Chapter 5: The Behavior Analyst’s Responsibility to Clients Guideline 2 Leigh O’Brien Caldwell College

“Wyatt Standards” Wyatt v. Stickney (1971) case in Alabama –Issue  institutionalized mental patients had right to receive individual treatment or be discharged to community First time the term right to treatment was put into legal arena

“Wyatt Standards” Services had to be … –Delivered in humane and least restrictive environments –Sufficient qualified staff –Include individualized treatment plans New goal  do your best work AND responsible to make sure person receiving treatment was not harmed

Where this left behavior analysts Initial concern – manipulate clients behavior for convenience of staff Over time – balance between what is right for client and others it might affect Issues with “first party” (i.e., client), “second party” (i.e., behavior analysts) and “third party” (i.e., school districts, etc.)

The 1980’s Behavior analysts were more widely accepting in treatment of mental retardation This forced behavior analysts to put other protections into place –Late 1980’s a blue-ribbon panel of experts were called upon to help make this happen Consensus was reached

Guideline 2.0 &  Behavior analyst’s responsibility to clients –Operate in the best interest of client –E.g., discontinue services with a client 2.01  definition of client –Broad term – can include individual person, parent, school, etc.

Guideline 2.02 &  Responsibility –Responsible to all parties affected by behavioral services 2.03  Consultation –Arrangement of consultation and referrals in done ONLY based on the best interest of client – with appropriate consent and other considerations –Cooperation with other non-behavioral professionals and acknowledge that they may have their own ethical guidelines

Guideline 2.04 Third-party requests for services –Define role, probable use of services provided or information obtained, and limits to confidentiality –If there is a risk to have to perform conflicting roles – clarify nature and direction of responsibility, keep all parties appropriately informed and resolve situation in accordance with guidelines –Case example and question 27: Dr. B

Guideline 2.05 Rights and prerogatives of clients –Supports individual rights under the law –Provide accurate and current set of credentials upon request –Consent is obtained to audio or video tape – if need/want to use recording for different purpose additional consent is necessary –Clients must be informed of their rights and how to complain about professional practice of the behavior analyst

Guideline 2.06 Maintaining Confidentiality –Primary obligation to take all precautions to ensure confidentiality established by law, institutional rules, or professional relationships –Should be discussed at the start of a relationship with client and as new circumstances arise –Reports, verbal or written, should only include information directly relevant to behavior change in question –Sharing information with other professionals should be restricted to those that will benefit in some scientific manner – any identifying information should be changed

Guideline 2.07 &  Maintaining Records –Responsible to create, use, store and destroy records according to HIPAA and these guidelines 2.08  Disclosure –Disclose confidential information when mandated by law or permitted by law for a valid purpose –Disclose confidential information with appropriate consent

Guideline 2.09 Treatment Efficacy –Responsibility to recommend scientifically supported MOST effective treatments –Clients have rights to effective treatments –Responsible to review and assess the effects of all alternative treatments – including those recommended by other professionals and no intervention

Guideline 2.10 &  Documenting of Professional and Scientific Work –Appropriate documentation of professional and scientific work –If potential for case to be part of legal proceeding, make sure all documents are complete 2.11  Records and Data –Keep and maintain records for as long as necessary, may depend on state or institute regulations AND always within requirements of these guidelines

Guideline 2.12 &  Fees and Financial Arrangements –Reach an agreement for compensation and billing as soon as possible –Fees should follow state and federal laws when applicable. If client is unable to meet the fee schedule discuss how this will impact the service provided and received 2.13  Accuracy in reports to those who pay for services

Guideline 2.14 &  Referrals and fees –Do not accept payment for making referrals 2.15  Interrupting or terminating services –Make arrangements to cover services to clients if you are unable to continue services indefinitely or for periods of time longer than a month –Review all contracts to ensure welfare of client is considered – Do not abandon clients – if have to discontinue services discuss needs with all relevant parties, help with transition of service and refer other professionals to the case