Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


41st Annual Convention; San Antonio, TX; 2015

Event Details

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Symposium #415
CE Offered: BACB
Clinical Expertise: An Essential Component of the Ethical Practice of Applied Behavior Analysis
Monday, May 25, 2015
4:00 PM–4:50 PM
213AB (CC)
Area: PRA/TPC; Domain: Service Delivery
Chair: Timothy A. Slocum (Utah State University)
Discussant: Patrick C. Friman (Boys Town)
CE Instructor: Katie Wolfe, Ph.D.
Abstract: Practitioners of applied behavior analysis make numerous clinical decisions on a daily basis. In an evidence-based practice framework, those decisions are influenced by (a) scientific evidence, (b) client values and context, and (c) the clinical expertise of the practitioner. The Behavior Analyst Certification Board has acknowledged each of these sources of influence in both the Guidelines for Responsible Conduct and the 4th Edition Task List, suggesting that the ethical practice of applied behavior analysis includes a consideration of these three factors. In this symposium, we will explore the topic of clinical expertise in applied behavior analysis by proposing a definition of clinical expertise and describing the role of clinical expertise in the evidence-based practice of applied behavior analysis. In addition, we will describe a functional assessment of clinical expertise that delineates variables that may influence this critical repertoire. Finally, we will recommend strategies for supporting practitioners in the development and maintenance of clinical expertise in applied behavior analysis.
Keyword(s): clinical expertise, decision making, evidence-based
Clinical Expertise: Inevitable and Necessary for Clinical Decisions
RONNIE DETRICH (The Wing Institute)
Abstract: Practitioners must make many clinical decisions daily. The basis for those decisions has come under scrutiny in recent years. Evidence-based practice (EBP) has been characterized as a decision-making framework in which decisions are influenced by three inputs: (1) best available evidence (2) clinical expertise (3) client values and context. To date most of the scholarly attention on EBP has been devoted to best available evidence. In this paper, we examine the construct of clinical expertise and its role in decision making. By recognizing expertise as a variable, the field can begin to talk explicitly about it and consider methods for improving it. We argue that judgments are inevitable in a field as complex as applied behavior analysis. Without judgment there is no analysis and practitioners become technicians implementing off-the-shelf interventions. Drawing from other disciplines, we propose a definition that is relevant to behavior analysts. We then argue that responsible professional conduct requires practitioners be explicit about the rationale for their recommendations. Formulating this rationale requires an understanding of the variables that influence decisions including biases and preferences.
A Functional Assessment of Clinical Expertise in Applied Behavior Analysis
KATIE WOLFE (University of South Carolina)
Abstract: Clinical expertise is a critical component of evidence-based practice and the effective, ethical practice of applied behavior analysis. The central role of clinical expertise suggests the importance of identifying variables that influence the development and maintenance of this repertoire. This paper will provide a functional assessment of clinical expertise, including motivating operations, discriminative stimuli, and consequences that influence clinical expertise. We will discuss organizational variables that impact behavior-analytic practice such as the Behavior Analyst Certification Board Guidelines for Responsible Conduct, state and national policies, rules and contingencies of the clinician’s employing organization, as well as client outcomes, and the clinician’s training program. Methods for improving clinical expertise will also be discussed, including 1) altering contingencies at the organizational and policy levels, 2) supporting constant practitioner contact with and analysis of client outcome data, and 3) directly targeting the development of clinical expertise in training programs through coursework and supervised fieldwork.



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