E Test 2 Flashcards
1
Q
As behavior analysis developed in the early days; how was ethical behavior demonstrated?
A
.conscious, common sense, own values, done in the public eye, parental/guardian consent
2
Q
What is the value of our field regarding the conduct of behavior analysts?
A
.states those professionals who want to call themselves BA must behave in a way that reflects positively on the field
3
Q
What - are the roots of our profession?
A
.decisions must be tied into science
4
Q
What is meant that the behavior analyst maintains the high standards of professional behavior of the profession–??
A
we must adhere to the code
5
Q
What is meant by reliance on scientific knowledge?
A
1.01 embassies our roots in science
everything we do must be linked to science.
6
Q
How is competence determined?
A
1.02 education, training, supervision
we must work within our competency level
we have to determine it ourselves. ‘
certificate or several week training is good
7
Q
Why is professional development important to the behavior analyst?
A
.field is actively changes we want professionals to use the newest procedures not the old ones no longer accepted (punishment)
don’t want them to hurt people or damage the field reputation
8
Q
If the guidelines are in conflict with a state law, what must the behavior analyst do?
A
.recognize and maintain high moral principles of your community
9
Q
Professional and scientific relationships state that your services should be provided in?
A
don’t give free advice it can damage relationships in the future if not followed to the letter resulting in poor outcomes.
10
Q
If you are asked to work with someone regarding a particular behavior and do not have expertise in this area, what should you do?
A
.get informed, or find someone who is and have them supervise you, pass off the case if you cant help
11
Q
Why is it important to avoid dual (multiple) relationships?
A
.lead to harmful effects
12
Q
What is meant by an exploitive relationship?
A
.when one person has power over another (e.g. supervision) and ask for extra favours
13
Q
Are sexual relations with clients, students, or supervisees permitted?
A
.no
need to wait 2 years
14
Q
Why is bartering discouraged?
A
.some one might feel cheated
15
Q
What did Wyatt vs Stickney do for persons in institutions?
A
.argued clients had a right to treatment and be released in to the community
no big changes accepts legal/terminology and paradigm shift
16
Q
Where should services be delivered?
A
.humane environments
least restrictive environments
17
Q
What type of behavioral programs were written by “behavioral specialists”?
A
.those that benefit the client
18
Q
What is the relationship of a behavior analyst and a client in a two party agreement?
A
.BA and client
no conflict of interested
19
Q
What is the relationship of a behavior analyst and a client in a third party agreement?
A
.BA - Client and another (maybe employer)
Sometimes conflict of interest when employer wants one thing and client wants another. Client comes first.
e.g. merger of services (OT and not evidence based)
20
Q
What rights did the blue ribbon task force reach consensus about?
A
.late 1980s said they had a right to treatment and therapeutic environment
21
Q
What is the behavior analyst’s responsibility to the client?
A
.operate in their best interests
22
Q
How is client defined?
A
.long term interaction
23
Q
What is the rule regarding accepting clients?
A
.only take on those within our boundaries of confidence (edu, training, experience)
24
Q
Who are you responsible to?
A
.all parties affected by services
25
What is the behavior analyst’s responsibility to third parties?
.to adhere to their policies as long as they do not interfere with the clients best interest
e.g. report from school - family examples
Must determine relationships at the start and resolve any conflicts
defines roles of involving parties
26
What is the guiding principle regarding individual rights?
.clients rights are paramount
- BA must provide credentials on request
- consent must be given for interview/services
- clients/supervisees must be aware of their rights
- BA comply to get a criminal check
27
How do permission and consent impact electronic recording?
.consent for different uses must be separate.
| consent must be obtained for recording
28
What is meant by confidentiality?
.maintain confidentiality at onset of relationship.
| Don't share identifiable information / maintain privacy
29
When should the limits of confidentiality be discussed?
.at the onset o the relationship and when new circumstances arise.
30
What is the right to privacy?
.
31
What is does HIPAA do?
The HIPAA Privacy Rule for the first time creates national standards to protect individuals' medical record
32
What conditions must be met to maintain records?
.must maintain and dispose records according to the current law and the code
1-7 years
33
Under what conditions may confidential information be disclosed?
.payment of services
protect client/others from harm
obtain appropriate professional consultation
to provide needed services tot he client
34
How is consent defined?
.2.07 written consent is required
35
What are the behavior analysts responsibilities regarding treatment efficacy?
.advocate for and educate the client about scientifically supported, most effective treatments.
36
What are the rules for documenting professional and scientific work?
.must document work and maintain records. to ensure accountability, provide services later, demonstrated they have met the requirements by law.
- must be detailed and of high quality
- create paper trails
37
When submitting data to professional conferences or publications, what must be documented?
.intake interviews, phone conversations, and meeting notes.
| separate file/paper trail for each client
38
As soon as you establish a professional relationship with a client, what must be done?
.signed contract outlining the purpose/roles of all parties , scope of services, and BAs obligations
39
What is a Declaration of Professional Services?
.type of contract that explains everything to the client.
40
Is it permissible to accept referral fees?
.no
41
Under what 4 conditions may you terminate a professional relationship?
only after efforts to transition have occurred
- no longer need services
- not benefiting from the services
- being harmed by continuing the services
- client requests discontinuation
42
When terminating a professional relationship, what must you do?
.have a meetings and create referrals if needed.
43
Why do we need to collect baseline?
make sure the Bx is operationally defined and observable
- maybe find controlling conditions\
- make sure there is actually a problem that needs to be solved
44
What is meant by limiting conditions?
- critical for understanding how BAs work in applied settings
- something that prevents treatment in some way (e.g. teacher doesn't believe in edibles but it is the only thing that motivates the child).
45
Why is it important to explain to the client what the data means?
code 3.04
so they can understand what is involved
-public relations function as well
46
Why do we graph data?
to illustrate key points
47
Why is it important to seek medical consultation?
3.02
| incase Bx is due to a medical reason
48
What must be done before behavioral assessment can be done?
explain the procedure and obtain written consent
49
Why do you conduct a functional assessment?
to determine the function of behaviour
50
What should a functional assessment include?
0
51
How should assessment results be explained?
using language and graphical displays that are understandable to the client
52
What must be established prior to obtaining or disclosing client records from or to other sources?
written consent before obtaining or disclosing client records.
53
What is meant by least restrictive procedures?
use reinforcement instead of punishment whenever possible
54
As a field (and provider) what are we primarily interested in?
dve Bx change programs that teach new appropriate adaptive Bs using non harmful reinforcers whenever possible
55
Why do we need termination criteria?
when will we stop treatment?
clinical judgement involved in this decision
client/surrogate would also be involved
56
What are the 4 principles involved in developing a behavior change program?
- conceptually consistent
- involve clients in planning and consent ?????
- individual Bx change procedures
- approving Bx change procedures
57
Why shouldn’t you plagiarize other behavior analysts behavior change programs (2 reasons)?
every program is designed specifically for the behaviour and client
plagiarism - unethical
58
Why do you have behavioral objectives?
understand goals, methods, timelines, and are not disappointed with results
59
Why should you describe environmental conditions for program success?
there are circumstances that need to be obtained for therapy to be effective.
60
If you identify an environmental condition that precludes implementation of a behavioral program what must you do?
recommend other professional assistance be sought
61
If you identify an environmental condition that hampers the implementation of a behavioral program what must you do?
seek to eliminate the enviro constraints or identify in writing the obstacles to doing so.
62
When is approval sought for behavioral intervention?
0
63
When developing a behavior change program, what procedures are recommended first?
reinforcement procedures
64
When using punishment programs, what must be included?
reinforcement procedures for alternative behaviours
- additional training, supervision, oversight
- a plan to remove punishment procedures
65
Before punishment procedures can be used, what must be provided?
functional assessment (3.01) to determine the controlling variables
66
What are least restrictive procedures
provide freedom of choice
- do not prevent ability to contact reinforcers
4. 09i
67
What are harmful reinforcers?
4.10
| minimize harmful reinforcers to health and development of the child.
68
What is meant by excessive motivating operations to be effective?
e.g. deprivation of food/water for long periods of time
69
When can modifications be made to a behavioral program?
When goals are achieved, lack of progress, request from family
70
When do you terminate clients?
- no longer need services
- not benefiting from the services
- being harmed by continuing the services
- client requests discontinuation
71
METO Settlement
| 1. What was the total settlement fund?
3 Million
72
What resources were mandated for staffing and training?
staffing and training costs were increased by 930,000
| 8 hours in therapeutic intervention, 8 personal safety, 12 in mechanical restraint.
73
What happened to METO?
It closed June 30, 2011
74
What is the role of the internal reviewer?
One employee to monitor the use of restraints
| Facility sends report to internal reviewer within 24 hours
75
What is the role of the external reviewer?
Employe of the state health department will serve as the external reviewer
-Sends quarterly reports as to whether they are adhering to the settlement agreement
76
What is the Olmstead Planning Committee?
Key Responsibilities of the Olmstead Planning Committee include:
Contributing to plan development and reviewing plan content
Gathering information from the relevant state agencies (data, regulations, and other programmatic information, etc.)
Updating individual agency leadership as the plan develops
77
What were the amounts of monetary settlements to clients who were at METO?
minimum of 75,000
| -approximately 200 for each instance for other clients
78
Office of the Ombudsman Follow-up
| 1. How were staff described during the follow-up visit?
taff said they give reminders or prompts to a client who misses a group or lunch;
79
What was the description of the households?
There has been some remodeling since METO.
- The former seclusion rooms are now medication rooms.
- stark households
- 3/5 clients sleeping
80
What was the client’s description of staff?
no they don’t, they don’t do shit here, they say
| they do, but they don’t.”
81
How were the recommendations of the internal reviewer handled?
His reviews appear to be thorough and give specific recommendations. Some of these recommendations were “accepted.” However, the majority were “accepted with … modifications”.
EXAMPLES
-The Internal Reviewer questioned whether JR’s transfer was clinically contraindicated because he appeared stable prior to his move to MSHS-Cambridge; he further questioned whether this might constitute abuse or neglect. The response indicated that this would be formally brought up at the next diversion meeting. We didn’t find documentation that this was done or that it was passed on to the CEP.
• The Internal Reviewer suggested completion of a functional behavior analysis (FBA)
82
What was the state of the records (data)?
- poor organization of records
- Several mistakes and filing errors were noted.
- most significant was the client record that contained two different History & Physical Forms,
83
What is the analysis of the “Boys Town” Model?
When Mr. Hazard was asked, “as the treatment director, how did you decide on this
MSHS Cambridge –Site Monitoring Visit
7
treatment modality, which is not an evidence based practice for the population you serve?” he answered “because it was a preset curriculum.” When Mr. Hazard was asked, “how has MSHS-Cambridge overcome the IM&R requirement of client’s recognizing and challenging highly cognitive distortions and behaviors?” he responded “while it doesn’t necessarily fit with our population of DD, it does meet some of their needs.” When asked for specific examples of ways in which the programming was modified to fit with their client
84
What was the conclusion of the “Be Cool” model?
Based on our reading we can’t tell whether this is evidenced based practice or is suited to this population.
85
As an adult who will be participating in the community, work skills are important. What happened to the vocational program?
- no employment or job training programs even though some residents want and can work.
86
What is an aversive procedure?
"Aversive procedure" means the application of an aversive
| stimulus contingent upon the
87
What is an aversive stimulus
Aversive stimulus" means an object, event, or situation that
is presented immediately following a behavior in an attempt to suppress the behavior. Typically,
an aversive stimulus is unpleasant and penalizes or confines.
88
What is a deprivation procedure
"Deprivation procedure" means the removal of a
positive reinforcer following a response resulting in, or intended to result in, a decrease in the
frequency, duration, or intensity of that response. Oftentimes the positive reinforcer available is
goods, services, or activities to which the person is normally entitled. The removal is often in
the form of a delay or postponement of the positive reinforcer.
89
How is emergency use of manual restraint defined
"Emergency use of manual restraint"
means using a manual restraint when a person poses an imminent risk of physical harm to self or
others and is the least restrictive intervention that would achieve safety. Property damage, verbal
aggression, or a person's refusal to receive or participate in treatment or programming on their
own do not constitute an emergency.
90
.What is an incident
Incident" means an occurrence which involves a person and requires
the program to make a response that is not a part of the program's ordinary provision of services
to that person, and includes:
91
What is meant by least restrictive alternative
.."Least restrictive alternative" means the
alternative method for providing supports and services that is the least intrusive and most
normalized given the level of supervision and protection required for the person. This level of
supervision and protection allows risk taking to the extent that there is no reasonable likelihood
that serious harm will happen to the person or others.
92
What is manual restraint
"Manual restraint" means physical intervention intended
to hold a person immobile or limit a person's voluntary movement by using body contact as
the only source of physical restraint.
93
What is a mechanical restraint
Except for devices worn by the person that trigger
electronic alarms to warn staff that a person is leaving a room or area, which do not, in and of
themselves, restrict freedom of movement, or the use of adaptive aids or equipment or orthotic
devices ordered by a health care professional used to treat or manage a medical condition,
"mechanical restraint" means the use of devices, materials, or equipment attached or adjacent to
the person's body, or the use of practices that are intended to restrict freedom of movement or
normal access to one's body or body parts, or limits a person's voluntary movement or holds a
person immobile as an intervention precipitated by a person's behavior. The term applies to the
use of mechanical restraint used to prevent injury with persons who engage in self-injurious
behaviors, such as head-banging, gouging, or other actions resulting in tissue damage that have
caused or could cause medical problems resulting from the self-injury.
94
What is a positive support transition plan
"Positive support transition plan" means the
plan required in section 245D.06, subdivision 5, paragraph (b), to be developed by the expanded
support team to implement positive support strategies to:
95
What is seclusions
.Seclusion" means the placement of a person alone in a room from
which exit is prohibited by a staff person or a mechanism such as a lock, a device, or an object
positioned to hold the door closed or otherwise prevent the person from leaving the room.
96
How is time out defined
Time out" means removing a person involuntarily from an ongoing
activity to a room, either locked or unlocked, or otherwise separating a person from others in
a way that prevents social contact and prevents the person from leaving the situation if the
person chooses. For the purpose of this chapter, "time out" does not mean voluntary removal or
self-removal for the purpose of calming, prevention of escalation, or de-escalation of behavior for
a period of up to 15 minutes. "Time out" does not include a person voluntarily moving from an
ongoing activity to an unlocked room or otherwise separating from a situation or social contact
with others if the person chooses. For the
97
When must a person be informed of there individual rights
.provide each person or each person's legal representative with a written notice that
identifies the service recipient rights in subdivisions 2 and 3, and an explanation of those rights
within five working days of service initiation and annually thereafter;
98
What are the persons service related rights
(1) participate in the development and evaluation of the services provided to the person;
(2) have services and supports identified in the coordinated service and support plan and
the coordinated service and support plan addendum provided in a manner that respects and takes
into consideration the person's preferences according to the requirements in sections 245D.07
and 245D.071;
(3) refuse or terminate services and be informed of the consequences of refusing or
terminating services;
(4) know, in advance, limits to the services available from the license holder, including the
license holder's knowledge, skill, and ability to meet the person's service and support needs;
(5) know conditions and terms governing the provision of services, including the license
holder's admission criteria and policies and procedures related to temporary service suspension
and service termination;
(6) a coordinated transfer to ensure continuity of care when there will be a change in the
provider;
(7) know what the charges are for services, regardless of who will be paying for the
services, and be notified of changes in those charges;
(8) know, in advance, whether services are covered by insurance, government funding, or
other sources, and be told of any charges the person or other private party may have to pay; and
(9) receive services from an individual who is competent and trained, who has professional
certification or licensure, as required, and who meets additional qualifications identified in the
person's coordinated service and support plan or coordinated service and support plan addendum.
99
What are a persons protection rights
1) have personal, financial, service, health, and medical information kept private, and be
advised of disclosure of this information by the license holder;
(2) access records and recorded information about the person in accordance with applicable
state and federal law, regulation,
or rule;(3) be free from maltreatment;
(4) be free from restraint, time out, or seclusion except for emergency use of manual
restraint to protect the person from imminent danger to self or others according to the requirements
in section 245D.06;
(5) receive services in a clean and safe environment when the license holder is the owner,
lessor, or tenant of the service site;
(6) be treated with courtesy and respect and receive respectful treatment of the person's
property;
(7) reasonable observance of cultural and ethnic practice and religion;
(8) be free from bias and harassment regarding race, gender, age, disability, spirituality,
and sexual orientation;
(9) be informed of and use the license holder's grievance policy and procedures, including
knowing how to contact persons responsible for addressing problems and to appeal under section
256.045;
(10) know the name, telephone number, and the Web site, e-mail, and street addresses of
protection and advocacy services, including the appropriate state-appointed ombudsman, and a
brief description of how to file a complaint with these offices;
(11) assert these rights personally, or have them asserted by the person's family, authorized
representative, or legal representative, without retaliation;
(12) give or withhold written informed consent to participate in any research or
experimental treatment;
(13) associate with other persons of the person's choice;
(14) personal privacy; and
(15) engage in chosen activities.
(b) For a person residing in a residential
100
What must an incident be reported
The license holder must respond to
incidents under section 245D.02, subdivision 11, that occur while providing services to protect
the health and safety of and minimize risk of harm to the person.
101
Who do you report an incident to
The license holder must maintain information about and report incidents to the person's
legal representative or designated emergency contact and case manager within 24 hours of an
incident occurring while services are being provided,
102
What are the prohibited procedures
The license holder is prohibited from using chemical
restraints, mechanical restraints, manual restraints, time out, seclusion, or any other aversive
or deprivation procedure, as a substitute for adequate staffing, for a behavioral or therapeutic
program to reduce or eliminate behavior, as punishment, or for staff convenience.
103
.What are the permitted procedures
The following procedures are allowed when the
procedures are implemented in compliance with the standards governing their use as identified in
clauses (1) to (3). Allowed but restricted procedures include:
(1) permitted actions and procedures subject to the requirements in subdivision 7;
(2) procedures identified in a positive support transition plan subject to the requirements
in subdivision 8; or
(3) emergency use of manual restraint subject to the requirements in section 245D.061.
For purposes of this chapter, this section supersedes the requirements identified in Minnesota
Rules, part 9525.2740.
Subd. 7. Permitted
104
When can restraint be used
(1) allow a licensed health care professional to safely conduct a medical examination or to
provide medical treatment ordered by a licensed health care professional to a person necessary to
promote healing or recovery from an acute, meaning short-term, medical condition;
(2) assist in the safe evacuation or redirection of a person in the event of an emergency
and the person is at imminent risk of harm.
(3) position a person with physical disabilities in a manner specified in the person's
coordinated service and support plan addendum.
(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment
ordered by a licensed health professional to treat a diagnosed medical condition do not in and of
themselves constitute the use of mechanical restraint.
105
.When can emergency manual restraint be used
(1) immediate intervention must be needed to protect the person or others from imminent
risk of physical harm; and
(2) the type of manual restraint used must be the least restrictive intervention to eliminate
the immediate risk of harm and effectively achieve safety. The manual restraint must end when
the threat of harm ends.
106
How do you report emergency use of manual restraint
Within three
calendar days after an emergency use of a manual restraint, the staff person who implemented the
emergency use must report in writing to the designated coordinator
107
.When must the internal review of emergency manual restraint be complete
5 working days
108
What is the purpose of the expanded support team review
discuss the incident reported in subdivision 5, to define the antecedent or event that
gave rise to the behavior resulting in the manual restraint and identify the perceived function the
behavior served; and
(2) determine whether the person's coordinated service and support plan addendum needs to
be revised according to sections 245D.07 and 245D.071 to positively and effectively help the
person maintain stability and to reduce or eliminate future occurrences requiring emergency use
of manual restraint.
(b) The license holder must maintain a written summary of the expanded support team's
discussion and decisions required in paragraph (a) in the person's service recipient record.
109
What is person centred planning
provide services in response to the person's identified needs, interests, preferences, and desired
outcomes as specified in the coordinated service and support plan
110
What is self determination
Self-determination" means the person makes decisions
independently, plans for the person's own future, determines how money is spent for the person's
supports, and takes responsibility for making these decisions. If a person has a legal representative,
the legal representative's decision-making authority is limited to the scope of authority granted by
the court or allowed in the document authorizing the legal representative to act.
111
When must a preliminary coordinated service and support plan be developed
Within 15 days of service initiation
112
When must the preliminary service plan be reviewed and or revised
30 days of a written request by the person,
113
What are the requirements to be a behaviour professional
competencies in areas related to:
(1) ethical considerations;
(2) functional assessment;
(3) functional analysis;
(4) measurement of behavior and interpretation of data;
(5) selecting intervention outcomes and strategies;
(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;
(7) data collection;
(8) staff and caregiver training;
(9) support plan monitoring;
(10) co-occurring mental disorders or neurocognitive disorder;
(11) demonstrated expertise with populations being served; an
(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board of
Psychology competencies in the above identified areas;
(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or university,
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services
in the areas identified in clauses (1) to (11);
(iii) physician licensed under chapter 147 and certified by the American Board of Psychiatry
and Neurology or eligible for board certification in psychiatry with competencies in the areas
identified in clauses (1) to (11);
(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services
who has demonstrated competencies in the areas identified in clauses (1) to (11);
(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11); or
(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is certified
as a clinical specialist or as a nurse practitioner in adult or family psychiatric and mental health
nursing by a national nurse certification organization, or who has a master's degree in nursing
or one of the behavioral sciences or related fields from an accredited college or university or
its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services.
114
What are the qualifications for a BA
(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
discipline; or
(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17.
(b) In addition, a behavior analyst must:
(1) have four years of supervised experience working with individuals who exhibit
challenging behaviors as well as co-occurring mental disorders or neurocognitive disorder;
(2) have received ten hours of instruction in functional assessment and functional analysis;
(3) have received 20 hours of instruction in the understanding of the function of behavior;
(4) have received ten hours of instruction on design of positive practices behavior support
strategies;
(5) have received 20 hours of instruction on the use of behavior reduction approved
strategies used only in combination with behavior positive practices strategies;
(6) be determined by a behavior professional to have the training and prerequisite skills
required to provide positive practice strategies as well as behavior reduction approved and
permitted intervention to the person who receives behavioral support; and
(7) be under the direct supervision of a behavior professional.
115
Can a BA work independently
No?
