By Matt Harrington, BCBA · Behaviorist Book Club · Clinical decision guide

Cool Versus Not Cool Procedure vs. Teaching Interaction Procedure for Social Skills Instruction via Telehealth

In This Guide

Side-by-Side Comparison
Clinical Decision Framework
Key Takeaways

One of the most consequential decisions a behavior analyst makes is not just what intervention to use, but how to approach the clinical question in the first place. For cool versus not cool procedure implemented via telehealth | learning | 0.5 hours, the difference between an evidence-based, individualized approach and a traditional, protocol-driven one can significantly impact outcomes.

This guide lays out the key factors side by side to support your clinical decision-making.

Side-by-Side Comparison

Factor	Evidence-Based Approach	Traditional Approach
Core Mechanism	Cool vs. Not Cool: Social discrimination training using labeled exemplars and non-exemplars to build judgment	Teaching Interaction Procedure: Sequential skill instruction with rationale, modeling, role-play, and performance feedback
Learner Prerequisites	Requires receptive label identification, attending, and basic conversational repertoires	Requires ability to follow multi-step verbal instructions and engage in extended role-play exchanges
Telehealth Adaptability	Well-suited to telehealth; visual materials and modeling can be formatted for digital display with manageable adaptation	Adaptable to telehealth but requires more complex role-play management and extended back-and-forth exchange across the video interface
Generalization Support	Discrimination training supports flexible responding across varied exemplars; requires explicit generalization programming	Rationale component builds conceptual understanding that may support generalization; still requires planned generalization probes
Data Collection	Trial-based probe data on correct discrimination responses; straightforward to code through video observation	Multi-component fidelity data across all TIP steps; more complex to code reliably in real-time telehealth sessions
Best Fit	Learners who need to build social discrimination skills across multiple contexts with concrete labeling support	Learners with stronger verbal and conversational repertoires who can benefit from explicit rationale and extended performance feedback

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Clinical Decision Framework

Use this framework when approaching cool versus not cool procedure implemented via telehealth | learning | 0.5 hours in your practice:

Step 1: Is intervention warranted?

Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?

YES → Proceed to assessment NO → Document reasoning, monitor

Step 2: Have you conducted an individualized assessment?

A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.

YES → Select evidence-based approach matched to function NO → Complete assessment first

Step 3: Is the individual/caregiver involved in decision-making?

Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.

YES → Proceed with collaborative plan NO → Engage in shared decision-making

Step 4: Verify your approach

✓ Is your intervention matched to the assessed function?
✓ Are you using the least restrictive effective approach?
✓ Is assent being monitored throughout?
✓ Do you have a data collection plan?
✓ Is there a plan for generalization and maintenance?

Key Takeaways

Individualization is non-negotiable. The best approach for one individual may not be appropriate for another, even with the same topography.
Assessment drives intervention. Function-based approaches consistently outperform topography-based ones in the literature.
Ethics are active, not passive. Ethical practice requires ongoing analysis, not just initial compliance.
Document everything. Both the decision to intervene and the decision not to intervene require documentation and justification.
Stay current. The evidence base in this area is evolving. What was standard practice five years ago may not reflect current best practices.

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Clinical Disclaimer

All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.