PSY 4600UNIT 8:

CREDENTIALING IN BEHAVIOR ANALYSIS

ETHICS

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Schedule:Tuesday and Thursday: LectureTuesday: Exam

END OF SEMESTER SCHEDULEThursday, 4/23

• Return of E8• Special grade sheet

• Can you benefit from taking ME2?• If so, how many points do you need for the next highest grade?

• ME2 study objectives• No lecture: Good day to do course evaluations during class time

Wednesday, 4/29: Make-up Exam 2, 12:30-2:30• Units 4-8• Room 1728• Be here at 12:30

• Remember you cannot start the exam after a student has left the room with the answers: you will receive a zero

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UNIT MATERIALS

Credentialing in behavior analysis• Dickinson article (2014)

Ethics• Martin & Pear (2015), Chapter 30, Ethics• Van Houten et al. (1988), Right to effective behavioral

treatment• Skinner (1978), The ethics of helping people• Hanley et al. (2005), On the effectiveness of and preference

for punishment and extinction components of function-based interventions

• OPTIONAL: Wolf, Risley, & Mees (1964), Application of operant conditioning procedures to the behavior problems of an autistic child

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SO1: CREDENTIALING IN BEHAVIOR ANALYSIS

Differences between certification and licensing

• Certification is voluntary, licensing is legally required • Certification is overseen by an international credentialing board

and licensing is overseen by states• Because of that the requirements for certification are the same

from state to state and, in fact, globally; while the requirements for licensing vary from state to state

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(purpose of credentialing, protect public, from individuals representing themselves as competent when they are not;in BA two types: certification and licensing, BACB, cert required for HSS; 19 states have license laws; not relevantfor experimental psychologists, whether they work with nonhumans or humans )

REQUIREMENTS FOR CERTIFICATION AND LICENSING ARE SIMILAR: WHY?

Certification predated licensing

• National certification began ~1998, licensing began ~2009/2010• BACB anticipated licensing and developed and posted a

“model” license law on its web site to assist states• States: why re-invent the wheel when a well-respected

organization had already developed standards and an exam?• Certified behavior analysts were typically the ones who

advocated for license laws and spearheaded their adoption

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(In almost all states, the requirements for licensing are the same or similar to requirements for certification; some states, identical; in a few you must be certified to be licensed; any event, similar. )

WHY LICENSE LAWS?To protect at risk-individuals seeking behavior analytic clinical services

To accompany autism insurance laws that have recently been passed, specifying and regulating the individuals who could receive insurance reimbursement

Some behavior analysts believe license laws should protect all consumers, not just at-risk individuals (also protecting the field in general)

Some believe that we will not achieve the same status as other professionals (doctors, licensed clinical psychologists) unless we are licensed

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(first two are the main ones; some states use certification as standard; Employees, athletes, college students, etc.;because of these differing views, two broad category of laws)

SO4: TWO TYPES OF LAWS

Restrictive laws

• Only behavior analysts who provide clinical services to individuals need to be licensed, for example

• Those who work with children diagnosed with autism

• Those who work with individuals with developmental and intellectual disabilities

• Those who work with seniors with dementia

Broad title and practice laws

• You cannot call yourself a behavior analyst (title) or practice behavior analysis (practice) unless you are licensed

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(in general, two types of laws, although one state has a “title” law; first type relates to the first 2reasons on the previous slide, the last type relates to all four reasons – last two; most laws includemental health parity for other relevant professionals who are credentialed in their specialization – seethe article)

STATES THAT HAVE EACH TYPE (ACCORDING TO DR. D)

Restrictive laws: 14 states

• Alabama, Alaska, Kansas, Louisiana, Maryland, Nevada, New York, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, and Virginia

• Michigan has a restrictive law pending (it is in the legislature)

Broad title and practice laws: 5 states

• Arizona, Kentucky, Massachusetts, Missouri, Wisconsin

Ten laws were passed last year: all were restrictive

• Due to revision of the BACB model license law in 2012, including wording for the potential exclusion of applied behavior analysts who provide non-clinical services, and explicitly OBM practitioners and applied animal trainers

• Seems to be the trend (although again I could be wrong)

8(I could very well be wrong; it is hard to interpret the laws; talk more about this in the article)

IMPLICATIONS FOR YOU

If you are planning on a career in human services

• You need to be certified• You need to be licensed in states that have license laws

If you are planning on a career in other applied behavior analysis areas

• You do not need to be certified• If you work/move to a state that has broad title and practice

law, you need to check with the licensing board in that state to determine if you need to be licensed

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(Questions?)

WORD OF WARNING

Last semester I accepted some E8 answers on the ethics material that I will not accept this semester if I ask those questions again this semester, specifically, the answers to Q4, Q13, and Q14.

Thus, if you are using the old exams to study, make sure you read the study objectives carefully and use my answers, not a friend’s answers!

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SO6: HINT

Why, in its early years, did the term “behavior modification” evoke many negative reactions, ranging from suspicion to outright hostility?

The study objective references 307,3. However, careful reading of the first and second sentences, indicates that part of the answer is in 307,2.

The answer is not contained in the sentence that contains “These early reactions were exacerbated..”

The study objective asks about “these early reactions” not why they were made worse, although you are welcome to include this material in your answer.

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(M&P’s chapter on ethics, but first…behavior analysis vs. behavior modification)

TWO ASSUMPTIONS OF SYSTEMATIC APPLICATIONS OF BEHAVIORAL PRINCIPLES

Behavior can be controlled

• Science of behavior can be used to help humanity• Science of behavior can be used to harm humanity

It is desirable to control behavior to achieve certain objectives

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(Martin & Pear; why we need ethical guidelines and monitoring of the use of this very powerfulscience and technology of behavior)

SO7: DEFINE ETHICS FROM A BEHAVIORAL PERSPECTIVE

Certain standards of behavior that a culture developed to promote the survival of that culture

• Respect for the possessions of others is reinforced• Stealing is punished

In prehistoric cultures, possibly stealing resulted in so much in-fighting, members of a culture became vulnerable to invasions by other cultures or did not have enough time, energy, or resources to provide an adequate amount of food for themselves.

Members may have killed each other off or defected to other groups so that the culture did not survive.

On the other hand, cultures that reinforced respect for the possessions of others survived.

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(Skinner, 1953, 1971, Science & Human Behavior & Beyond Freedom and Dignity; legal contingencies – go to jail; codified into contingencies related to religious beliefs: 10commandments -next)

5 OF THE 10 COMMANDMENTS

Thou shalt not kill

Thou shalt not commit adultery

Thou shalt not steal

Thou shalt not bear false witness

Thou shalt not covet

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(first five have to do with principles relating to worship; but last five are certainly rules thatprevent disruption to a culture and contribute to its survival)

SO8: IS ALL CONTROL UNETHICAL?It is sometimes argued that all control is unethical. Why, upon a little reflection, doesn’t this argument make sense?

The goal of any social help professional can only be achieved by exerting control over behavior

• Teachers can only teach children to read by changing their behavior

• Drug addiction counselors can only get addicts clean by changing their behavior

• Behavior analysts can only get autistic children to successfully interact with the world and learn new skills by changing their behavior

• Sports psychologists can only get athletes to improve their skills by changing their behavior

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(go on to make the point that control is ubiquitous, and when left to chance sometimesthings go horribly wrong – look at all the problems in our society, even with our legal system)

SO10: COUNTERCONTROLFrom a behavioral perspective, countercontrol is the most fundamental and effective safeguard to ensure individuals and groups are treated ethically.

Countercontrol is the reciprocal of control; influence the controllee has on the controller by having access to suitable reinforcers (and punishers)

• Citizens vote politicians out of office• Workers unionize• A client stops seeing a therapist

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SO10: COUNTERCONTROLWhen individuals lack meaningful forms of countercontrol, the culture/group creates safeguards (arranges contingencies) to ensure ethical treatment

• Ethical guidelines for behavior analysts working with at-risk individuals (monitored by the BACB and profession)

• Loss/suspension of certification• Loss/suspension of license

• Ombudsman and Office of Student Conduct at WMU• Students can complain to the ombudsman about a faculty

member without retaliation• Students can only be charged with academic dishonesty after

a hearing with an unbiased panel overseen by the OSC

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(I am going to move on to the Van Houten article – any questions on this material?)

SO13: RIGHT TO EFFECTIVE TREATMENT AND RESTRICTIVENESS

An individual is entitled to effective and scientifically validated treatment

Selection of treatment should be consistent with the philosophy of the least restrictive but effective treatment (both italicized terms are critical)

• It is unacceptable to expose an individual to a restrictive procedure unless it can be shown that such a procedure is necessary to produce safe and clinically significant behavior

• It is equally unacceptable to expose an individual to a nonrestrictive procedure if assessment results or research indicate that other procedures would be more effective

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(one of the first set of ethical guidelines for behavior analysts; generated by controversy surroundingthe use of punishment; one of the most important things in this article, statement with respect to whatdetermines the overall restrictiveness of a procedure)

SLOW-ACTING NONRESTRICTIVE PROCEDURES

Slow-acting nonrestrictive procedures could be considered highly restrictive if prolonged treatment:

• Increases risk• An autistic child’s head banging can lead to very serious injury

• A child with pica can swallow a life-threatening object/liquid

• A child that bites can hurt himself, his siblings, his parents

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(may not have thought about this, but you must consider all of the effects of alternatives; SR mayBe more restrictive than SP; he ethicalnature of a decision/treatment cannot be judged in isolation; increased physical risk is the one that people think of most often, but there are others…next slide)

For samples of severe self-injurious behaviors, see youtube.comThe videos are very disturbing and emotionally distressing.

SLOW-ACTING NONRESTRICTIVE PROCEDURES

Slow-acting nonrestrictive procedures could be considered highly restrictive if prolonged treatment not only increases risks, but:

• Inhibits or prevents participation in needed training programs (aggressive behaviors toward others)

• Delays entry into a more optimal social or living environment (hospitalization vs. a group home or living at home)

• Leads to a adaptation to the treatment and eventual use of a more restrictive procedure

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Conclusion: In some cases, a client’s right to effective treatment may dictate the immediate use of quicker acting, but temporarilymore restrictive procedures.

SO14: WHAT DETERMINES OVERALL RESTRICTIVENESS?

Absolute level of restrictiveness

• Antecedents vs. consequences, reinforcement vs. extinction vs. punishment, restraints, medication

Amount of time required to produce an acceptable outcome

Consequences associated with interventions that have delayed effects

21(to summarize; questions, comments, on to Skinner)

SO16: ETHICS

Give a man a fish and you feed him for the day. Teach a man to fish and you feed him for a lifetime.

By giving too much help, we postpone the acquisition of effective behavior and perpetuate the need for help.

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(Not Chinese proverb, if you give a man a fish he is hungry again in an hour. If you teach him to catch a fish you do him a good turn. Anne Ritchie (1885); Skinner’s basic point – and deprive him of reinforcement, which defines/is responsible for quality of life)

SO 18 & 19: VERY IMPORTANT

Three reasons why the behavior of some individuals is not sufficiently reinforced

1. Others do things for them

2. They have not learned to do things for themselves

3. They are given things their behavior would otherwise be reinforced by

When we refer to people as lacking initiative, having weak wills, suffering from apathy and boredom, what are they actually suffering from?

• A world in which their behavior is not positively reinforced

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HANLEY ET AL. INTROI included this article because of what it indicates about (a) restrictiveness of interventions and (b) that the selection of treatments should not be based on “personal conviction” about what is “good” or “bad”

To quote my colleague, Dr. Doug Johnson, we should not be using the Golden Rule to select treatments, but the Platinum Rule

• Golden Rule: Treat others as we would like to be treated• Platinum Rule: Treat others as they would like to be treated

24(I am quoting Van Houten et al. here again)

HANLEY ET AL. SUMMARYParticipants: Two children

• Jay• 5 years old, moderate retardation, autism, seizure disorder• Self-injurious behaviors: hitting and slapping head with hands, hitting head

with objects, biting arms, and eye poking• Aggression: hitting, kicking, pushing, pinching, hair pulling, scratching, and

head butting• Disruption: throwing objects, breaking objects, and knocking objects to the

floor

• Betty• 8 years old, mild to moderate retardation, ADD, and oppositional defiant

disorder• Aggression: hitting, kicking, pinching, scratching, biting, pulling hair, and

throwing objects at people (behavior targets in the study)• Pica and self-injury (not treated in the current study due to the fact that these

were controlled by different variables than her aggression)

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HANLEY ET AL. SUMMARYIV

• Functional communication with extinction• Functional communication with punishment• Punishment only for inappropriate behavior (control)

Functional Communication Training First

• Taught children to emit appropriate responses that would result in adult attention (inappropriate behaviors were being reinforced with that attention)

• Jay: Handing a yellow card that had the word “play” written on it to the therapist

• Betty: Taught her to say “attention, please” and “excuse me”

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HANLEY ET AL. SUMMARY

IV• Functional communication with extinction (FCT only)

• FCT: Jay: if he handed the card to the therapist, 20 seconds of praise/interaction with the therapist

• FCT: Betty: if she said, “attention, please” or “excuse me”, 20 seconds of praise/interaction with the therapist

• Extinction for inappropriate behavior

• Functional communication with punishment• FCT: same as the above for Jay and Betty• Punishment for inappropriate behavior: Jay: 30 seconds hand-down

procedure (therapist stood behind him and held his hands to his sides)

• Punishment for inappropriate behavior: Betty: 30 seconds hand-down procedure plus vision screen (therapist stood behind Betty, and placed one arm around Betty’s arms while placing the other hand over Betty’s eyes.

• Punishment only for inappropriate behavior (control)• Punishment only, same as above

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HANLEY ET AL. SUMMARY

DV: Selection of treatment by Jay and Betty

• Pressed one of three different-colored switches, each of which was paired with one of the treatment conditions

• After they pressed the switch, they were:• Immediately praised by the E regardless of which switch they pressed

• Were exposed to the corresponding treatment for 2 minutes

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HANLEY ET AL. SUMMARY:SO 30 & 32

Results

• Both children strongly preferred functional communication with punishment, rather than functional communication with extinction

Possible reason

• Functional communication with punishment was more effective in decreasing their inappropriate behaviors

• Because of that, a higher percentage of their responses were reinforced

• They preferred the condition in which they received the highest rate of reinforcement

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HANLEY ET AL. SUMMARY:SO 30 & 32

Back to Skinner and Van Houten et al.• Skinner:

• What they are suffering from is a world in which their behavior is not positively reinforced

• The “good life” is not a world in which they have what they need; it is one in which the things they need figure as reinforcers in effective contingencies

• Van Houten et al.• A procedure’s overall level of restrictiveness is a combined function of

its absolute level of restrictiveness, the amount of time required to produce a clinically acceptable outcome, and the consequences associated with delayed outcomes

• Selection of a specific treatment is not based on personal conviction. Techniques are not considered either “good” or “bad” according to whether they involve the use of antecedent rather than consequent stimuli or reinforcement versus punishment.

30(Onto Dicky)

DICKYWOLF, RISLEY & MEES

One of the most famous articles in behavior analysis

• First written account of behavior analysts working with an autistic child, 1964

• First use of time out

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(Before I talk about this, I want to just briefly review some earlier material so that will be fresh)

SO 21: SKINNER, BEHAVIOR ANALYSIS VS. TRADITIONAL VIEWS OF HELPING OTHERS, THE CONFLICT

Why was it inevitable that there would be a conflict between behavior modification and the traditional views of helping others, particularly those in institutional care?

In order to help individuals with complex behavioral problems and provide a reinforcing environment, we need to implement effective contingencies of reinforcement.

The arrangement of effective contingencies of reinforcement involves depriving individuals to some extent of powerful reinforcers; things that have been traditionally viewed as guaranteed rights and withholding them until the habilitative behavior occurs.

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VAN HOUTEN ET AL.

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Their conclusion re restrictiveness of a procedure

In some cases, a client’s right to effective treatment maydictate the immediate use of quicker acting, but temporarilymore restrictive procedures.

(How do we decide? How restrictive?, asked you in abstract, is it OK to deprive – Dicky; I am going to spendquite a bit of time on this because I do believe it is important, even though I don’t have any sos over it; a lotof benefit of the class thinking about and considering this issue; I am not going to ask/require you to take a particular viewpoint, but I do want you to think about this)

One of the individual’s rights stated in that article

An individual has the right to the most effective treatment procedures available.

DICKYWOLF, RISLEY & MEESDicky was 3.5 years old

Progressed normally until he was 9 months• Cataracts were discovered in both eyes• Severe temper tantrums and sleeping problems developed• When two years old, he had a series of eye operations which

made wearing glasses necessary; if he didn’t wear them it would result in permanent loss of macular vision (central as opposed to peripheral vision)

• He was seen by a variety of specialists who diagnosed him as:• Mentally retarded, diffuse and locally brain-damaged, psychotic

(among other things)• It was recommended that he be placed in an institution for the

retarded because his prognosis was so poor

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DICKYWOLF, RISLEY & MEESBehavioral problems

• Did not eat normally, lacked social and verbal repertoires, and engaged in self-injurious behaviors such as head-banging, face-slapping, hair-pulling, and face-scratching

• Would not sleep at night, forcing one or both parents to remain by his bed

His mom said that after a severe tantrum

• “he was a mess, all black and blue and bleeding.”

Sedatives, tranquilizers, and restraints were tried, without success

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DICKYWOLF, RISLEY & MEESAt three, he was admitted to a children’s hospital with the diagnosis of schizophrenia (subsequently released)

Wolf, Risley, & Mees brought into consult

• They did readmit him to the hospital temporarily until they could change his disruptive behaviors

They dealt with

• His temper tantrums (using time out), bedtime problems, wearing his glasses, throwing his glasses (which he began to do after he started wearing them), verbal behavior, and eating problems

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(so that’s where we start: how many would like this case? I am going to focus on his glasses: getting back tothe ethical consideration raised by Skinner: the necessity to deprive individuals of powerful reinforcers andconflicts with traditional views of helping and the rights of individuals.)

DICKYWOLF, RISLEY & MEESAt three, he was admitted to a children’s hospital with the diagnosis of schizophrenia

Wolf, Risley, & Mees brought into consult

• They did readmit him to the hospital temporarily until they could change his disruptive behaviors

They dealt with

• His temper tantrums (using time out), bedtime problems, wearing his glasses, throwing his glasses (which he began to do after he started wearing them), verbal behavior, and eating problems

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(so that’s where we start: how many would like this case? I am going to focus on his glasses: getting back tothe ethical consideration raised by Skinner: the necessity to deprive individuals of powerful reinforcers andconflicts with traditional views of helping and the rights of individuals.)

DICKYWOLF, RISLEY & MEESThey conducted a session at breakfast, using food as the reinforcer: that didn’t work

They conducted a session at lunch, using food as the reinforcer: that didn’t work

They conducted a session at 2:00 that afternoon:

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Started with fruit & candy; modified the glasses a number of times – more “wearable”, less easy to take off;(they were not having much success getting him to wear the glasses 5 weeks – shaping – so the authors decided to get directly involved. Quote from the article.., remember permanent loss of vision – one more slide on this)

Dicky had received very little to eat all day, just a few pieces of dry cereal,and was most interested in the ice cream we brought to the session. At thebeginning of the session it was quite obvious that our reinforcers weremuch powerful than earlier in the day….After this, progress was rapid and he was soon wearing his glasses continuously during the meal sessions in his room.

DICKYWOLF, RISLEY & MEES

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After wearing the glasses was established in these sessions, it couldbe maintained with other, less manipulable reinforcers. For example,the attendant would tell Dicky, “Put your glasses on and let’s go for awalk.” Dicky was usually required to wear the glasses (during meals, snacks, automobile rides, walks, outdoor play, etc.). If he removed theglasses, the activity was terminated.

Fast forward a bit: Dicky was released from the hospital and according to his mom, six months later Dicky had continued to wear his his glasses, did not have any tantrums, had no sleeping problems, was becoming increasingly verbal, and was a new source of joy to the members of his family.

(one more slide)

DICKYWOLF, RISLEY & MEESSo, essentially, the authors:

• Food deprived a 3.5 year-old autistic child for, give or take, 7-8 hours (not counting overnight) so food would function as an effective reinforcer and

• Punished him for removing his glasses by taking away food and activities he enjoyed

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Were these procedures and interventions ethical or were Dicky’s rights violated?

Question:

QUESTIONS/COMMENTS/DISCUSSION

Exam: 4/21

Instructional assistance hours: 4/20, 6:30-8:00 pm

Thomas will be there

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