressing the importance of confidentiality and ethical guidelines. If the breach persists, she should escalate the issue to her practice’s leadership or ethics committee. Additionally, she could consult with legal professionals to determine the appropriate course of action, ensuring that client confidentiality is upheld and any necessary corrective actions are taken.

In addressing these ethical dilemmas, it’s crucial to prioritize the well-being of clients, uphold ethical standards, and seek guidance from relevant authorities or professional organizations when needed. Always remember that ethical decision-making in behavior analysis requires a thoughtful and principled approach.