Full Answer Section

• Cultural/Contextual Considerations: The location (Dubai) and client background (Emirati) are central. The resolution hinges entirely on understanding the profound cultural significance of hospitality in this context. Applying a rigid, Western-centric interpretation of the “no gifts” rule without considering Code 1.07 would be inappropriate and potentially unethical in its own right due to the damage caused.

Worksheet 2: Scenario 2 – Supervisor Refusal to Sign Form

• Scenario Summary: A supervisor refuses to sign Ashley’s fieldwork verification form upon completion, stating discomfort and concerns about readiness, despite no prior documented deficiencies or negative feedback.

• Identify the Ethical Conflict(s): The supervisor’s actions potentially violate multiple ethical responsibilities related to supervision, including providing ongoing, timely, and objective feedback; documenting supervision accurately; acting with integrity; and fulfilling contractual obligations. Ashley is denied verification without due process or prior warning.

• Relevant BACB Ethics Code Sections:

  • 4.04 Accountability in Supervision: Supervisors are responsible for their supervisory activities.

  • 4.06 Providing Supervision and Training: Supervision must be behavior-analytic, evidence-based, and meet requirements. This implicitly includes providing formative feedback.

  • 4.08 Documenting Supervision: Supervisors must provide accurate and timely documentation. This includes performance feedback.

  • 4.09 Evaluating Effects of Supervision: Supervisors must regularly evaluate the supervisee’s performance and provide feedback. This should be an ongoing process, not a surprise at the end.

  • 4.10 Communicating About Supervision: Clear communication about expectations, evaluations, and completion requirements is necessary.

  • 4.11 Providing Supervision Feedback: Supervisors must provide timely, specific, objective, and actionable feedback.

  • 1.04 Integrity: Behavior analysts are honest and promote accuracy. Withholding concerns until the last minute and citing vague reasons lacks integrity.

  • BACB Fieldwork Standards: These standards outline documentation and attestation requirements, implying a process based on documented performance throughout the supervision period.

• Analysis/Discussion: Effective supervision requires ongoing communication and evaluation. The supervisor’s failure to provide any prior negative feedback or document concerns represents a significant lapse in their ethical duties (Codes 4.06, 4.08, 4.09, 4.11). Refusing sign-off based on subjective feelings (“just does not feel comfortable”) without specific, documented behavioral evidence of incompetence is unacceptable. Citing “ethics” and “reputation” without substantiation appears defensive and avoids accountability for poor supervisory practices. Ashley has been blindsided and potentially harmed professionally and financially due to the supervisor’s negligence.

• Proposed Resolution/Action Steps (For Ashley and ethically for the Supervisor):

  1. Ashley Requests Formal Meeting: Ashley should formally request a meeting with the supervisor to discuss the refusal.

  2. Ashley Requests Specifics & Documentation: Ashley should ask for specific, behavioral examples of the concerns and request any documentation (supervision notes, evaluations) supporting these concerns (referencing Code 4.11).

  3. Review Supervision Contract: Ashley should review her signed supervision contract regarding evaluation procedures, feedback frequency, and criteria for successful completion.

  4. Document Everything: Ashley must meticulously document the situation: the date of the refusal, the supervisor’s stated reasons (or lack thereof), notes from the meeting, and copies of her fieldwork forms/logs.

  5. Supervisor’s Ethical Obligation: The supervisor should provide specific, documented evidence of performance deficits linked to core competencies. If such deficits exist and were somehow never addressed, the supervisor needs to acknowledge their own failure and potentially propose a remediation plan (though this is very late). If no such evidence exists, the supervisor should ethically sign the form, perhaps documenting any specific, objective remaining concerns if truly warranted and previously discussed. Vague feelings are insufficient grounds for refusal.

  6. Seek Consultation/Mediation: If the supervisor remains unreasonable, Ashley could seek consultation from another trusted BCBA or explore mediation options if available through an employer or professional organization.

  7. Report to BACB (If Necessary): If the supervisor refuses to provide justification or documentation and continues to block verification without cause, Ashley may need to consider filing a formal Notice of Alleged Violation with the BACB against the supervisor for violating ethical codes related to supervision (Section 4.0).

• Contextual Considerations: The power imbalance inherent in the supervisory relationship makes this situation particularly difficult for the supervisee. The supervisor’s actions have significant implications for Ashley’s ability to become certified and practice independently.

Worksheet 3: Scenario 3 – Request to Administer Medical Marijuana

• Scenario Summary: A family using medical marijuana (MMJ) for their child with developmental disabilities in MA wants the BCBA providing clinic-based services to administer a dose mid-day.

• Identify the Ethical Conflict(s): The core conflict is the family’s request versus the BCBA’s professional and ethical limitations. This involves: Scope of Practice/Competence (BCBAs do not administer medication), Legal/Regulatory Compliance (state laws, clinic policies regarding medication administration), Informed Consent (consent is for ABA, not medical procedures), and Collaboration vs. Responsibility (collaborating with medical team vs. taking on medical duties).

• Relevant BACB Ethics Code Sections:

  • 1.02 Boundaries of Competence: Behavior analysts provide services only within the boundaries of their competence, based on education, training, and supervised experience. Medication administration is outside this scope.

  • 1.03 Maintaining Competence through Professional Development: Professional development focuses on behavior analysis, not medical procedures.

  • 1.05 Professional and Scientific Relationships: Behavior analysts act with integrity and clarify roles. Administering MMJ would blur roles. (Subsection c: Adhering to legal and ethical codes).

  • 1.06 Responsibility: Behavior analysts act in the best interest of clients within their defined role and scope.

  • 2.09 Treatment Efficacy: Behavior analysts recommend and implement evidence-based behavioral treatments. MMJ is a medical intervention.

  • 2.10 Collaborating with Colleagues: Behavior analysts collaborate with other professionals (like prescribing physicians) when indicated.

  • 2.11 Obtaining Informed Consent: Consent must be specific to the services provided (ABA). It does not extend to medical procedures performed by the BCBA.

  • Adherence to Laws, Regulations, and Policies: BCBAs must adhere to all applicable laws, regulations, and organizational policies, which likely prohibit non-medical personnel from administering medication, especially controlled substances like MMJ.

• Analysis/Discussion: Administering medication, regardless of its legal status for medical use in MA, is unequivocally outside the scope of practice for a BCBA. It requires medical training and licensure/authorization that behavior analysts do not possess. Doing so would violate ethical codes (1.02, 1.05), potentially break laws/regulations, and violate clinic policies, putting the child, the BCBA, and the clinic at risk. While the family’s goal (behavior management) is relevant to ABA, the requested method (MMJ administration) is medical. The BCBA’s role is to implement behavioral interventions and potentially collect data on the effects of other interventions (like MMJ administered by appropriate parties), not to administer them.

• Proposed Resolution/Action Steps:

  1. Clarify Scope: The BCBA must clearly, politely, and firmly explain to the family that administering any medication, including MMJ, is outside their scope of practice, competence, and legal/ethical boundaries as a behavior analyst (citing Code 1.02). Explain this is standard professional practice, not a personal refusal.

  2. Review Clinic Policy: The BCBA must consult their supervisor and review clinic policies regarding medication administration. It is highly likely the policy prohibits this. Share this policy with the family if appropriate.

  3. Acknowledge Family Goals & Offer Collaboration: Validate the family’s desire to help their child and acknowledge their observations. Express willingness to collaborate within ethical bounds.

  4. Offer Data Collection: Offer to collect objective behavioral data (e.g., frequency/duration of target behaviors, measures of attending) to help evaluate the effects of the MMJ when administered by the parent/guardian or designated personnel according to the physician’s orders and state/clinic regulations. This data collection is within the BCBA’s scope.

  5. Recommend Physician Consultation: Advise the family to discuss administration logistics (who can administer it at the clinic, if anyone, according to law/policy) and monitoring with the prescribing physician.

  6. Coordinate with Prescriber (with Consent): Offer to communicate with the prescribing physician (with written parental consent) to share behavioral data and align goals (Code 2.10).

  7. Focus on Behavioral Strategies: Continue to focus on developing and implementing evidence-based behavioral strategies to address the target behaviors, regardless of the MMJ use.

• Contextual Considerations: The legality of MMJ in Massachusetts is relevant background but does not change the BCBA’s scope of practice. The focus must remain on the BCBA’s professional role and limitations. Sensitivity is needed in communicating this boundary to the hopeful family.