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| Implementing the Risk Driven Approach: Practical Strategies in Action |
| Sunday, May 25, 2025 |
| 8:00 AM–8:50 AM |
| Marriott Marquis, M4 Level, Capitol & Congress |
| Area: DDA/LBD; Domain: Service Delivery |
| Chair: Andrew Pierce Blowers (Center for Applied Behavior Analysis) |
| CE Instructor: Andrew Pierce Blowers, Ph.D. |
| Abstract: The Behavior Analysis Certification Board (BACB) Ethics Code mandates that behavior analysts prioritize clients’ best interests by actively working to maximize desired outcomes while minimizing risk (BACB, 2020, p. 5). The Risk-Driven Approach (RDA), developed by Taylor and colleagues (2023), offers a structured framework for case conceptualization that focuses on enhancing quality of life by maximizing individualized outcomes and minimizing risks. The Risk-Driven Approach evaluates risk across four key domains: health and safety, available resources, individual and stakeholder characteristics, and intervention efficacy. This symposium will introduce the Questions About Risk Level (QARL), an indirect assessment designed to measure risk across these domains and present its development and evaluation. In addition, clinical applications of the QARL tool utilized in conjunction with the RDA will be presented to demonstrate its utility in socially meaningful case conceptualization across multiple settings. The symposium will also review broader implications for the RDA as well as future research directions. |
| Instruction Level: Basic |
| Keyword(s): Case Conceptualization, Ethics, Risk-Driven Approach, Socially Meaningful |
| Target Audience: Prerequisite skills and competencies comprise (1) understanding the BACB ethics codes, (2) assessment of dangerous interfering behaviors, (3) treatment of dangerous interfering behaviors, and (4) the Risk Driven Approach |
Learning Objectives: 1. Participants will be able to identify the four Risk Driven Approach domains with regard to ethical obligations to identifying risks and developing risk mitigation strategies.
2. Participants will be able to describe how they can implement the Questions About Risk Level in practice.
3. Participants will be able to describe the Risk Driven Approach to case conceptualization. |
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| A Tool for Measuring Risks in the Risk Driven Approach: Developing the Questions About Risk Level |
| MICHELE D. WALLACE (California State University, Los Angeles), Andrew Pierce Blowers (Center for Applied Behavior Analysis), Benjamin Thomas Heimann (CABA), Alexis Munoz (Center for Applied Behavior Analysis), Ashley Avalos (California State University Los Angeles), Astrid Yesebel La Cruz Montilla (BCBA), Richard Colombo (University of Washington) |
| Abstract: The Risk-Driven Approach (RDA) is a structured approach to Applied Behavior Analysis (ABA) service delivery that ensures clients’ rights to effective services towards an improved quality of life by identifying and mitigating the impact of risks (Taylor et al., 2023). The purpose of this research was to develop a standardized assessment tool for identifying and quantifying levels of risk across health and safety, available resources, characteristics of individuals and stakeholders, and efficacy of interventions to support clinicians in service delivery and case management. The Questions About Risk Level (QARL) is a 20-question indirect assessment that assesses and quantifies risk factors to identify risk levels (High, Moderate, Low). We examined the reliability of the tool by having practitioners conduct the assessment with two informants and then comparing the results with respect to individual questions and overall domain scores. In addition, we assessed the social validity of the QARL by asking practitioners (N = 18) how helpful conducting the QARL was in consultation with caregivers and with respect to case conceptualization and programming. Results demonstrated that the scores across the two informants were moderately reliable across all domains and overall scores (R = 61% - 74 %) and that practitioners found it help during consultation with caregivers (89%) and case conceptualization (89%). Directions for clinical dissemination and future research will be discussed. |
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| Treating Severe Interfering Behaviors: Clinical Applications of the Questions About Risk Level |
| ANDREW PIERCE BLOWERS (Center for Applied Behavior Analysis), Michele D. Wallace (California State University, Los Angeles), Rachel Taylor Taylor (Center for Applied Behavior Analysis), Benjamin Thomas Heimann (Center for Applied Behavior Analysis), Alexis Munoz (Center for Applied Behavior Analysis), Ashley Avalos (Center for Applied Behavior Analysis), Astrid Yesebel La Cruz Montilla (BCBA) |
| Abstract: Behavior analysts have an ethical responsibility to maximize desired outcomes while minimizing risks (BACB, 2020). The Risk-Driven Approach, developed by Taylor and colleagues (2023), offers the only structured framework for conceptualizing risks that can impact an individual’s quality of life. By identifying and categorizing risks across various domains, this approach enables practitioners to develop a socially meaningful case conceptualization with tailored risk-reduction strategies to meet each client’s unique needs. In this way, clinicians using the Risk Driven Approach can deliver services in a manner that reduces risks to the consumer achieving an improved quality of life. This presentation provides clinical examples modeling the utility of the Questions About Risk Level, an indirect assessment tool designed to quantify risks systematically to permit development of related risk reduction strategies. Attendees will gain practical insights through case studies demonstrating the use of the Risk-Driven Approach and the Questions About Risk Level to address severe interfering behaviors in community-based settings. In addition, attendees will be equipped with essential knowledge to enhance their practice and improve client outcomes. |
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| Supporting Adults in Community-Based Residential Care Settings: Integration of the Risk Driven Approach |
| ASTRID YESEBEL LA CRUZ MONTILLA (BCBA), Benjamin Thomas Heimann (Center for Applied Behavior Analysis), Michele D. Wallace (California State University, Los Angeles), Andrew Pierce Blowers (Center for Applied Behavior Analysis), Alexis Munoz (Center for Applied Behavior Analysis), Ashley Avalos (California State University, Los Angeles) |
| Abstract: California was among the first states to move toward de-institutionalization with the passage of the Lanterman Act (Lanterman Developmental Disabilities Services Act, 1977). Since the enactment, California has seen an exponential increase in adults needing residential support and has consequently opened different types of community-based group homes to answer this need. While the shift to community-based residential settings partially mitigated risks inherent to institutions, practitioners are now faced with a different set of risks not only with the residents, but with the community at large. These residential-care homes pose unique challenges that require specialized approaches to case conceptualization, particularly concerning clients’ rights, federal regulations, and conservatorship. The Risk-Driven Approach (RDA) provides a framework for practitioners to develop a socially meaningful case conceptualization that focuses on maximizing individualized outcomes while mitigating risk. This presentation will walk the audience through direct examples of how to utilize the RDA when working with adults in community-based residential care, emphasizing its alignment with the specific demands of these settings. |
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