By Matt Harrington, BCBA · Behaviorist Book Club · Clinical decision guide
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 dear don ethics panel nov%202023, 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.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Speed | Intuitive: Fast; decisions can be made immediately based on gut feeling and experience | Structured: Slower; requires deliberate progression through multiple analytical steps |
| Comprehensiveness | Intuitive: May overlook stakeholders, consequences, or ethical dimensions that are not immediately salient | Structured: Systematically considers all stakeholders, multiple options, and various ethical frameworks |
| Bias Susceptibility | Intuitive: Highly susceptible to cognitive biases including self-interest, recency effects, and emotional reasoning | Structured: Built-in checks against bias through systematic consideration of multiple perspectives and principles |
| Consistency | Intuitive: May produce different decisions for similar situations depending on mood, context, and recent experiences | Structured: More consistent application of principles across similar situations over time |
| Defensibility | Intuitive: Difficult to explain or justify the reasoning behind decisions; 'it felt right' is not a defensible rationale | Structured: Documented reasoning provides clear justification for decisions to colleagues, oversight bodies, and courts |
| Learning Value | Intuitive: Limited opportunity for reflection and improvement; each decision is made and forgotten | Structured: Documentation and reflection enable learning from each ethical decision; reasoning skills improve over time |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching dear don ethics panel nov%202023 in your practice:
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
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
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
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Dear Don Ethics Panel Nov%202023 — CASP CEU Center · 1 BACB Ethics CEUs · $
Take This Course →1 BACB Ethics CEUs · $ · CASP CEU Center
Research-backed educational guide
Research-backed answers for behavior analysts
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.