As behaviour analysts who practice in Ontario, we are guided by both provincial and federal legislation, as well as the Professional and Ethical Compliance Code for Behaviour Analysts or more commonly known as “The Code” outlined by the Behaviour Analyst Certification Board (BACB). At times these legislations can be challenging to decipher and all of the information provided can become quite overwhelming! Luckily, some valuable resources have been created by the Ontario Association of Behaviour Analysis (ONTABA) that can help support your professional practice. These resources cover topics related to consent, privacy and confidentiality, billing practices, and interprofessional collaboration. So whether you are a new BCBA heading into the field, or an experienced clinician wanting to ensure you are keeping up with best practices, these 9 key resources can be of use to you! 

To help identify which resources may be of value to you, I have separated the resources based on topics related to consent, privacy and confidentiality, business practices, and interprofessional collaboration. 

Considering Ethical Practices Related to Consent

1) Consent & Capacity in ABA 

As one of the first steps in providing behavioural services, navigating the process of obtaining consent can be challenging. This resource breaks down who can provide consent to behavioural services, how a behaviour analyst can obtain informed consent, and how to identify if your client has the capacity to provide consent.

2) Obtaining Valid Consent 

Not only must behaviour analysts obtain consent, but they must also be sure that the consent that is provided is valid. This means that the consent provided by the client or substitute decision-maker must be (1) legal, (2) informed, and (3) voluntary. In this resource from ONTABA, the three conditions of consent are clearly explained to help clinicians identify if the consent provided is valid. In addition to explaining this, the resource provides information on proper documentation and includes a checklist for behaviour analysts that outlines the consent process for service agreements and for assessment and treatment. 

Maintaining privacy and confidentiality

3) File Access & Correction (Frequently Asked Questions)

Have you ever had a client ask to review their file? Had a client question the information within their file? Or, asked you to remove something from their file completely? This can be a very tricky situation to navigate, but it is essential that we as behaviour analysts respect a client's right to access their files and make corrections as outlined by the Personal Health Information Protection Act (PHIPA, 2004). To support your understanding of the legislation surrounding file access and correction, ONTABA has created a resource that provides answers to frequently asked questions regarding client’s rights to access files, what happens when a client disputes the information within their file and documenting corrections. For more information on this topic, you can also check out the Information and Privacy Commissioner of Ontario’s website https://www.ipc.on.ca/

4) Recording Keeping Safety & Security Tips

As behaviour analysts, we have a responsibility to keep client records confidential and to protect the privacy of personal health information. It is important to make sure that our actions are not putting our client’s information at risk of a privacy breach. This resource provides some great information on how to protect client records, which is especially important as we all navigate working from home and the increased use of technology to transmit and store our client’s personal health information. 

5) Information Sharing Tips

I am sure that we have all experienced the pain of listening to an oversharer (the worst!), however, unlike oversharing about our personal lives to a coworker, oversharing the personal health information of a client is a breach of privacy. In this helpful resource, ONTABA outlines the Do’s and Don’ts of information sharing inside your organization, in your reports, and outside your organization. Although we love gathering and presenting information and data, it is important to remember that including or sharing information that is not pertinent to the case or target behaviours in question is not acceptable. 

6) 5 WH - Questions for Record Keeping

Simply put, this resource outlines the who, what, where, when, how, and why of record keeping. Again, this resource is super helpful for those who would like to review our responsibilities as behaviour analysts to protect and store client information while working from home and using technology to store and transmit client information.  

7) Privacy and Confidentiality in ABA

Within our field, we often find that the terms privacy and confidentiality are used interchangeably. However, these two terms are not one and the same. This resource clearly outlines the difference between the two while providing some information on disclosing personal health information and the limits of confidentiality. As behaviour analysts, we may find ourselves in a position where we must exercise our “duty to warn” or “duty to report.” This resource outlines the cases in which a breach in privacy may be warranted and our requirements for reporting privacy breaches. 

Best Business Practices

8) Ethical Billing and Business Practices 

When it comes to billing practices for behaviour analysts in Ontario, there are a lack of resources that provide guidelines on best practices. This may be in part due to the fact that behaviour analysis is not currently regulated in Ontario. Fortunately, ONTABA has created a tipsheet that outlines some resources to support billing practices while also outlining some Do’s and Don’ts for ethical billing and business practices.

Ethical Considerations for Collaborating with Others

9) Ethical Principles for Interprofessional Collaboration 

As behaviour analysts, we often work with various professionals to provide support for individuals that are client-centered. This resource provides a guide for behavior analysts to work with other professionals so that clinicians are able to provide comprehensive services. This includes identifying common values and goals, ensuring the client is involved with the service recipients in the treatment, focusing on the scope of practice and permitted activities of each professional, and looking at the billing practices of each. If you are interested in learning more about collaborating with other professions check out the article cited below by Newhouse-Oisten and colleagues (2017). In this article the authors provide ethical considerations when collaborating with professionals and outline a decision-making process for ensuring use of evidence-based treatment when working with prescribing professionals. 

Newhouse-Oisten, P., Peck, K.M., Conway, A.A., & Frieder, J.E. (2017). Ethical considerations for interdisciplinary collaboration with prescribing professionals. Behavior Analysis in Practice, 10(2), 145–153. https://doi.org/10.1007/s40617-017-0184-x

Whether you are new to the field or an experienced clinician, I encourage anyone reading this to take the time to review these materials and consider how their own practices may be improved to meet the outlined standards set out by the relevant legislation and the BACB Compliance Code. It is through consistent critical reflection of our own professional behaviour that we are able to maintain best practices that reflect positivity on our clients and the profession as a whole!  

All of the resources discussed here were created and made available by the Ontario Association of Behaviour Analysis (ONTABA). To review the outlined resources and other resources related to ABA check out https://training.ontaba.org/