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 when good ethics go bad: understanding evidence based practice, 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 | Individual client assessment data and learning history | Diagnosis category or program model intake criteria |
| Procedure selection | Selected and adapted based on client's current repertoire and response to training | Selected from standardized protocol based on diagnostic category |
| Response to non-progress | Systematic barrier assessment followed by individualized procedure modification | Increase intensity or switch to next protocol step |
| Role of clinical expertise | Essential — expertise guides individualization and interpretation of client data | Reduced — protocol specifies decisions; clinician implements fidelity |
| Code 2.14 compliance | Built in — individualization includes ongoing evaluation and modification based on data | May be limited — protocol adherence can delay or prevent modification when indicated |
| Client values and preferences | Actively incorporated into goal selection and procedure design (Code 2.09) | May be secondarily considered after protocol requirements are met |
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 when good ethics go bad: understanding evidence based practice 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.
When Good Ethics Go Bad: Understanding Evidence Based Practice — Do Better Collective · 2 BACB Ethics CEUs · $
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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.