This comparison draws in part from “Learnings from EOM's First Two Years” by Lalan Wilfong, MD (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →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 learnings from eom's first two years, 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 |
|---|---|---|
| Theoretical Foundation | Traditional: Operant and respondent conditioning principles; emphasis on environmental contingencies and observable behavior | ACT-Informed: Adds Relational Frame Theory; explicitly addresses verbal behavior and derived relational responding as maintaining variables |
| Treatment of Private Events | Traditional: May acknowledge private events but focus intervention primarily on environmental manipulation and observable outcomes | ACT-Informed: Directly targets the function of private events (thoughts, feelings) in maintaining problematic behavior patterns |
| Primary Intervention Targets | Traditional: Specific behaviors targeted for increase or decrease based on functional assessment | ACT-Informed: Psychological flexibility as an overarching target; specific behaviors addressed within the context of values-consistent living |
| Role of Values | Traditional: Preferences assessed to identify reinforcers; goals set collaboratively but may not explicitly address values | ACT-Informed: Values clarification is a core process; all intervention targets are explicitly linked to client-identified values |
| Approach to Avoidance | Traditional: Escape-maintained behavior addressed through functional analysis and contingency manipulation | ACT-Informed: Experiential avoidance (escape from private events) identified as a functional process; acceptance as an alternative to avoidance |
| Therapeutic Relationship | Traditional: Relationship important for rapport; therapist primarily functions as contingency manager and skill trainer | ACT-Informed: Relationship is a context for modeling psychological flexibility; therapist practices ACT processes themselves |
| Outcome Measurement | Traditional: Direct observation of target behaviors; rate, frequency, duration, and accuracy measures | ACT-Informed: Behavioral measures plus process measures (flexibility, fusion, values consistency) and quality-of-life indicators |
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 learnings from eom's first two years 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.
Learnings from EOM's First Two Years — Lalan Wilfong · 1 BACB Ethics CEUs · $30
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
239 research articles with practitioner takeaways
233 research articles with practitioner takeaways
147 research articles with practitioner takeaways
1 BACB Ethics CEUs · $30 · 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.