Introduction
The present paper aims at discussing ethical standards based on a case study. The paper uses Scenario #2 from the Ethical Challenge Assignment Scenarios, which describes the case of George, a BCBA/LBA who works in a group home serving individuals with developmental disabilities. According to the scenario, George was assigned a new client with a history of self-injury without suicidal attempts. However, accepting the case revealed several ethical issues that should be recognized and addressed. The present paper will outline all the ethical and professional concerns in the scenario and provide recommendations for the next steps after acknowledging the problems.
Ethical and Professional Concern
The review of the Professional and Ethical Compliance Code for Behavior Analysts and the New York State Laws, Rules and Regulations revealed several issues associated with Geoge’s professional behavior. First, the case was accepted without a prior review, which violates principle 2.01 described by the Behavioral Analyst Certification Board (BACB, 2014). According to this section, professionals should accept cases only if the professional has the needed training, experience, and time (BACB, 2014). George had no required competencies to work on the case, which caused significant problems for the organization. Second, the supervisor let George lead the case with the new client even though he did not have the required competence. According to BACB’s (2014) ethical principle number 5.03, according to which they can delegate their duties only to qualified personnel. One can argue that principle 5.03 was not breached since the supervisor provided conditions for the acquisition of the needed skills. However, the provision of training was against principle 5.04, which required all training to be efficient (BACB, 2014). Since George had to abandon three cases from his caseload for training purposes, it cannot be called efficient.
Third, George failed to keep records for all of his current clients, which is a direct violation of §29.2 Section A3 of the New York State Laws, Rules and Regulations (NYSED, 2011). According to the section, healthcare professionals are required to keep appropriate records for all of their patients for 6 years after the provision of services. Moreover, failure to keep records is against principles 2.10 and 2.11 described by BACB (2014). Fourth, George and his supervisor were engaged in romantic relationships, which is against principle 1.07 described by BACB (2014), which prohibits exploitive behavior, including sexual contacts with patients and supervisees. This principle was breached by both George and the supervisor.
Finally, it should be acknowledged that George breached principle 3.01 of the Professional and Ethical Compliance Code for Behavior Analysts. The principle explains that behavior analysts need to conduct a thorough assessment before providing any recommendations. However, George failed to conduct the evaluation before making the recommendation that the services of a psychiatrist were no longer needed. In summary, the analysis revealed that George and his supervisor breached the New York State laws and the ethical code at least five times.
Next Steps
There several steps that need to be followed after the breaches were discovered. First of all, the situation should be reported to an ethics supervisor of the organization. After that, a Notice needs to be sent to BACB as the central part of the reporting procedure (BACB, 2021). The Notice needs to describe the actions taken by a person over whom BACB has jurisdiction no earlier than six months before sending. Additionally, it should have a valid signature, include all the supporting documentation, and avoid being retaliatory in nature (BACB, 2021). BACB will take up to 30 days to review the case and implement disciplinary actions against both George and his supervisor. Before the final decision is made, BACB will contact the subjects of the ethics case to clarify the matters of interest (BACB, 2021). If the subjects fail to respond by the mentioned date, BACB can suspend them (BACB, 2021). Thus, the first two steps after the violation of ethics were acknowledged would be to report to BACB and respond to their inquiries in time. A complaint may also be sent to a regional office of professions of NYSED to investigate the case. The complaint must use a specified format, have a valid signature, full contact information, the name of the subject, and a description of the violation.
After the decision is issued, the subject of the notice has 30 days to appeal the results. The final decision may be associated with the implementation of corrective actions, sanctions, or both (BACB, 2021). Corrective actions include professional development, mentorship, verification of competency, and paper of product submission (BACB, 2021). Sanctions may include certification invalidation, revocation, certificate suspension, eligibility suspension, practice restriction, and mandatory supervision (BACB, 2021). If a complaint is sent to the office of professions of NYSED, the possible sanctions may also include fines and probation.
The recommended sanctions and corrective actions will differ for George and his supervisor. The first violation made by George was the acceptance of the case without prior assessment, which does not seem to need any sanctions. Instead, George is recommended to receive professional development to ensure such misconduct does not happen again. The same corrective action is recommended for the fifth violation, which was giving recommendations without evaluation of the client. Professional development should focus on the importance of preliminary assessment of the client before accepting the case and giving any recommendations.
The section violation conducted by George was a failure to keep records of his clients for four years. This is a significant violation, as it may harm the clients or prevent their further improvement. Failure to keep records prevents consistency, continuity, and integrity of care. In January 2020, Paula Pesha Cohen was sanctioned for one year of probation and a $1,500 fine for failing to make separate entries in the patients’ treatment record (NYSED, 2021). However, this sanction should be stricter to George as he did not keep any records for his clients. Thus, it is recommended that George is fined $5,000, and the probation period is extended to two years.
One of the most difficult situations in the case study is the presence of romantic relationships between George and his supervisor. The recommended measure for addressing the violation is submitting a paper that discusses the downside of romantic and exploitive relationships. Additionally, George and his supervisor need to stop any romantic relationships or start working in different organizations. The supervisor also needs to be mentored to avoid assigning cases to professionals with a lack of knowledge and experience in working on such cases. In summary, the recommended actions towards George include professional development in the field of preliminary assessment of clients, submission of a paper on romantic relationships, probation for two years, and a $5,000 fine. As for George’s supervisor, she needs to submit a paper on romantic relationships as well and be mentored for one year.
Conclusion
The case study demonstrates that following ethical codes of conduct is crucial for behavior analysts. Failure to follow the code may result in corrective actions and sanctions. Even though George’s violations were numerous, the sanctions were relatively moderate. Any other violations may have resulted in a suspension of the license or even its termination.
References
Behavioral Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. BACB. Web.
Behavioral Analyst Certification Board. (2021). Code-enforcement procedures. Web.
NYSED. (2011). Rules of the board of regents. Web.
NYSED. (2021). Summaries of regents actions on professional misconduct and discipline. Web.