Ethical Relationships and Boundaries (Families, Clients, Supervisors)
Can we accept gifts from clients?
With the new 2.0 RBT Ethics Code, RBTs can accept gifts that do not exceed a $10 value... but CCABA will continue to uphold our current policy.
-Think about frequency of the gift in these situations as well.
Jessica's daily arrival to sessions varies from on time to 4-6 minutes late. The client's parents have never voiced concerns or complaints. Is there an issue?
Yes, according to Code 2.03 RBTs should always arrive on time to session to maintain professionalism and meet medically recommended hours.
What measures can you take to maintain client confidentiality in the clinic setting?
-public setting (school, community)
-home setting
-Having conversations in a private space to protect PHI.
-Providing space for you client to advocate for themselves.
-Including the client in the conversation (with parents, peers,etc.)
True/False.
False
-As RBTs, we can create an ethical environment with fellow RBTS, supervisors, and client stakeholders.
Why is so important to sign a contract with your supervisor?
Tp uphold code 1.04 and set boundaries-RBTs are never employers of their supervisor.
What are some other boundaries that contracts can outline?
What are some ways that we can maintain treatment integrity?
Revisit program protocols every few weeks to a month.
Asking your BCBA to take IOA and ensure that you understand programs before running them.
-BST, modeling.
How can you ensure you are honoring client consent during session?
-Providing choices
-Checking in with your proximity to client and their levels of engagement throughout session.
-Honoring body language, verbal behavior, gestures that signal "I am giving consent." or "I am not giving consent."
How many standards were added to the RBT Ethics code 2.0?
7 standards were added
While in a home session, the parent tells the RBT that their child has starting engaging in elopement behavior at the onset of dinner time. The parent asked for advice on how to respond to the behavior. What should the RBT in this situation do?
....
Code 2.06
Your supervising BCBA has done program modification via tele-health 3 weeks in a row. You feel like supervision has not been effective for you or the client. How can you address this?
Code 3.01
-Telehealth does count as supervision, but can always communicate with your BCBA if you do not feel supported or tele-health is not effective for your client.
During a clinic session, your client has a toileting accident in front of peers. What can you do to maintain client dignity?
-If possible, transition your client to the bathroom without drawing attention (walking beside them.)
-If your client began engaging in challenging behavior, gently/discretely communicate with other RBTs to navigate the situation.
What are the 4 core principles that are the foundation for the Ethics Code?
1.RBTs benefit others.
2. Treat others with compassion, dignity, and respect.
3. Behave with integrity.
4.Ensure their own competence.
The client's mom has brought Sam (RBT) a Starbucks coffee 2 days in a row at the start of session. What ethical issue can arise here and what steps would you take to address it?
This refers to code 1.11-Gift Policy. Although a single coffee may not exceed $10, getting one everyday will add up quickly, so it is important to think about these variables here.
According to the ethics code, when can RBTs implement restrictive or punishment based procedures?
Code 2.05
Only when included in a documented behavior-change plan and after their supervisor has verified their competence.
You ask your client "Can I sit next to you?" and they say "I want some space right now." You sit close to them anyways. What is not being honored here?
You are not honoring the client's consent or boundaries. They voiced that they wanted space, so as an RBT we should honor that communication and provide that space until we see a shift in engagement or proximity.
When did the RBT Ethics Code 2.0 go into affect?
January 2022
You are a case and are unfamiliar with the family's cultural practices. During session one day, you accidentally offend one of the client's family members. Your BCBA brings this up to you. How can you respond?
-Cultural humility
-Being compassionate and taking accountability.
Adam notices that his BCBA is working on his client's BIP and has access to the file within Central Reach. Adam decides to read over the BIP and implements the procedures before instructed to do so by his BCBA. Is this ethical behavior?
According code 2.05, Adam should ensure his competence in these procedures before implementing them with a client.
How does maintaining client dignity, consent, and confidentiality increase overall client engagement during session?
-Client buy in.
-Rapport building.
-Instructional control.
Your client's parent has planned a birthday party for the client during their session time and notes that several family members and friends will be attending. What should you do?
-Reach out to your BCBA for support on handling this situation.