The issue of ethics has become a very HOT topic over the last year. And unfortunately, not in a favorable way as what it means to provide ethical services is often being misconstrued. This issue has been brewing for some time and stemmed originally from multiple instances of insurance fraud which rightly put everyone on high alert. But, how to operate ethically in the ABA space has been vague at best. From the insurance carriers paying the claims, to the BACB, it is challenging to get a direct answer. So, as a result, many BCBAs are panicked and hyper focused on what is “ethical” in fear of jeopardizing their credential. I have heard it all- from it is “unethical to bill when a tantrum is occurring” to it is “unethical to schedule make-up time for cancelled sessions.” The result is unfortunate as BCBAs are operating under a false assumption of what is right and wrong, and they are not to blame. The blame rests with a lack of training and understanding of what is ethical and what is not and that must be clearly delivered from the AMA, payers and/or the BACB. The unfortunate outcome is that “Johnny”, the client who needs ABA services is ultimately the person who suffers from the lack of clarity around what is and is not ethical and I for one, want to see “Johnny”, Jane, Joey and Mike reach their full potential.
It’s time to do a re-assessment of how and what ethics training is provided to every level of clinical staff because if the result of the current training is to be resistant and push back on what fundamentally is ABA and what enables it to be impactful then where is ABA headed?
