Risk-Benefit Analysis of a Controversial Intervention

Capella University

PSY7710: Ethics App Behavior Analysis

Professor Bratton

September 13th, 2020

 According to Bailey & Burch, (2016), risk-benefit analysis is comparing the risk of a

situation to the benefits. Using the risk-benefit analysis can help ensure that Code (4.05) help

reach the objective. Using a risk-benefit analysis can help determine how to move forward with a

plan and if there are any liabilities that need to be considered. In the case of the Principal from

Massachusetts who wanted to use the electric shock tool, the risk-benefit analysis can provide

clarity to the family so they are able to determine how to move forward. The analysis provides

understanding and peace of mind to both the client and the specialist.

General Risk Factors for Behavioral Treatment

Risk-Benefit Worksheet

ABA Procedure: Delivering electric shock to decrease SIB

Special Methods: 1)

Sending electric shocks when SIB’s are displayed to decrease harm to the client and two

teachers
Risk Factors Notes
1. Nature of the behavior to be Nature of the behavior is aggressive behaviors that

treated—is it SIB or dangerous to have caused injuries, including lacerations and a

others? broken finger, to two teachers. Due do the physical

harm it caused to teachers the SIB is dangerous to

others
2. Are there sufficient personnel or Teachers who work with the student will need to

mediators to administer the be properly trained in the use of the electric shock

treatment? device
3. Are they skilled and able to The teachers are not skilled and able to administer.

administer it correctly? It is the request of the principal for the tool to be

 used.
4. Is the setting appropriate for the The classroom is clean and organized, however,

treatment? Safe, well lighted, clean, there are items such as desks, chairs, and other

temp controlled? classroom supplies that can get in the way. The

classroom is lit by natural lighting along with a

light switch. There are some possible factors that

can make the space unsafe.

5. Is the BCBA experienced in the The BCA was contacted for their opinion. A

treatment of this type of case? BCaBA conducted a formative assessment but

conducted it without the oversight of a BCBA

6. Is there any risk to others in the Some risk factors can be the reaction of the student

setting? during shocks that results in the physical harm to

the teacher administering the shock, or others who

may be in the classroom.

7. Is there buy-in from the key people The principal is interested in using the tool, but the

associated with this case? teachers have not commented and the parents are

seeking a second opinion.

8. Is there any liability to the BCBA? There is no liability to the BCBA as the treatment

will be delivered by the

Risk Benefits of Treatment

Benefits Notes

1. shock can be delivered quickly and By delivering the shock quickly the delay in

sometimes remotely punishing the behavior can be avoided

2. Does not interfere with client daily In some cases invasive tools or procedures
 activities can cause issues with activities or

interactions. With this tool there is less need

for restriction
3. Using the electric shock tool does not Some tools such as ammonia capsules can

affect other stimuli leave a lingering smell that can be irritating to

the client even after the target behavior has

stopped
4. The shock level can be determined to Controlling the shock level can help avoid

ensure there is no physical harm possible liability issues

Summary of Benefits: The benefits of the procedure do not outweigh the risks of the

treatment. The staff is not skilled in providing treatment and there is a lot of possible harm that

can happen to the client. Although the shock tool may help decrease the SIB behavior, there

are still too many factors that demonstrate risks that can result in physical harm and liability

issues.

The benefits of this procedure outweigh the risks in terms of the student having the ability to

remain in class and to be taught in a generalized education classroom with his peers. This

procedure of response blocking (providing a series of quick demands that are able to get the

student back on track) is a method and technique that is used in schools for behavior

interventions.
 Relevant BACB Ethical Codes

Code 4.07/4.07

This code requires that we only work in settings where the behavior plan will be successful. It is

important that the setting is beneficial to the procedure so that the behavior plan is not set up for

failure. In addition to the success of the plan, it also helps to ensure that the client and behavior

analysts are not put in harm’s way (Bailey & Burch, 2016).

Elements Met

The elements would be met if the setting is safe and appropriate for the procedure.

Having a well lit environment with trained facilitators for the treatment can help ensure that the

element is met.

Elements Not Met

The element would not be met if the procedure took place in an environment that was

dangerous and could result in harm to the client or facilitator. Without a good temperature or

well-lit space there can also be chances of the environment not being met.

Is the Mediator Well Trained

It is critical that those providing the services are properly trained and able to guarantee

success. Without the right reinforcement the wrong behaviors can be reinforce the wrong

behaviors. Being distracted or missing critical parts of the treatment can lead to detrimental or

severe ramifications that cannot be undone (Bailey & Burch, 2016).

Elements Met

In order to meet this element it is important to ensure that anyone leading or facilitating

the program is well trained and up to date on the terms and practices. Verifying the credentials of

those working can also help meet the elements.

 Elements Not Met

Elements will not be met if clients are put to work with individuals who are not trained,

and the treatment is not conducted the way the plan is prescribed.

Risk Factors and Lack of Research

Quite often most reviews of procedures will not be published if there results demonstrate

a failed attempt (Bailey & Burch, 2016).

Elements Met

Conducting a risk-benefit analysis to weigh the options to see if using the procedure

chosen will be beneficial to the client and target behavior

Elements Not Met

Conducting the procedure without weighing the risks and benefits is not meeting the elements

and possibly putting the client in harm’s way.

Is There Risks to Others in the Setting

When deciding to implement a procedure it is important to consider if those in the setting

will be at risk. Harm in the setting should not be downplayed, however it should be discussed so

that all parties involved can be discussed and understand the risks (Bailey & Burch, 2016).

Elements Met

The element is met when all parties involved are aware of the risks involved and have

agreed to the final procedure plan that will take place.

Elements Not Met

The element is not met when the possible risks to others in the setting are down played

for the approval for the process.

Client Direct Benefit

The plan should reflect a direct concern for the client’s success. Being specific and

explaining how each section of the plan will benefit the client is important to making sure their

benefit is being met (Bailey & Burch, 2016).

Elements Met

The elements are met when the needs of the clients are listed and then broken down to

explain what benefits the client will receive.

Elements Not Met

The elements are not met when the plan is not concerned with the benefit of the client.

The plan does not reflect the needs of the client being met.
To the Parents of

Recommendation Letter

Thank you for reaching out regarding the possible treatment plan for your child. The use of the

electric shock tool has its pros and cons that I considered. After conducting an analysis of the

risks and benefits of this possible treatment I would recommend that the risks outweigh the

benefits. The electric shock tool has some concerns such as its creation was developed for

eliciting responses from animals, not for the therapeutic use of human (Linscheid et al., 1990).

Although the tool can help decrease some of the self-injurious behavior (SIB), there are many

risks that can impact both your child and the facilitator. Based on the records there is no

indication that the teachers are trained and able to properly facilitate the treatment in a way that

benefits the well being of your child. I understand the concern of the Principal and it is true that

forms of punishment can be successful. However, the punishment procedure should be weighed

and only used if it benefits the client. My recommendation is to speak with the principal and a

BCBA in addition to the BCaBA so that you can develop a well thought out plan for your child.

Sincerely,

From Remichia Castro (BCBA)

 References

Bailey, Jon, and Mary Burch. Ethics for Behavior Analysts, Taylor & Francis Group, 2016.

ProQuest Ebook Central, https://ebookcentral-proquest-

com.library.capella.edu/lib/capella/detail.action?docID=4456440.

Linscheid, T. R., Iwata, B. A., Ricketts, R. W., Williams, D. E., & Griffin, J. C. (1990). Clinical

evaluation of the self-injurious behavior inhibiting system (Sibis). Journal of Applied

Behavior Analysis, 23(1), 53-78. https://doi.org/10.1901/jaba.1990.23-53