Introduction
In the Scenario, George is a Licensed Behavior Analyst and a Board-Certified Behavior Analyst (BCBA/LBA). He is experienced in vocational and social skills training, but he takes on a new client out of his range of expertise. This client’s self-injurious behavior requires specific training, which the BACB does not possess. Apart from failing to review the new client’s case before agreeing to it, George also neglects to provide sufficient attention to his existing clients or to keep notes on them, which creates problems for future professionals taking over these cases. This situation raises several ethical concerns, and it is vital to report George’s professional behavior and evaluate the next steps for treating his existing clients.
Ethical and Professional Concerns
George’s actions show his failure to respect the Professional and Ethical Compliance Code for Behavior Analysts. First, it is stated that George does not evaluate the caseload for his new patient, and he later realizes that the patient’s history of self-injurious behavior is out of his experience. This is a violation of Code 1.02 and 2.01 – BCBAs must work within their boundaries of competence and accept cases that align with their specific training (Behavior Analyst Certification Board [BACB], 2014). The New York State Education Department’ Rules of the Board of Regents, Part 29.1.9 also states such action as a violation (BACB, 2014). Thus, it was both unethical and unprofessional of George to ignore the evaluation process and accept the client.
Second, upon learning about the patient’s specific needs, George does not contact his supervisor to discuss this problem. Instead, he requests to take time for research review and remove three other clients with whom he has worked for four years. Here, one may highlight the Codes 2.0 and 2.15, especially paragraphs (b), (d), and (e) (BACB, 2014). It is apparent that George does not place the interests of his existing clients first, which is a violation of Code 2.0 (BACB, 2014; Bailey & Burch, 2016). George cannot simply stop his professional relationship with clients who require his assistance and have not indicated any desire to change their caretaker.
Moreover, the BCBA does not contact his clients, hear their opinion about the care termination, find ways of transition, or make any effort to make the clients comfortable. In the scenario, it is stated that clients may stay without services for some time, which is a sign of great neglect of their needs by the analyst. George’s sudden decision to drop these clients without facilitating the continuation of their care can be viewed as abandonment (BACB, 2014).
Code 2.15 of the ethics code shows that discontinuation of a client can occur only after making a significant effort of transfer, and it should be based on sufficient reasons (BACB, 2014; Bailey & Burch, 2016). Part 29.2.1 of the Rules of the Board of Regents prohibits abandoning or neglecting a client without making arrangements that would not disrupt their care (Office of the Professions [OP], 2018).
George’s relationship with his supervisor is rather unethical as they have engaged in romantic relationships, and George seems to have some power in overseeing the Supervised Experience Hours. One may consider Code 1.07 in this instance; however, it is unclear whether George has sufficient authority over his supervisor to officially raise this concern (BACB, 2014). Nevertheless, his decisions also impact the ethical and professional conduct of the supervisor, putting them at risk of disciplinary action as well.
Finally, while discussing the transfer of George’s clients to other BCBAs, it is revealed that George did not keep any notes for over four years. Part 2.10 of the Code implores BCBAs to maintain client records for them to be used by the current or future specialists as well as for disclosure and transparency (BACB, 2014). According to the Rules of the Board of Regents, George has violated section 29.2.3 by not making any notes that would reflect their evaluation and treatment (OP, 2018).
Recommendations
As can be seen, George has engaged in several unethical behaviors, and his first decision of taking on a client revealed several crucial errors in his practice over a long period of time. Thus, the first step would be to talk to George and discuss some of the violations to determine if there exists an informal resolution, according to Code 7.02.c (BACB, 2014). Next, one has to contact relevant authorities in order to protect the clients, starting with the employer (BACB, 2019).
The state regulatory authority should also be notified as George’s failure to keep any notes endangers the future care of his clients. A formal complaint to the Behavior Analyst Certification Board (BACB) is necessary to ensure that the violation of the Code is recorded and reviewed, as per Code 10.02 (BACB, 2019; BACB, 2014). Overall, it is vital to take steps to make sure that George understands the potential harm of his decisions.
As the Code emphasized the well-being of clients, this scenario presents a complex problem to resolve. George is currently responsible for four clients, one of whom requires care out of George’s expertise. It is vital to timely transfer the new client to the professional who possesses knowledge or certification to work with self-injurious behavior. Next, one has to consider how clients who have been overseen by George can receive care without disruptions. They cannot be removed from his care immediately, as it would leave them without supervision for an extended period of time. Nevertheless, as George is likely to be disciplined, the organization needs to prepare the clients for transfer.
The records of the New York Education Department show some examples of enforcement actions for cases similar to George’s. In the most recent case, a Registered Nurse failed to complete progress notes for patients. The action included one year of stayed suspension, one year of probation, and a $750 fine (OP, 2021). However, George may also face actual suspension, as well as longer periods of probation and larger fines. Overall, if George takes steps to review his actions and improve his moral fit for the profession, he may avoid license revocation (BACB, 2019; OP, 2018). In any case, if George decides to work with clients outside of his expertise in the future, he needs to take proper steps and receive mentored experience and certification.
Conclusion
Scenario 2 presents a case where a professional makes one decision, which leads to uncovering several unethical practices. George’s lack of evaluation also exposed his neglectful behavior and lack of attention to proper documentation. Thus, it is vital to discuss these issues with George and report such unethical conduct. George’s violation of the Code can result in suspension, probation, and fines. If he does not take timely steps to change, he may also face revocation.
References
Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts (3rd ed.). Routledge.
Behavior Analyst Certification Board. (2014). Professional and Ethical Compliance Code for Behavior Analysts. Web.
Behavior Analyst Certification Board. (2019). Code-enforcement procedures. Web.
Office of the Professions. (2018). Rules of the Board of Regents: Part 29, unprofessional conduct. New York State Education Department. Web.
Office of the Professions. (2021). Summaries of regents actions on professional misconduct and discipline: January 2021. New York State Education Department. Web.