Thursday, March 24, 2016

Ethics Crash Course


Photo source: www.ethics.efpa.eu, www.asme.org


Ethics can be defined as a standard of practice and conduct. Ethics help to define and establish what is appropriate, what is inappropriate, and also help protect the public/consumers.

If you work in this field in some capacity --even if you just work part time for a small company --you need to be aware of the ethical standards for this field. Why, you ask? Well, you can cause harm to yourself and/or others if you are providing services in an unethical manner.

Like other BCBA's, I have often been in the position of leading the "new staff training".  What I have noticed is these trainings often gloss over, or completely leave out, information about ethics. I don't agree with that at all. Let's face it: this is a young field. It is not uncommon to work with very young staff who may have never had a "real" job before. Or whatever they were doing before ABA was a non-professional position. I have had many situations of having to pull a new staff aside to discuss their work attire, cell phone use, or defensiveness when receiving correction. This is why I started generally going over professionalism with all my new staff, with a crash course in ethical behavior.

Hopefully this information will provide a good jumping off point for creating your own staff resources, or could possibly be integrated into a comprehensive training. This information could also be used to create company policies, or an employee handbook.
I strongly suggest using lots of real examples when teaching about ethics. I vividly remember sitting in a training years ago as a new ABA therapist, and the trainer was explaining that we cannot take food out of the children's lunchboxes (this was a center facility). I remember thinking to myself what a dumb thing to go over in a training, but then the trainer explained a therapist was just fired for repeatedly eating the children's food!
So now when I'm putting together trainings of my own, I always aim to include actual ethics fails that I have seen to make things much more relevant. :-)

Here is a quick overview of the topics I try to cover with my staff. I have found that when problems happen or when families complain, usually it is about one of these issues.

Crash Course Suggestions:

Professional Dress
Most of my direct staff are young females, many of whom have never had a job before where they work in someone’s home. Yoga pants, halter tops, high heels, huge earrings, super tight pants…I’ve seen it all! And NONE of it is appropriate. This is a job where you often work with children, typically kneeling, bending over, squatting, running…. you get the point. Improper clothing is one of the top things parents complain to me about when it comes to direct staff.
Confidentiality & Privacy
This is a big one. If your staff are new to a professional position, this will be completely foreign to them. I used to work at a facility in a very small town, and it was hard to get the staff to understand they could not gossip at the local bar about their clients after work. It is imperative to protect client information, which can include data sheets, verbal information, client address, client diagnosis, etc. Especially if the client receives insurance funding, HIPAA compliance is a must!
Professional Boundaries
I started in this field as a direct therapist, so I get it: it is easy to get chummy with the families you serve and start to form friendships. Parents will blur the boundaries when they like you, because hey…you are always at their house! As the professional, it is YOUR job to set clear boundaries and to maintain them. All of the ethical burden falls on you, and it is much easier to maintain a clear boundary than it is to try and establish a boundary after lines have been crossed.
Respecting the Dignity of the Client
This would be things like allowing a 10- year old client to cuddle with you while sitting on your lap, or teaching play skills to an adult client using Barbie dolls. At all times the dignity of the individual you are serving needs to be at the front of your mind. Think about how you would want to be treated if you were the client. Your nonverbal clients won’t be able to tell you if their rights are being violated, so again, all of the ethical burden falls on you.
Boundaries of Competence
It is very important to know the limitations of your competencies, and to seek out appropriate supervision and training. If you are not qualified or knowledgeable to do something, its best to step back. I know this can be hard depending where you work…. some companies pay no attention to staff competency when staffing cases. This also refers to knowing when to be quiet. I have had to correct new staff for giving parents medical advice, recommending supplements, or suggesting changes to the behavior plan. Learn the following phrase and be prepared to say it often: “You need to speak to the BCBA about that:-)
The Social Media Minefield
So as technology continues to get fancier, this is a topic I have to address more and more with staff. It’s inappropriate to “friend” clients on social media, OR to discuss/vent about your clients on social media. Even if you don’t name names. Be very careful, I have seen people face legal action over things like this. Just because you don’t say a name, if you describe the client enough that I can figure out who you are talking about then you have violated that client’s privacy, as well as behaved unethically.

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