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Ethics in ABA: 7 Ethical Quandaries
Faced by Applied Behavior Analysts
A quandary is a state of perplexity or
uncertainty over what to do in a difficult
situation. Every individual in any sort of
occupational position is going to
stumble upon a quandary from time to
time. It is inevitable. And each
occupation is going to have its own
unique difficulties and dilemmas.
Applied behavior analysts definitely
have their own set of problems they
have to overcome, things they need to
watch out for and be vigilant of, and
uncertain occurrences that happen that
may need to be looked into.
2
An ethical behavior analyst is trained to navigate most problematic events and/or
ethical issues that pop up while working. There may come a time when a good behavior
analyst is surprised by a situation, and they do not know what to do.
As an applied behavior analyst, ethical concerns are common. Few professions involve
the level of intimacy and in-home care that ABA does. Therapists must be aware of the
potential pitfalls of their profession. From overbearing parents to overbooked
schedules, therapists must bring compassion and commitment to their work to
overcome ethical issues.
The Behavior Analyst Certification Board created a set of ethics for behavior analysts
including Board Certified Behavior Analysts (BCBA) Board Certified Assistant Behavior
Analysts. This new Ethics Code for Behavior Analysts replaces the previous Professional
and Ethical Compliance Code. The new code includes standards that outline ethical
principles related to the:
Responsibility as a Professional
Responsibility of Practice
Responsibility to Supervisees and Trainees
Responsibility in Public Statements
Responsibility in Research
Within each of these professional activities are unique ethical challenges practitioners
may face. This article will take readers through the top seven ethical quandaries that
ABA therapists have the potential to face in their careers.
The seven ethical issues applied behavioral analysts
must consider are:
Self-Care Concerns
Friendships with Clients or Families
Inappropriate Parenting
Financial Concerns
Ethical Concerns with Employer
Ethical Considerations Regarding Research
Complicated Decision-Making
Self-Care Concerns
Becoming an ABA therapist requires a high level of compassion for others. Therapists
may be yelled at or even physically assaulted while caring for children with
developmental disabilities. More commonly, therapists may feel emotionally
overwhelmed and drained by their jobs. Behavioral therapists have a special obligation
to uphold their scheduling commitments, for example. Children with autism spectrum
disorder benefit from consistent schedules, so frequently calling in for mental health
2
days is harmful to clients.
Professionals who work with clients need to be vigilant about how their own mental and
physical health are affecting them in their work environment. Feeling overly exhausted,
under the weather, and overworked can potentially lead to making inappropriate
decisions.
The best thing for ABA therapists to do is to figure out what self-care techniques work
for them and have a go-to “toolbox” of coping strategies they can rely on to resolve
these challenges in an ethical manner.
Psych Central lists nine self-care strategies that clinicians and therapists can use in their
day-to-day life:
1. Identify what activities help you feel your best.
2. Put it on your calendar — in ink!
3. Sneak in self-care where you can.
4. Take care of yourself physically.
5. Know when to say no.
6. Check in with yourself regularly.
7. Surround yourself with great people.
8. Consider the quality of self-care.
9. Remember that self-care is non-negotiable.
Friendships with Clients or Families
With long hours spent working with a
single client, often in a family’s home,
it’s easy for ABA therapists to build
relationships. However, there are
professional boundaries ABA
providers must maintain. This is one of
the most challenging ethical issues in
applied behavior analysis.
This might mean turning down an invitation to stay for dinner, declining to meet the
family outside of the home or redirecting intimate conversations. Training programs in
ABA techniques can help students learn how to gracefully set boundaries with clients
and families.
Below are a few ethical scenarios that are good examples of what ABA therapists hope
not to encounter.
The therapist spends lengthy phone hours with the client during the workday or even
on personal time. 2
The therapist may begin to spend frequent time with clients at various restaurants,
movie theaters, or other public places outside of the client’s home, or even at the
therapist’s home, under the guise of a client visit.
The therapist tends to spend an inordinate amount of time with the client, both
scheduled and unscheduled visits, in comparison to other clients.
The best route to go is to use common sense in these types of BCBA ethical
dilemmas.
Inappropriate Parenting
Having a child with autism can be stressful. Parents can quickly reach their breaking
point dealing with challenges like:
emotional meltdowns
social skills and communication training
toilet training
the need for constant supervision
ABA therapists may witness inappropriate behavior, such as a parent:
yelling at a child
locking a child in a room for time-out
even using pseudoscientific “cures” for autism, like essential oils or bleach
In these situations, ABA therapists must balance the obligation to protect their clients
with the need to allow families to manage their own lives. According to the Centers for
Disease Control and Treatment, up to one-third of parents of children with autism try
alternative medical therapies, some of which may be harmful. ABA providers must be
prepared to encounter this issue.
Here are a few things therapists want the parents to know:
Children need you to separate behavior from love.
Kids need consistency.
You must take care of yourself to take care of others.
You can ask for help.
When you enable, you disable.
Practice what you preach.
Give the plan time to work.
Unless the parent is harming their child or self, or is an imminent danger to the child,
any intervention needs to be dealt with lightly. It is not appropriate to reprimand the 2
parent or tell them how to parent their own child. Applied behavior analysis ethics
guidelines support giving suggestions and recommendations in a positive manner.
Financial Concerns
As service providers, ABA specialists
may struggle with charging appropriate
prices for their services. If a family
claims they cannot afford their co-pay
or begs for additional, non-
compensated therapy, it may be hard
for a compassionate provider to say no.
ABA therapists must be willing to stand
up for themselves, refuse to work for
free, and follow up on unpaid bills. Some of this difficulty can be alleviated by working
for an organization that handles billing, leaving the therapist free to concentrate on
providing excellent services.
Establishing fees, handling the non-payment of fees, and the issues of bartering, and
exchanging gifts are all quandaries related to ethics in behavior analysis. Having a
bottom line for fees can be difficult. It’s all about meeting in the middle and being a little
flexible. Therapists don’t need to be too harsh and lose clients that need help, yet they
also don’t want to be used or exploited for being nice. ABA therapists should decide
what their low limits are for a sliding scale (if they choose) and be prepared for clients to
inquire about fees.
If you are new to ABA therapy and aren’t sure about the fees, ask around to other more
seasoned therapists and see how they handle these types of ethical dilemmas and
decisions in ABA.
Ethical Concerns with Employer
Although most people who start an ABA therapy business have their hearts in the right
place, it’s easy to get sidelined by:
regulations
overhead costs
a competitive market
Small companies might find themselves cutting corners, and large corporations may be
more concerned with turning a profit than helping clients. Entry-level ABA professionals
may not have the confidence to stand up to a boss or raise ethical concerns in the
workplace.
As the ABA field grows and distinguishes itself from other psychology specialties,
therapists will develop their own ethical code. For now, applied behavioral analysts 2
facing ethical dilemmas can rely on professors, coworkers, mentors, and employers for
help.
APA Services list various ethical issues related to supervision, as in these are potential
issues that any type of therapist might encounter with their supervisor or employer.
Boundaries of Competence
Delegation of Work to Others
Exploitative Relationships
Recording
Accuracy in Reports to Payers and Funding Sources
Design of Education and Training Programs
Student Disclosure of Personal Information
Assessing Student and Supervisee Performance
Sexual Relationships With Students and Supervisees
Publication Credit
Assessment by Unqualified Persons
Informed Consent to Therapy
Ethical Considerations Regarding Research
When therapists, educators, or really whomever are conducting research in order to
search for and to implement a new educational or behavioral strategy, things can easily
go wrong. Not every single study online is valid or peer-reviewed, and each one should
not be followed blindly. Many studies are difficult to read and do not take the average
person into account regarding readability; this can cause issues when someone on the
outside is interpreting the data and results.
Other limitations and considerations to take into account are:
Not all studies have been approved by an Institutional Review board.
Not all studies are reliable or valid.
Not all studies have used an appropriate sampling pool of participants.
Not all studies have reduced the risk of harm to all involved.
Not all studies have a lack of conflict of interest.
Not all studies are transparent with their findings.
Not all studies come forward with the limitations.
When using treatment methods to use with clients, ABA therapists need to ensure they
are using research-based, sound, and up-to-date studies to back up their reasoning for
using those techniques. Increasing research literacy is always encouraged!
Complicated Decision-Making
ABA therapists will need to make complicated decisions throughout their career; it is
inevitable. Unfortunately, it is hard to determine when a crucial decision must be made
2
regarding a client, treatment method, or occurrence, as the need for action can happen
so spontaneously. Understanding ethics in ABA is a highly important skill ABA
therapists should practice. Ethical dilemmas come in all shapes and sizes and can
happen at any moment.
An article from the professionals at the Science Education Resource Center at Carleton
College discuss the concept of beneficence and questions professionals should ask
themselves when caught in an ethical quandary.
Beneficence is the concept that scientific research should have as a goal the welfare of
society. It is rooted in medical research, the central tenet is “do no harm” (and corollaries
remove harm, prevent harm, optimize benefits, “do good”). For a more expansive
introduction to beneficence, see the essay on The Principles of Beneficence in Applied Ethics
from the Stanford Encyclopedia of Philosophy. Some simple guiding questions in applying the
concept of beneficence to ethical dilemmas include:
Who benefits?
Who are the stakeholders?
Who are the decision-makers?
Who is impacted?
What are the risks?
By asking themselves these questions along with taking a deep dive into the situation
with perhaps a colleague, supervisor, or mentor, the ABA therapist will minimize any
harmful outcome the decision may have upon the client.
How to Speak Up About Ethical Issues
If you are an ABA therapist, support one, or are working with one as the client’s (child or
adult with autism) teacher or parent, and you have encountered an ethical issue during
a session, it is important that you are aware of the appropriate route to take to make
these potential ABA ethics issues known and get them resolved.
Each place of business should have some form of ethical compliance training through
their human resource department; and those ABA therapists who work for themselves,
are freelancing, or are contracted out hopefully had some form of training on this topic
during their educational/professional experience.
Regarding ethical issues in the workplace, a Gallup article states:
Cultures that prompt employees to reflect on and question workplace scenarios without fear
give employees a platform for their concerns about serious ethical problems.
As well as…
Managers need to make integrity, ethics, and compliance a regular topic of conversation to
familiarize employees with these topics and give them practice discussing their implications. 2
While not all individuals feel comfortable reporting an ethical issue, the hope is that
through education, support, and an understanding that it is the right thing to do, more
and more will report if necessary.
