Ethics and Au-sm Services:

Transcription

1 Ethics and Au-sm Services: 7 deadly sins and fi8y shades of grey Rob Holdsambeck, Ed.D.,LCP, BCBA- D Execu-ve Director Cambridge Center for Behavioral Studies Founder, Holdsambeck and Associates, Inc.

2 7 Deadly sins(590a.d. Pope Gregory 1) & 7 Heavenly Virtues Superbia- Pride- Humility Invidia- Envy- Kindness Gula- GluVony- Temperance Luxuria- Lust- Chas-ty Ira- Wrath (anger)- Pa-ence Avaridia- Avarice (greed)- Charity Acedia- Sloth (lazy)- Diligence

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4 Behavior can be illegal but moral

5 Behavior can be legal but unethical for persons in power

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9 Unethical is not synonymous with legally liable the Ethics Code standards does not by itself determine whether the psychologist is legally liable in a court ac-on, whether a contract is enforceable, or whether other legal consequences occur. Whew!

10 Why we study ethics

11 Working late is not always the best se`ng event for ethical conduct

12 Greed, an alterna-ve perspec-ve and a confession

13 "greed, for lack of a bever word, is good. Greed is right, greed works. Greed clarifies, cuts through, and captures the essence of the evolu-onary spirit. Greed, in all of its forms; greed for life, for money, for love, knowledge has marked the upward surge of mankind.

14 Greed and Envy Meta con-ngencies and Au-sm supply/ demand- $ and resentment How much should you make?- APA/BACB guidelines? What will people pay you to do? Salary/hourly/bonuses? Your own prac-ce- for profit/non profit

15 Shades of grey and some that aren t Dishonesty about charges- to individual AND third party payers Figuring out co- pays/deduc-bles/which ac-vi-es are billable Selling snake oil Staying skep-cally op-mis-c and current Ignoring labor laws Understanding labor laws

16 Some-mes it seems grey but it isn t 2.15 Referrals and Fees. When a behavior analyst pays, receives payment from, or divides fees with another professional other than in an employer- employee rela-onship, the referral shall be disclosed to the client.

17 And some-mes it gets grey 6.07 Referrals and Fees When psychologists pay, receive payment from, or divide fees with another professional, other than in an employer employee rela-onship, the payment to each is based on the services provided (clinical, consulta-ve, administra-ve, or other) and is not based on the referral itself.

18 Lust Sex with clients/students/research par-cipants/supervisees

19 1.07 Exploita-ve Rela-onships. RBT (a) Behavior analysts do not exploit persons over whom they have supervisory, evalua-ve, or other authority such as students, supervisees, employees, research par-cipants, and clients. (b) Behavior analysts do not engage in sexual rela-onships with clients, students, or supervisees in training over whom the behavior analyst has evalua-ve or direct authority, because such rela-onships easily impair judgment or become exploita-ve. (c) Behavior analysts are cau-oned against bartering with clients because it is o8en (1) clinically contraindicated, and (2) prone to forma-on of an exploita-ve rela-onship.

20 Psychologists do not engage in sexual in-macies with current therapy clients/ pa-ents. Psychologists do not engage in sexual in-macies with individuals they know to be close rela-ves, guardians, or significant others of current clients/pa-ents. Psychologists do not terminate therapy to circumvent this standard.

21 Psychologists do not accept as therapy clients/ pa-ents persons with whom they have engaged in sexual in-macies. (a) Psychologists do not engage in sexual in-macies with former clients/pa-ents for at least two years a8er cessa-on or termina-on of therapy. (b) Psychologists do not engage in sexual in-macies with former clients/pa-ents even a8er a two- year interval except in the most unusual circumstances.

22 Lust Sexual Harassment Flir-ng Sex with co workers? Bosses? How do you define sex? Dress codes and mandated training?

23 It is unlawful to harass a person (an applicant or employee) because of that person s sex. Harassment can include sexual harassment or unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature.

24 Although the law doesn t prohibit simple teasing, opand comments, or isolated incidents that are not very serious, harassment is illegal when it is so frequent or severe that it creates a hos-le or offensive work environment or when it results in an adverse employment decision (such as the vic-m being fired or demoted).

25 The harasser can be the vic-m's supervisor, a supervisor in another area, a co- worker, or someone who is not an employee of the employer, such as a client or customer.

26 Sexual Harassment Repor-ng Statute of limita-ons- up to 1 year a8er the alleged viola-on (California) Under 18- one year past the 18 th birthday

27 Professional boundaries- blurred lines Friends/students/ co- workers/clients? Dual rela-onships in small towns Tradi-onal Psychology versus ABA- Rewarding coopera-on

28 Pride versus Humility Eclec-c therapies ABA experts in everything? Psychologists who think they know EIBI Behavior Analysts who think they know clinical psychology

29 Bearing false Witness

30 BACB 9.05 Avoiding False or Decep:ve Statements. RBT Behavior analysts do not make public statements that are false, decep-ve, misleading, or fraudulent, either because of what they state, convey, or suggest or because of what they omit, concerning their research, prac-ce, or other work ac-vi-es or those of persons or organiza-ons with which they are affiliated.

31 APA 5.01 Avoidance of False or Decep-ve Statements (b) Psychologists do not make false, decep-ve, or fraudulent statements concerning (1) their training, experience, or competence; (2) their academic degrees; (3) their creden-als; (4) their ins-tu-onal or associa-on affilia-ons;(5) their services; (6) the scien-fic or clinical basis for, or results or degree of success of, their services; (7) their fees; or(8) their publica-ons or research findings.

32 1.04 Integrity. (a) Behavior analysts are truthful and honest. Diagnos-c dilemma's in Au-sm- changing criteria and ge`ng help for families Tx request denials and the reframe - (helping a deficit become an excess) Charts that exaggerate

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35 Confiden-ality and duty to warn 2.09 Disclosures. RBT (a) Behavior analysts disclose confiden-al informa-on without the consent of the individual only as mandated by law, or where permived by law for a valid purpose, such as (1) to provide needed professional services to the individual or organiza-onal client, (2) to obtain appropriate professional consulta-ons, (3) to protect the client or others from harm, or (4) to obtain payment for services, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose.

36 Confiden-ality and duty to warn (b) Psychologists disclose confiden-al informa-on without the consent of the individual only as mandated by law, or where permived by law for a valid purpose such as to (1) provide needed professional services; (2) obtain appropriate professional consulta-ons; (3) protect the client/pa-ent, psychologist, or others from harm; or (4) obtain payment for services from a client/pa-ent, in which instance disclosure is limited to the minimum that is necessary to achieve the purpose.

37 If you stay in prac-ce long enough, you will mess up. Name it and claim it- privately Immediately take steps to limit harm Recognize you are not alone and seek guidance from a trusted colleague Avoid the tempta-on to distort and cover up.

38 An odd but helpful thought If you do your job correctly, some people will dislike you (For example: discon-nuing service, failing to change a Dx, repor-ng suspicions of abuse, firing employees)

39 Where to call for help CPA members may request a free personal and confiden:al consulta:on from members of the CPA Ethics CommiVee on ques-ons related to Ethics in Psychology.

40 ABAI Hotline hvps:// Miscellaneous/ABAIHotLine.aspx Thank you Jon Bailey and others

41 2 Old Testaments and 1 new Genesis- Psycho- Genesis/Immuno- Genesis(Jenny- sis) Exodus- Failure to Exit

42 Revela-ons- Predic-ng outcomes