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 values into action: a guided session toward creating your balanced scorecard, 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 |
|---|---|---|
| Starting Point | Values-Based Strategy (ACT/BSC): Begins with facilitated values clarification; indicators and targets derived from authentic organizational values; strategy is anchored in what the organization is fundamentally for | Metrics-First Strategy: Begins with identification of measurable performance indicators; values may be stated but are not the primary driver of indicator selection; strategy is anchored in what is measurable |
| Risk of Mission Drift | Values-Based Strategy (ACT/BSC): Lower risk of mission drift because performance indicators are explicitly connected to values; values-action gaps are visible and must be resolved through genuine organizational decisions | Metrics-First Strategy: Higher risk of mission drift; organizations can hit all metrics while gradually abandoning the clinical and ethical commitments that motivated the enterprise; drift is often invisible until it is significant |
| Staff Engagement | Values-Based Strategy (ACT/BSC): Staff who understand and share the organizational values find performance targets meaningful rather than arbitrary; committed action is intrinsically motivated by values alignment | Metrics-First Strategy: Staff may experience targets as externally imposed and disconnected from clinical purpose; compliance rather than commitment is the typical motivational mode |
| Quality of Strategic Conversations | Values-Based Strategy (ACT/BSC): ACT-based facilitation attends to the psychological dynamics of planning conversations; fusion and avoidance are named and worked with; honest engagement with difficult data is more likely | Metrics-First Strategy: Planning conversations may proceed efficiently but without genuine engagement with the values tensions underlying performance challenges; difficult data may be avoided or rationalized |
| Adaptability to Organizational Change | Values-Based Strategy (ACT/BSC): Values provide a stable foundation for strategic adaptation; when market conditions or regulatory contexts change, values-based decision-making provides clear guidance for how to adapt while remaining true to mission | Metrics-First Strategy: Metric targets may be revised frequently in response to environmental changes without a stable values foundation guiding the direction of revision; organizational direction can become reactive and incoherent |
| Alignment with BCBA Ethics Code | Values-Based Strategy (ACT/BSC): Explicitly operationalizes Ethics Code obligations at the organizational level; values such as client best interest, competent practice, and professional development are built into the measurement framework | Metrics-First Strategy: Ethics Code compliance may be treated as a separate compliance function rather than integrated into organizational strategy; clinical and operational metrics may not reflect ethical priorities |
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 values into action: a guided session toward creating your balanced scorecard 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.
Values into ACTion: A Guided Session toward Creating your Balanced Scorecard — Celina Lopez · 1 BACB General CEUs · $0
Take This Course →1 BACB General CEUs · $0 · BehaviorLive
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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.