By Matt Harrington, BCBA · Behaviorist Book Club · Research-backed answers for behavior analysts
The most common categories include school-based practice challenges such as conflicts between administrative directives and professional standards, in-home service boundary issues with caregivers, supervision concerns including adequacy of oversight and supervisee competence, insurance-related dilemmas involving billing practices and medically necessary treatment determinations, and systemic concerns related to private equity-owned companies where corporate practices may conflict with client welfare. Emerging categories include questions about social media conduct, telehealth ethics, and the appropriate response when organizational practices appear to prioritize profit over client outcomes.
A BCBA should never alter assessment findings to support a predetermined conclusion, as this violates the Ethics Code requirement to base services on the best available evidence. The appropriate response is to explain the assessment findings clearly, provide the data supporting the conclusions, and offer to discuss any concerns the administrator has about the report. If the administrator disagrees with the methodology, the BCBA can explain the rationale for the assessment approach used. If pressure continues, the BCBA should document the request and their response, consult with colleagues or a supervisor, and consider contacting the BACB ethics department for guidance.
When insurance denials conflict with clinical judgment, the behavior analyst should first ensure that their treatment recommendations are well-documented, data-supported, and clearly articulated in the authorization request. If a denial is received, file an appeal with additional data justifying the medical necessity of services. Advocate for the client while maintaining accurate and honest documentation. The BACB Ethics Code (2022) requires behavior analysts to advocate for appropriate services for their clients. However, behavior analysts should never falsify clinical documentation to obtain insurance approval, as this constitutes fraud regardless of the perceived benefit to the client.
Private equity ownership creates potential conflicts of interest when the financial return expectations of investors influence clinical decisions. Common concerns include pressure to maintain high caseloads that may exceed what allows for quality supervision and treatment, incentives to extend treatment duration beyond clinical necessity, staffing models that prioritize billable hours over supervision and training, and acquisition-driven growth that may compromise continuity of care. Individual behavior analysts working in these environments must remain vigilant about ensuring that their clinical decisions are based on client need rather than organizational revenue targets, and should document any situations where they believe financial pressures are compromising care.
Common supervision ethics concerns include supervisors who provide insufficient direct observation of supervisee performance, supervisors who sign off on supervision hours without providing meaningful oversight, supervisors who assign responsibilities to supervisees that exceed their competence, organizations that assign supervision caseloads that make adequate oversight impossible, and supervisors who fail to address known competency deficits in supervisees. These concerns often reflect systemic issues where organizational practices create conditions that make adequate supervision difficult, rather than individual supervisors who deliberately choose to provide inadequate oversight.
The BCBA should maintain neutrality and focus exclusively on the client's welfare and treatment goals. Explain to the caregiver that your role is to provide behavioral services to their child, not to evaluate parental fitness or provide opinions about custody arrangements. If asked to provide testimony or records in custody proceedings, consult with an attorney about your legal obligations and ensure that any information you provide is limited to factual observations about the client's treatment. The BACB Ethics Code (2022) requires behavior analysts to avoid multiple relationships that could impair their professional judgment, and taking sides in a custody dispute would create exactly this type of compromising relationship.
The BACB Ethics Code (2022), Code 1.15, provides guidance on this situation. The first step is to attempt to resolve the issue directly by bringing the concern to the colleague's attention, assuming this can be done without risk to clients. If direct resolution is not possible or the concern involves immediate risk to client welfare, the behavior analyst should consider reporting to the colleague's supervisor, the organization's compliance department, or the BACB. Documentation of the concern and the steps taken to address it is essential. The behavior analyst should also consider whether the situation requires mandatory reporting to other authorities, such as child protective services.
Self-protection begins with documentation. Maintain written records of any directives that conflict with ethical standards, your responses to those directives, and any consequences you experience. Build a professional network outside your organization for consultation and support. Familiarize yourself with whistleblower protections in your state. When possible, advocate for policy changes through appropriate organizational channels before considering external reporting. The BACB Ethics Code (2022), Code 2.15, requires behavior analysts to report and address conditions that interfere with their ability to provide appropriate services. Having a clear understanding of your rights and obligations strengthens your position.
Robust informed consent practices prevent many of the situations that generate ethics hotline calls. When clients and caregivers clearly understand the nature of services, the expected duration, the roles and responsibilities of all parties, the limits of confidentiality, the complaint process, and the basis for treatment decisions, misunderstandings that escalate into ethical conflicts are less likely to occur. Informed consent should be an ongoing process, not a one-time paperwork event. Revisiting consent when treatment plans change, when new interventions are introduced, or when circumstances shift maintains transparency and reduces the potential for disputes.
Several systemic changes would address the root causes of common ethics concerns. Stronger regulatory oversight of ABA organizations, particularly those owned by private equity, would reduce financially-motivated ethical pressures. Mandated supervision ratios that account for the complexity of cases and the competence level of supervisees would improve supervision quality. Standardized FBA procedures in school settings would reduce conflicts between administrative convenience and assessment integrity. Enhanced ethics training in graduate programs that focuses on applied decision-making rather than abstract rule-learning would better prepare new practitioners. Insurance reform that reduces authorization burden and aligns reimbursement with evidence-based treatment durations would address billing-related ethical pressures.
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Ready to go deeper? This course covers this topic with structured learning objectives and CEU credit.
A Day in the Life of an Ethicist: Questions from the ABA Ethics Hotline Tell a Lot About Our Field — Jon Bailey · 1 BACB Ethics CEUs · $20
Take This Course →1 BACB Ethics CEUs · $20 · BehaviorLive
Research-backed educational guide with practice recommendations
Side-by-side comparison with clinical decision framework
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.