When ABA Professionals Disagree: Effective Collaboration

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The Ethics of It:

healthywf-behavioral.jpg As Applied Behavior Analysis (ABA) professionals, and as a commitment to the clients we serve, we are required to follow the ethical code for behavior analysts. In the section of the Ethics Code for Behavior Analysts referred to as “Responsibility in Practice” behavior analyst are required to collaborate with colleagues as outlined in Section 2.10: “Behavior analysts collaborate with colleagues from their own and other professions in the best interest of clients and stakeholders. Behavior analysts address conflicts by compromising when possible and always prioritizing the best interest of the client. Behavior analysts document all actions taken in these circumstances and their eventual outcomes.” Behavior analysts are required to obtain informed consent to arrange appropriate consultation with referrals, and operate in accordance with all requirements including, but not limited to regulations, laws, and funder policies (Section 3.06: Consulting with Other Providers).  Collaboration with colleagues is an integral and necessary part of clinical practice, and time should be allotted for effective collaboration. One method to establish effective collaboration is by creating opportunities to collaborate from the outset–this can be achieved by including colleagues in the initial assessment process.

Initial Assessment:

When conducting an initial assessment with a new client, the initial assessment is typically comprehensive, and includes direct observations of the client in their natural environment; preference assessments; the utilization of formal assessment protocols; parent interviews; and data collection pertaining to possible behaviors targeted to be decreased. In designing their initial assessment process, behavior analysts should seek to collaborate with school personnel to understand some of the strengths and interests of the learner. For example, a paraprofessional may have insight into items that can be incorporated into a preference assessment for a learner. In including other professionals in the initial assessment process, one can not only gain valuable information about the client, one can also build a professional relationship from the outset, and potentially create a foundation to be able to address (possible) future disagreements in a cordial manner. 

Open Lines:

Effective, thoughtful and empathetic communication is essential to building meaningful collaborative relationships. Indeed, communication should be initiated when challenging behaviors arise and when clients are performing well. Collaboration shouldn’t only occur in times of difficulty–it should occur when progress is directly observed, and planned long or short-term objectives are met. In this sense, maintaining open lines of communication means collaboration can be enduring, authentic and positive. In my own experience of managing more complex cases, proactively securing consent to connect with school-based behavior analysts has helped to facilitate the functional behavioral assessment process, increase the effectiveness of data collection procedures, and ensure continuity of skill acquisition goals. 

Managing Disagreements:

How one communicates in disagreements is equally as important as what one communicates during disagreements. Disagreements should be approached from the perspective of mutual respect and intention to understand. We can demonstrate mutual respect by actively listening through nonverbal and verbal communication—leaning towards the speaker, nodding our head, and even taking notes are outward behavioral signs that one is engaged with the speaker. We can practice active listening even in moments when we may disagree.  In addition, mutual respect involves recognizing that one is working within their discipline, and attempting to tackle problems from the perspective of their discipline, and this commitment to helping the learner should be respected even if there is disagreement. I have practiced active listening in virtual meetings with related service providers whose nonverbal communication has indicated their disagreement with my approach. In allowing other providers space and time to articulate their point, even when there is visible disagreement, I’ve created effective opportunities for collaboration.

On-Site Visits:

With the onset of the pandemic, many collaborative opportunities have moved to a virtual mode; however, one should consider scheduling onsite visits and in-person meetings. Such meetings not only provide an authentic context for communication, they simultaneously offer opportunities to observe the learner in a different environment to program for the generalization of skills. For example, the behavior analyst who works with a learner who also attends a Saturday program at a sensory gym under the supervision of an occupational therapist, may not only gain insight into the learner’s behavior in a different context, they may also have the chance to display mutual respect, and active listening during a pre-scheduled meeting with the occupational therapist. 

Mode & Flexibility:

Importantly, in-person meetings may not always be the preferred or available mode of collaboration. Time constraints and commute times may make regular in-person meetings difficult to schedule. One must decide on a mode or multiple modes of collaboration that are effective. Some providers may prefer to meet via a video call or in person. It’s important to establish modes of collaboration and times of day that work in order to schedule meetings for all parties involved. With the intention of resolving and/or preventing disagreements, behavior analysts can see advantages in flexible scheduling with collaborators. I’ve seen the benefits of exhibiting flexible scheduling particularly in collaborating with school-based staff whose schedules might be busy with larger caseloads, and faculty meetings–in scheduling meetings that are convenient for collaborators, I’ve been able to build connections, and open lines of communication, which would otherwise have not occurred. 

Word Choice:

When communicating, behavior analysts should refrain from the utilization of behavior analytic terminology, which could serve as a barrier to effective collaboration. Such terminology may be confusing to a professional who is unfamiliar with the science of ABA. Not everyone is familiar with how to label different components of verbal behavior. Further, it is within our scope of practice to communicate in a way that helps the listener understand, and therefore able to implement our recommendations.  In summary, it is necessary to collaborate with providers, teachers, and healthcare professionals who may not be familiar with ABA–we must obtain informed consent prior to doing so. While we have a commitment to practicing ABA rooted in evidenced-based techniques, we should also adopt methods to facilitate ongoing collaboration and resolution of disagreements while centering the individual needs of the client.     

References:

Behavior Analyst Certification Board (2020) Ethics Code for Behavior Analysts https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf