|Problem-solving step||Your response||Response example|
|Identify the problem||
Treatment protocol is not being followed and mechanical restraint which is illegal is the current course of action being implemented.
|Kathy’s trainee is using a procedure that put the client in danger through the client’s continued escalation and eventual restraint. The procedure is also considered a mechanical restraint, which is not permitted by the state where Kathy and Kevin work.|
|Relevant ethical codes||
2.09, 4.09, 7.02
|Some of the codes that may pertain to Kathy’s situation with Kevin:
4.09 Least Restrictive Procedures – Escape extinction may likely be too restrictive for noncompliance with desk work
5.03a Supervisory Delegation – Kevin is not handling the matter competently, ethically, and safely
5.03b Supervisory Delegation – As his supervisor, Kathy has a responsibility to teach Kevin how to provide a more appropriate intervention
5.06 Providing Feedback to Supervisees – Kathy’s initial feedback to Kevin was not effective in changing his performance. She is ethically required to persist with teaching Kevin until the desired performance is achieved.
7.02 Ethical Violations by Others and Risk of Harm – The intervention is leading to a mechanical restraint, a behavioral escalation, and physical restraints which all present a risk of harm to the client
9.01 Conforming with Laws and Regulations – Use of the chair in this manner is a violation of applicable laws
|Consider dimensions of the problem||
This could be potentially harmful for the client and all parties involved. This goes agains the state laws and could affect the client as well as the BCBA overseeing the case.
|Kathy may investigate further how this intervention was developed by reviewing the assessment and treatment history of the client.
Kathy might also follow-up with how behaviors are addressed by the client’s other staff and family. The issue may be larger than just Kevin’s approach with the client.
This issue may signify a culture of restrictive procedures within the company. Kathy might talk to other behavior analysts and consider the need for staff training.
|Consider courses of action & potential consequences||
The supervisor should be sure to utilize the BST model if the supervisee is not implementing the protocol correctly then modeling should occur immediately. A one on one meeting could occur to work on this and then the supervisor should go out and see the client and supervisee the next time they are together to ensure that feedback is being implemented.
|– Repeat what she had already said to Kevin (though since this did not have an affect the first time, she may want to try something else)
– A one-on-one meeting to discuss how the client’s program may be revised to minimize behavioral escalations
– Call an IEP meeting and share the issue with the school and parents
– Write Kevin up with a formal disciplinary note, warning him that additional disciplinary notes could lead to termination of supervision
– Consult the supervision contract, review what is stated about following through with a supervisor’s feedback
|Select a course of action||
This course of action of engaging in the BST model would help to ensure that the supervisee understands the protocol. However, due to the seriousness of the violation of state laws I would give a written warning to the supervisee that he will no longer utilize the current procedure due to our ethical responsibilty to our client.
|After giving it some thought, Kathy decides to bring Kevin in first thing the following morning for a meeting. The last-minute meeting stresses the urgency of the situation and communicates that this is a priority matter. At the meeting, Kathy asks Kevin why the procedure is still in place. After listening to his struggles with identifying an alternative procedure, Kathy reviews the assessment report and options for escape motivated behavior with Kevin. Together, they come up with an alternative protocol. Kathy and Kevin practice the new procedure together and Kathy provide Kevin with a procedural checklist that she to evaluate implementation of the new procedures. Kathy is present when Kevin implements the procedure for the first time with the client and provides feedback.|
|Implement and evaluate course of action||
It satifies the ethical concerns that have come up. It could make the supervisee defensive but the safety of the client is priority.
|A week later, Kathy makes another observation of Kevin and he is implementing the new protocol with a high degree of integrity. She is happy with Kevin’s performance and decides to invite him to speak about the situation with his client and its resolution at the next all-staff meeting.|