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 telehealth tuesday may 19 2020, 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 |
|---|---|---|
| Clinical Evidence Base | In-Person: Strongest evidence base for direct skill acquisition with complex learners; direct physical prompting and proximal behavioral observation available | Telehealth: Strong evidence for caregiver training, naturalistic teaching support, and BCBA consultation; growing evidence for broader applications |
| Caregiver Role | In-Person: BCBA or RBT directly implements; caregiver may observe or participate with BCBA guidance | Telehealth: Caregiver often the primary implementing agent; requires prior training and ongoing coaching capacity |
| Access and Reach | In-Person: Limited by geographic proximity to qualified providers; not accessible in underserved areas | Telehealth: Expands geographic reach significantly; requires adequate technology access which creates different equity barriers |
| Billing Complexity | In-Person: Established billing procedures; standard documentation requirements well understood by most payers | Telehealth: Payer-specific policies vary widely; documentation requirements include telehealth-specific elements; policy landscape remains dynamic |
| Crisis Management | In-Person: BCBA or RBT can intervene directly; trained crisis response immediately available in the session environment | Telehealth: Crisis management limited to verbal coaching of caregiver; requires explicit advance planning and caregiver competency |
| Supervisory Application | In-Person: Most comprehensive observation; direct demonstration and physical guidance available for supervisory feedback | Telehealth: Enables remote supervision continuity; BACB-specified requirements apply; some behavioral observation limitations inherent to video |
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 telehealth tuesday may 19 2020 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.
Telehealth Tuesday May 19 2020 — CASP CEU Center · 1 BACB Supervision CEUs · $
Take This Course →1 BACB Supervision 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.