Problem-solving prompt Your response Response example
Problem or risk

Inappropriate to block access to bathroom if client truly has to access – might end up in socially inappropriate behavior (soiling oneself)

If the client’s behavior is escape-maintained, denying the bathroom breaks could lead to an extinction burst, extinction-induced aggression, and emotional behavior.
Relevant ethical codes

2.09 Treatment / intervention efficacy – The client is not being provided with an effective treatment
2.05 The Rights and Prerogatives of Clients
3.01 Behavior-Analytic Assessment – PRIOR to intervention implementation
4.02 Involving Clients in Planning and Consent
4.08 Considerations Regarding Punishment Procedures

3.01 Behavior analytic assessment – Some variation of a functional analysis should be conducted at the job site prior to making treatment recommendations
4.04 Approving behavior-change programs – An escape extinction procedure is not part of the current plan
4.05 Describing behavior-change program objectives – A risk-benefit analysis was never disclosed because the plan changed abruptly
4.09 Least restrictive procedures – Escape extinction is a highly restrictive procedure for an environment such as a job placement, which is low-restrictiveness

Treatment considerations

FA to determine function of frequent bathroom breaks
Determine more appropriate reinforcer for work behavior
Help schedule bathroom breaks

To stay ethical and effective, Carol will need to make some quick decisions and give the problem the attention it requires. Carol can visit and make a definitive determination regarding the function. If it is escape, she might consider ways in which the job tasks could be more engaging for the client, such as providing continuous arbitrary reinforcement (headphones), NCR for escape (scheduled breaks), and contingency-based progressive delay to create greater temporal distance between requests to use the bathroom.