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 we, the people - part 2: a seat at the table, 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 |
|---|---|---|
| Scope of Impact | Individual Advocacy: Affects one client or family at a time. Immediate, tangible outcomes for that individual. | Systemic Policy Advocacy: Affects entire populations of clients. Changes can improve conditions for all individuals served by a system. |
| Skill Requirements | Individual Advocacy: Requires clinical expertise, knowledge of client rights, and the ability to navigate institutional processes such as IEP meetings or insurance appeals. | Systemic Policy Advocacy: Requires understanding of legislative processes, data presentation skills, coalition building, and the ability to translate behavioral science into policy-relevant language. |
| Time to Outcome | Individual Advocacy: Results can be achieved relatively quickly, often within weeks or months through existing institutional processes. | Systemic Policy Advocacy: Change is typically slow, often requiring years of sustained effort across multiple legislative sessions or administrative cycles. |
| Ethical Grounding | Individual Advocacy: Directly grounded in Code 3.01 (Responsibility to Clients) and Code 2.01 (Providing Effective Treatment) for a specific client. | Systemic Policy Advocacy: Grounded in broader ethical obligations to the profession and community, including the principle that behavior analysts should promote access to effective behavioral services. |
| Risk of Conflict | Individual Advocacy: May create tension with specific institutions or providers but is generally within the expected professional role. | Systemic Policy Advocacy: May involve political dynamics, conflicts with institutional interests, and the risk of being perceived as operating outside professional boundaries. |
| Sustainability | Individual Advocacy: Gains are specific to the individual and may not transfer when the client moves to a new setting or the behavior analyst is no longer involved. | Systemic Policy Advocacy: Successful policy changes create durable structural improvements that persist beyond any individual case or advocacy effort. |
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 we, the people - part 2: a seat at the table 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.
We, the People - Part 2: A Seat at the Table — Portia James · 1.5 BACB Ethics CEUs · $0
Take This Course →1.5 BACB Ethics 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.