This comparison draws in part from “OPENING REMARKS and Beyond Buy-In: Using Relationship Intelligence to Turn Difficult Conversations into Compassionate Partnerships with Families” by Ellie Kazemi, PhD (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 →Behavior analysts navigate family relationships using one of two implicit frameworks, even when neither is consciously chosen. The buy-in model positions the clinician as the holder of expertise who needs to persuade the family to accept and implement recommended treatment. It is not inherently disrespectful, but its transactional structure — clinician presents, family agrees or resists — shapes how difficult conversations unfold. When families push back, the clinician's job is to overcome the resistance and secure agreement.
The relationship intelligence model, as developed by Ellie Kazemi, starts from a different premise: the family and the clinician are collaborative partners building a shared understanding together, and the clinician's job includes genuinely learning what the family needs, not just communicating what the clinician already decided. When families push back in a RIQ framework, the pushback is treated as informative rather than obstructive — as data about what the current approach is missing, not as an implementation problem to solve.
Both models can produce family compliance in the short term. The difference emerges over time, in the texture of the relationship, the quality of implementation, and the family's capacity to function as genuine partners in their child's treatment.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Orientation to family pushback | Treated as informative data about what the approach may be missing | Treated as resistance to be overcome through better persuasion |
| Goal of difficult conversations | Shared understanding and collaborative agreement, even when positions differ | Family agreement with the clinician's recommended approach |
| Role of emotion | Validated as meaningful communication that informs how the conversation proceeds | Managed as an obstacle to rational clinical discussion |
| Treatment plan development | Co-constructed with family values and priorities actively shaping goals | Clinician-developed and presented to family for approval |
| Family engagement over time | Sustained by relational trust and genuine partnership investment | Sustained by clinician persuasion skill and family compliance |
| Response to implementation difficulty | Explored collaboratively as a shared problem; family perspective central to solution | Addressed through re-education, re-training, or escalating expectations |
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Use this framework when approaching opening remarks and beyond buy-in: using relationship intelligence to turn difficult conversations into compassionate partnerships with families 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.
OPENING REMARKS and Beyond Buy-In: Using Relationship Intelligence to Turn Difficult Conversations into Compassionate Partnerships with Families — Ellie Kazemi · 1 BACB Supervision CEUs · $20
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.
244 research articles with practitioner takeaways
239 research articles with practitioner takeaways
195 research articles with practitioner takeaways
1 BACB Supervision CEUs · $20 · 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.