| Was this response problematic with regard to ethics, professionalism, or the client’s treatment program? | When/how might feedback be delivered by the supervisor? | What types of additional training might improve this supervisee's performance? |
|---|---|---|
Provide concise feedback referencing the code of ethics and confidentiality. | Meeting should be scheduled immediately (must be before the next session) | Scenarios involving confidentiality and the code of ethics. |
It was unethical if the grandmother is not part of the child's treatment team. | Prior to the next session in writing. | Review of ethics and privacy laws related to sharing client information. |
Yes. Clients and stakeholders have the right to withhold all non-relevant information from people not directly involved in services. | *Something similar to what is stated above* As well as... "Supervisees, even qualified supervisors, should be cautious when discussing long-term outcomes for client treatments with stakeholders, in my opinion. This is due to unforeseen consequences, extraneous variables that were foreseen but not considered an issue, and confounding variables that are accounted for but cannot be controlled. We are a data-driven field of science, and to talk about such things is hypothetical. The best we can offer is data trends and changes to treatments if something is not going as we predicted. We account for, use our instruments and research-backed procedures, and stick to the plan; that is the path to long-term outcomes." | Review of the Client's rights section for the ethics code as well as the stance that behaviorists take when talking to non-behavioral personnel. As well as never making promises and hypothesizing large changes without proof first (e.g., data trends). |
yes | immediately | options of how to answer questions supervisee is unsure of answering |
yes there are ethical concerns | provide feedback to RBT with explication and instruction for further care-giver interactions | role play |
yes | as soon as possible via meeting | boundaries and client privacy protection |
Yes, anyone outside of stakeholders and client require a two way authorization form | Feedback can be given as soon as possible | Supervisoree should review ethical guidelines about responibilities to client and stakeholders |
This was problematic because they shared private health information. This information should not have been shared by the clinician. The parents could have shared if they wanted to. It was unethical. | Immediately. Clinician should be reminded of the ethics codes. | Ethic codes training |
Yes | As soon as aware of the situation. Supervisor should listen to supervisee and revue ethics and privacy code | Ethics |
Yes - given the supervisee discussed PHI and personal predictions. | The supervisor can follow-up immediately by clarifying the expectations around client confidentiality and share how they will communicate with parent/others moving forward. | Review of PHI and when/where/to whom the supervisee can redirect the questions. |
Yes, this leans toward being problematic as it is unclear whether the appropriate consent has been obtained to share any information with the grandmother. | Feedback should be delivered at the upcoming supervision meeting or before the clinician goes to see the client again. The supervisor should follow-up on who has consent to obtain information. The supervisor and clinician should have this discussion at the onset of service to ask if there is any other care parties involved and have clear boundaries set from the start so that if the clinician is alone with other family members she is aware of any boundaries in place. | how to respond in a professional way that sets limits, such as supporting the supervisor to say something like "I appreciate your thoughtful questions, I have to abide by my ethical code to ensure I do not over share any personal health or treatment information you are welcome to follow-up with my supervisor or I can follow-up with you next session.. " |
yes | Directly | Reviewing ethics codes |
Yes, it was problematic. It violates client's confidentiality; thus it is ethically and professionally a program. Additionally, the RBT's breach may result in the family cancelling services. | Immediately. At the first opportunity the supervisor should review with the RBT HIPAA rules and professional boundaries. | Reviewing professional boundaries, reviewing HIPPA rules and regulations. |
Yes- unprofessional, since the supervisee didn't know who was/wasn't part of the treatment team/programming. This also probably impeded the client's treatment since the supervisee was focused on answering grandma's questions, rather than engaging with the client. | Immediately. Supervisor should review ethical codes and give supervisee sample responses to say instead when asked about treatment by family members, especially if unaware of who is/isn't part of the team. | |
Yes, the supervisee provided sensitive information to someone in the clients family who is not the direct stake holder. Additionally, they shared information about the clients health. The supervisee also provided their own opinions on the effectiveness of treatment, which they are not qualified to answer. | Feedback should be deliver by the supervisor by sharing the ethics code and the areas violated. Then, examples of how to handle these questions should be provided. | Training in client communication done through role plays |
Yes. Only those who have written permission from the legal guardians can have access to protective health information. The supervisee should never predict the long term outcomes for the client. It is beyond their scope of competence. | At the next supervision session, the supervisor should go over the ethics code with the supervisee regarding protecting the confidentiality of protected health information, and alternative methods of responding that would be more effective. | Ethics training. |
Protecting the privacy of clients and stakeholders is of concern. | Coaching should be provided to reiterate that information can only provided to those that have releases on file. If they have not been authorized information cannot be shared. The RBT can refer the grandmother to the parent when she returns. Also, she is not acting in the scope of her position. If she has questions she should ask her supervisor prior to responding. | The RBT should be retrained on the RBT task list and possibly the Ethics code. |
yes | The supervisor should talk to the supervisee immediately for at least before the supervisee conducts another session with a client | Discussion with the supervisee over who is entitled to that information and going over the ethics code |
yes | following the session treating it as an urgent matter, follow up with the parent to discuss the issue | training on who has written permission to be involved in the clients treatment and who has access to HIPPA and what to do if a parent has to leave a session |
The RBT disclosed HIPPA related information. | Feedback should include training on how to handle talking with family members and other people within the home. | The supervisor should provide reminders about HIPPA related information. Additionally, the supervisor should discuss the ethical codes associated with relationships. |
Yes | Firm explanation of rules and boundaries | Reading research |
Yes, this response was problematic due to ethics because the supervisee was not given consent to tell the mother in law specifics about the child's program. | Feedback should be delivered immediately and in person. | Role play with ethic scenarios. |
Yes - ethics and professionalism. | Review the situation with the supervisee regarding determining what levels of information can and should be shared. Also discussing strategies for when those outside of immediate caregiver relationship are inquiring about information that would breach client's confidentiality/PHI/etc. | Roleplaying and practicing scenarios to build supervisee confidence with identifying situations that are not appropriate to share additional information as well as how best to communicate that the to the person inquiring. |
This response was problematic in regards to ethics because the supervisee should have redirected any questions related to the service to their supervisor. | Feedback should be delivered immediately and discuss the ethic code violation for code 2.06. | Additional training that may be beneficial related to the ethics code, where the supervisee identifies scenarios that are potential ethics code violations and how to appropriately respond to varying scenarios. |
yes | before the next session with this client | ethics, protecting rights and confidentiality of clients, reviewing stakeholders that you can discuss the client's progress with. |
| Was this response problematic with regard to ethics, professionalism, or the client’s treatment program? | When/how might feedback be delivered by the supervisor? | What types of additional training might improve this supervisee's performance? |
