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RBT Ethics & Professional Conduct Guidelines

Professional conduct and scope of practice represent critical components of ethical and effective service delivery as an RBT. Understanding your role, responsibilities, limitations, and ethical obligations is essential for client welfare and professional integrity. This section covers ethics, supervision requirements, and scope of practice boundaries.

F-1: Describe the BACB’s RBT Ethics Code

RBT Ethics Code Overview

Purpose and Foundation: The RBT Ethics Code outlines the ethical and professional obligations of Registered Behavior Technicians. Adherence to this code is mandatory for all RBTs and serves as the foundation for ethical practice. The code protects clients, maintains professional standards, and upholds the integrity of behavior analytic services.

Structure of the Code:

  • The RBT Ethics Code is a subset of the broader Ethics Code for Behavior Analysts
  • Specifically adapted for the RBT role and scope of practice
  • Organized into sections addressing different ethical domains
  • Consists of enforceable standards (not aspirational principles)
  • Violations may result in disciplinary action from the BACB

Responsible Conduct:

  1. Maintaining Professional Boundaries
    • Avoiding dual relationships that compromise effectiveness
    • Not accepting gifts of significant value
    • Maintaining clear professional relationships
    • Respecting cultural and individual differences
  2. Professional Representation
    • Accurately representing qualifications and training
    • Using RBT credential only while certified
    • Not practicing outside scope of competence
    • Not misrepresenting ABA procedures or outcomes
  3. Professional Communication
    • Using clear, respectful, culturally sensitive communication
    • Obtaining consent before recording or sharing client information
    • Maintaining professional tone in all communications
    • Respecting confidentiality in written and verbal communication

Example Ethics Scenario: “An RBT has been working with a family for several months and has developed a positive professional relationship. The family invites the RBT to their child’s birthday party on the weekend. The appropriate ethical response would be to politely decline the invitation while explaining professional boundary requirements, as attending could create a dual relationship that might compromise treatment effectiveness and objectivity.”

Core Ethics Requirements

Client Confidentiality:

  • Protecting all client information from unauthorized disclosure
  • Discussing client only with authorized team members
  • Securing physical and electronic records appropriately
  • Obtaining proper consent for any information sharing
  • Reporting only necessary information for legitimate purposes
  • Avoiding client discussions in public settings
  • Maintaining anonymity in case discussions outside team

Example Confidentiality Application: “When seeking advice from your supervisor about a client’s challenging behavior, ensure the discussion occurs in a private setting where others cannot overhear. Use client initials or non-identifying information in written communications. Secure data sheets and reports in locked cabinets or password-protected electronic systems.”

Informed Consent:

  • Implementing services only with proper informed consent
  • Verifying consent documentation before beginning services
  • Respecting client/guardian right to withdraw consent
  • Implementing only procedures included in consent
  • Ensuring ongoing consent for significant program changes
  • Immediately reporting consent concerns to supervisor
  • Documenting consent verification process

Example Informed Consent Application: “Before implementing a new teaching procedure, the RBT should verify with their supervisor that the procedure is covered under the existing consent. If introducing token economy was not specifically included in original treatment consent, the BCBA must obtain additional consent before the RBT can implement this system.”

Evidence-Based Practice:

  • Implementing only procedures based on ABA principles
  • Following intervention plans precisely as designed
  • Not modifying procedures without supervisor approval
  • Maintaining fidelity to evidence-based protocols
  • Reporting implementation challenges to supervisor
  • Collecting accurate data to evaluate evidence-based interventions
  • Avoiding non-behavior analytic or pseudoscientific approaches

Example Evidence-Based Practice Application: “When a parent suggests incorporating an alternative treatment approach they read about online, the RBT should acknowledge the parent’s input respectfully while explaining that they must implement only the procedures in the behavior plan developed by the BCBA. The RBT should encourage the parent to discuss new treatment ideas directly with the supervising BCBA.”

Client Dignity and Respect:

  • Using person-first language when preferred
  • Respecting cultural, religious, and individual differences
  • Maintaining client privacy during services
  • Providing services in least restrictive manner
  • Avoiding potentially stigmatizing practices
  • Respecting client’s right to decline specific activities
  • Advocating for humane, effective treatment

Example Dignity Application: “When implementing a toileting program, the RBT ensures privacy by closing doors, using screens, and minimizing unnecessary observers. The RBT uses matter-of-fact, respectful language about bodily functions without showing disgust or making embarrassing comments, even with very young clients or those with limited awareness.”

Ethics Code Compliance

Mandatory Reporting Requirements:

  • Immediately reporting suspected abuse/neglect to authorities
  • Reporting observed ethics violations by colleagues
  • Documenting and reporting safety concerns
  • Self-reporting any criminal charges/convictions
  • Reporting changes in supervision relationship
  • Following agency and legal reporting mandates
  • Documenting all mandatory reports appropriately

Example Mandatory Reporting Application: “If an RBT observes unexplained bruising and the client makes a statement suggesting physical punishment at home, the RBT must immediately report this information to their supervisor and follow organizational procedures for mandatory reporting to child protective services. The RBT should document the observations objectively without speculation.”

Ethical Decision-Making Process:

  1. Identify the ethical issue: Recognize when a situation raises ethical concerns
  2. Consult the Ethics Code: Determine which standards apply
  3. Seek supervision: Discuss ethical dilemmas with supervisor
  4. Consider multiple perspectives: Evaluate impact on all stakeholders
  5. Document concerns and actions: Maintain records of ethical issues
  6. Implement resolution: Follow through with ethical decision
  7. Reflect and evaluate: Review outcome of decision

Example Ethical Decision-Making Application: “An RBT notices another RBT using their phone to take pictures of a client for personal social media. The ethical decision-making process would involve: 1) Identifying this as a potential ethics violation (confidentiality, professional boundaries), 2) Consulting the RBT Ethics Code regarding confidentiality, 3) Reporting the observation to a supervisor, 4) Considering impact on the client and family, 5) Documenting the concern and supervisor notification, 6) Following supervisor direction regarding resolution, and 7) Reflecting on the situation for future professional development.”

Ethical Vulnerability Areas for RBTs:

  • Social Media Boundaries: Inappropriate client discussions, photos
  • Confidentiality Breaches: Public conversations, unsecured data
  • Scope of Practice Violations: Independent program modifications
  • Multiple Relationship Issues: Babysitting clients, excessive personal involvement
  • Implementation Fidelity Problems: Deviating from approved protocols
  • Documentation Issues: Falsifying data, inaccurate recording
  • Supervision Avoidance: Working without required supervision levels

Example Vulnerability Management: “To avoid social media boundary issues, RBTs should maintain separate professional and personal accounts, never post about clients (even anonymously), decline client/family connection requests, and regularly review privacy settings. If uncertain about a potential post, always consult with a supervisor before sharing any content that might indirectly reference professional work.”

F-2: Respond to Feedback and Maintain or Improve Performance

Professional Feedback Process

Purpose of Performance Feedback:

  • Ensure treatment integrity and effectiveness
  • Promote professional development and skill enhancement
  • Maintain consistency across implementation team
  • Address potential problems proactively
  • Ensure ethical and professional standards
  • Support evidence-based decision making
  • Facilitate continuous quality improvement

Types of Feedback:

  1. Direct Observation Feedback: Based on in-person observation
  2. Video Review Feedback: Analysis of recorded sessions
  3. Data-Based Feedback: Evaluation of implementation data
  4. Written Performance Feedback: Formal documentation of performance
  5. Immediate Coaching Feedback: Real-time guidance during sessions
  6. Peer Feedback: Input from other team members
  7. Self-Assessment Feedback: Structured self-evaluation

Effective Feedback Characteristics:

  • Specific and behavior-focused
  • Balanced (positive aspects and areas for improvement)
  • Timely and relevant
  • Actionable with clear improvement steps
  • Objective and data-based
  • Delivered in appropriate setting
  • Linked to client outcomes

Example Effective Feedback: “During today’s session, I observed that you implemented the error correction procedure correctly in 8 out of 10 opportunities (80%). You consistently provided the verbal prompt immediately after incorrect responses. To reach our 90% implementation goal, remember to also reset materials between trials as specified in the protocol. Let’s practice this component together now and I’ll observe again during tomorrow’s session.”

Receiving and Responding to Feedback

Productive Feedback Reception:

  1. Active Listening: Full attention without interruption
  2. Clarification: Asking questions to understand feedback
  3. Acknowledging: Recognizing the feedback without defensiveness
  4. Contextualizing: Understanding how feedback relates to client outcomes
  5. Action Planning: Developing specific improvement steps
  6. Follow-up: Checking for understanding and progress
  7. Documentation: Noting key feedback points for reference

Barriers to Effective Feedback Reception:

  • Defensive responses or justifications
  • Emotional reactions overwhelming logical processing
  • Focusing only on negative aspects
  • Personalizing professional feedback
  • Generalizing specific feedback too broadly
  • Avoiding or delaying feedback opportunities
  • Agreeing without actual implementation intention

Strategies for Overcoming Feedback Barriers:

  • View feedback as professional development opportunity
  • Separate professional performance from personal worth
  • Focus on specific behaviors that can be changed
  • Request examples and demonstrations when unclear
  • Practice self-regulation techniques for emotional responses
  • Schedule adequate time for processing feedback
  • Maintain notes for consistent implementation

Example Effective Feedback Response: RBT receives feedback that reinforcement delivery is inconsistent

Productive Response: “Thank you for that observation. I see I’ve been missing some opportunities to reinforce approximations. Could you clarify exactly which client responses should receive reinforcement? I’ll create a quick reference guide to keep with my materials and self-monitor my reinforcement rate during tomorrow’s session.”

Unproductive Response: “I thought I was doing it right. The client doesn’t always respond clearly, and I was distracted because the parent was asking questions at the same time.”

Performance Improvement Planning

Components of Effective Improvement Plans:

  1. Specific Target Behaviors: Clearly defined performance areas
  2. Objective Measurement System: Method for tracking improvement
  3. Baseline Assessment: Current performance level documentation
  4. Measurable Goals: Specific, time-bound improvement targets
  5. Intervention Strategies: Specific methods to improve performance
  6. Implementation Timeline: Schedule for intervention and assessment
  7. Evaluation Plan: Process for determining effectiveness

Common RBT Performance Targets:

  • Procedural integrity (following protocols exactly)
  • Data collection accuracy and timeliness
  • Prompting technique implementation
  • Reinforcement delivery consistency
  • Professionalism and boundary maintenance
  • Time management and session organization
  • Communication with team members and families

Example Performance Improvement Plan:

Performance Area: Implementation of least-to-most prompting procedure

Current Performance: 60% accuracy (based on supervisor observation on 5/15/23)

Target Performance: 90% accuracy on all components

Improvement Strategies:
1. Review written protocol and clarify questions with supervisor
2. Complete 15-minute role-play practice with feedback before next client session
3. Use procedural checklist during first 3 sessions
4. Video self-implementation for self-assessment
5. Request additional observation and feedback after one week

Timeline:
- Protocol review: Complete by 5/17/23
- Role-play practice: 5/18/23
- Implementation with checklist: 5/19/23 - 5/23/23
- Video review: 5/24/23
- Follow-up observation: 5/25/23

Evaluation: Supervisor will conduct direct observation with procedural integrity data collection on 5/25/23 to measure improvement.

Self-Monitoring Techniques:

  • Implementation checklists for procedural fidelity
  • Audio/video recording for self-assessment
  • Data collection on personal implementation targets
  • Reflective journaling on performance challenges
  • Peer observation exchanges with feedback
  • Performance graphing and visual analysis
  • Structured self-evaluation against competency standards

Example Self-Monitoring Implementation: “To improve consistency in reinforcer delivery, the RBT creates a simple tally counter system, marking each correct response and each reinforcer delivery. After each session, the RBT calculates the reinforcement-to-response ratio and graphs the daily percentage. This visual feedback allows the RBT to track improvement toward the target of 1:1 correspondence between correct responses and reinforcer delivery.”

F-3: Communicate with Stakeholders About the Program

Professional Communication Fundamentals

Key Stakeholders in ABA Services:

  1. Clients: Recipients of direct services
  2. Parents/Guardians: Legal decision-makers for clients
  3. Supervising BCBA: Professional responsible for program
  4. Other Professionals: Team members from related disciplines
  5. Funding Sources: Insurance, schools, agencies
  6. Educational Staff: Teachers, paraprofessionals, administrators
  7. Extended Family: Others involved in client’s life

Communication Boundaries for RBTs:

  • Communicating within scope of defined role
  • Providing factual information about observed behavior
  • Sharing objective data about implemented procedures
  • Discussing day-to-day implementation details
  • Redirecting clinical questions to supervising BCBA
  • Maintaining confidentiality in all communications
  • Following agency-specific communication protocols

Topics Outside RBT Communication Scope:

  • Diagnosis or diagnostic impressions
  • Long-term prognosis predictions
  • Treatment plan design or major modifications
  • Recommendations for additional services
  • Medication discussions or recommendations
  • Service intensity or duration determinations
  • Billing or insurance coverage details

Example Appropriate RBT Communication: “During today’s session, Alex completed 8 out of 10 requesting trials independently using his communication device. This continues the progress we’ve seen over the past week. He seemed especially motivated by the new reinforcers we introduced today according to the preference assessment results. The specific data is in today’s session note, and I’ve implemented all procedures as outlined in the current behavior plan developed by the BCBA.”

Example Communication Requiring Redirection: Parent asks: “Do you think we should increase therapy hours? And will he ever be able to speak in full sentences?”

Appropriate RBT Response: “Those are important questions about Alex’s overall progress and treatment recommendations. While I can share the data we’re collecting on his current communication goals, questions about therapy intensity and long-term projections would be best addressed by our supervising BCBA. I can note your questions and have the BCBA contact you, or you can discuss these at your upcoming team meeting on Thursday.”

Effective Daily Communication

Session Summary Components:

  1. Programs Implemented: Specific targets addressed
  2. Performance Summary: Objective data on client responses
  3. Behavioral Notes: Relevant behavior patterns observed
  4. Materials Used: Resources implemented during session
  5. Reinforcers Utilized: What motivated client effectively
  6. Challenges Encountered: Implementation difficulties
  7. Successes Celebrated: Positive achievements to reinforce
  8. Next Steps: Brief preview of upcoming focus

Example Effective Session Summary: “Today we worked on identifying community safety signs, two-step instructions, and appropriate requests using ‘I want’ sentence starters. Jordan identified 7/10 safety signs correctly, followed 8/10 two-step instructions, and used complete sentence requests in 6/10 opportunities. He was especially motivated by the new dinosaur stickers and computer game. He had some difficulty maintaining attention during the safety sign activity, so we broke it into shorter segments with movement breaks. He did especially well with the requesting activity and used a new word (‘cookies’) spontaneously. Tomorrow we’ll continue these same programs with some additional community signs as specified in the current program.”

Communication Adaptation by Stakeholder:

  • Parents/Guardians: Focus on functional skills, daily progress, home carryover
  • Teachers: Emphasize classroom-relevant behaviors, academic connections
  • Other Therapists: Highlight interdisciplinary connection points, coordination needs
  • Supervisors: Provide detailed implementation data, procedural questions
  • Clients: Age/ability-appropriate progress feedback, reinforcement of efforts

Example Stakeholder-Specific Communication: For Teacher: “Sophia successfully used her visual schedule in today’s session with minimal prompting. She independently checked her schedule between 5 different activities. This aligns with your classroom schedule system, and she’s generalizing the skill nicely. She still needs an occasional gestural prompt to return to the schedule after activities.”

For Parent: “Sophia did really well with her independent transitions today using the visual schedule. She’s remembering to check what comes next without reminders most of the time now. This might be helpful at home during morning routines or bedtime sequences if you’d like to try a similar visual support.”

For Supervisor: “Sophia achieved 80% independence with schedule following today (8/10 transitions without prompts), which meets the criterion specified in her current program. The two prompted instances occurred following highly preferred activities. Data sheet attached shows a steady increase from 50% independence three sessions ago. Ready to move to next phase?”

Cultural Sensitivity in Communication:

  • Respecting family communication preferences
  • Using preferred language when possible
  • Being attentive to cultural norms around feedback
  • Acknowledging diverse perspectives on development
  • Avoiding imposing personal cultural values
  • Seeking clarification when cultural factors may impact understanding
  • Adapting communication style to match cultural context

Example Culturally Sensitive Communication: “I’ve noticed you prefer to receive updates in writing rather than verbally at pickup time. Would you like me to continue with the written daily notes, or would another communication method work better for your family? I want to make sure I’m respecting your preferences while keeping you informed about Jordan’s progress.”

Managing Challenging Communications

Addressing Parent Concerns:

  1. Listen fully without interruption
  2. Acknowledge the concern empathetically
  3. Clarify specific aspects when needed
  4. Provide objective information within scope
  5. Avoid defensiveness or dismissal
  6. Offer appropriate action within role
  7. Refer to supervisor for concerns beyond scope
  8. Follow up consistently

Example Concern Response: Parent Concern: “I don’t think the current program is working. He’s still having tantrums at home constantly.”

Appropriate Response: “I understand you’re concerned about the tantrums continuing at home, which must be really frustrating. Could you tell me more about when they’re occurring? While I can’t make changes to the behavior plan myself, I can share this important information with our supervisor, and I’ll make sure she contacts you today to discuss these concerns. We can also schedule some time to review the current data we’re collecting on tantrums during our sessions, which might help identify patterns.”

Maintaining Boundaries in Communication:

  • Redirecting clinical questions to appropriate professional
  • Keeping consistent professional relationship definitions
  • Declining to discuss other clients or team members
  • Maintaining scheduled communication times/methods
  • Using professional language and tone consistently
  • Separating personal opinions from professional information
  • Following established communication chain of command

Example Boundary Maintenance: Boundary Challenge: “Can I have your personal cell number to text you questions in the evenings?”

Appropriate Response: “I understand wanting quick access for questions that come up. Our agency has a communication policy that all client communication should go through our secure client portal or office phone during business hours. This helps ensure your privacy and allows us to properly document all communications. For urgent concerns outside office hours, we have an on-call supervisor available at this number.”

Documentation of Significant Communications:

  • Recording date, time, participants
  • Summarizing key discussion points objectively
  • Noting questions requiring supervisor follow-up
  • Distinguishing between facts and opinions/interpretations
  • Describing planned follow-up actions
  • Including relevant client responses or behaviors
  • Sharing documentation with supervisor promptly

Example Communication Documentation:

Date: 5/12/2023
Time: 3:45-4:00 PM
Participants: RBT (self), Mrs. Johnson (client's mother)

Content: Mrs. Johnson expressed concern about generalization of requesting skills to home environment. Reported client is not using picture communication system at home despite reported mastery in therapy sessions. I shared current data showing 90% independence in clinical setting but acknowledged home environment differences. Explained importance of consistent implementation across settings.

Questions for BCBA: Mrs. Johnson asked about potential system modifications for home use and additional parent training options.

Follow-up: Informed Mrs. Johnson that BCBA will contact her by 5/14 to discuss home implementation strategies. Provided copy of current picture communication protocol for home reference. Noted concern in supervision meeting agenda for 5/13.

Client Behavior: Client present during conversation but engaged with puzzle activity; did not appear to be attending to adult conversation.

F-4: Maintain Professional Boundaries and Stay Within Ethical and Professional Guidelines

Scope of Practice Boundaries

RBT Role Definition: The Registered Behavior Technician (RBT) is a paraprofessional who practices under the close, ongoing supervision of a Board Certified Behavior Analyst (BCBA) or Board Certified Assistant Behavior Analyst (BCaBA). The RBT is primarily responsible for the direct implementation of behavior-analytic services as designed and delegated by the supervisor.

Core RBT Responsibilities:

  1. Implementing assessment and intervention procedures as directed
  2. Collecting and recording data accurately
  3. Following behavior reduction procedures precisely
  4. Implementing skill acquisition protocols faithfully
  5. Assisting with training stakeholders in basic procedures
  6. Communicating with supervisors about client progress
  7. Maintaining ethical and professional conduct
  8. Providing direct client care with procedural integrity

Activities Within RBT Scope:

  • Direct implementation of behavior plans developed by supervisor
  • Collection of data using prescribed methods
  • Preparation of materials for sessions
  • Implementation of established crisis procedures
  • Basic environmental organization for sessions
  • Objective reporting of client behavior and progress
  • Participation in treatment planning meetings as directed
  • Implementation of caregiver training as designed by supervisor

Activities Outside RBT Scope:

  • Independent assessment of clients
  • Behavior plan development or significant modification
  • Independent goal setting or criteria changes
  • Diagnostic activities or interpretations
  • Making treatment recommendations
  • Representing self as able to work independently
  • Creating novel intervention procedures
  • Billing decisions or insurance determinations
  • Conducting functional analyses without direct supervision

Example Scope Distinction: Within Scope: An RBT implements a token economy system exactly as designed by the BCBA, collects data on client response, and reports results to the supervisor.

Outside Scope: An RBT notices the token economy isn’t working well and independently changes the reinforcement schedule, required responses, or token values without supervisor approval.

Supervision Requirements

Minimum Supervision Standards:

  • At least 5% of hours spent providing behavior-analytic services
  • At least 2 supervisor/RBT contacts per month
  • At least one contact must be individual (1:1) supervision
  • Supervision must include direct observation of RBT with client
  • Distribution across RBT’s full range of cases
  • Conducted by qualified supervisor (BCBA/BCaBA)
  • Documented according to BACB requirements

Supervision Activities:

  1. Direct Observation: Supervisor watching RBT implement services
  2. Performance Feedback: Specific input on implementation quality
  3. Modeling of Techniques: Demonstration of correct procedures
  4. Review of Data Collection: Verification of accurate measurement
  5. Program Modification Discussion: Updates to intervention approaches
  6. Problem-Solving Collaboration: Addressing implementation challenges
  7. Ethics and Professional Conduct Review: Ensuring ethical practice

RBT Responsibilities in Supervision:

  • Scheduling regular supervision at required frequency
  • Actively participating in supervision activities
  • Preparing questions and concerns for supervision meetings
  • Implementing feedback from supervision sessions
  • Documenting supervision as required
  • Reporting implementation challenges honestly
  • Requesting additional supervision when needed
  • Ensuring supervision occurs before independent implementation

Example Supervision Documentation:

Date: 5/20/2023
Time: 2:00-2:45 PM (45 minutes)
Supervision Type: Individual, In-person, Direct Observation
Client(s): J.T.
Supervisor: Jane Smith, BCBA

Activities:
- Direct observation of mand training protocol (20 minutes)
- Performance feedback on prompting sequence (10 minutes)
- Review of data collection accuracy (5 minutes)
- Discussion of challenging behavior observed (10 minutes)

Performance Assessment:
- Procedural integrity at 90% for mand training
- Data collection accuracy at 100% for frequency recording
- Professional interaction with client and family appropriate

Follow-up Actions:
- RBT to practice gestural prompt fading
- Supervisor to modify protocol for challenging behavior by next session
- Additional observation scheduled for 5/25/2023

RBT Signature: __________________ Date: 5/20/2023
Supervisor Signature: ____________ Date: 5/20/2023

Addressing Insufficient Supervision:

  1. Document current supervision frequency and activities
  2. Compare current practice to BACB requirements
  3. Communicate concerns directly to current supervisor
  4. Request specific supervision schedule meeting requirements
  5. If unresolved, contact agency clinical director or supervisor’s supervisor
  6. In ongoing problematic situations, consult BACB Ethics Hotline
  7. Never continue practice without required supervision

Example Insufficient Supervision Response: “I’ve noticed that we haven’t had a direct observation supervision session this month as required by the BACB. My understanding is that I need at least two supervision contacts monthly, including one individual session with direct observation. Could we schedule this required observation this week to ensure compliance with RBT requirements? I’m available these times: [list availability].”

Professional Relationship Boundaries

Multiple Relationship Considerations:

  • Definition: Dual or multiple relationships occur when professionals engage in more than one relationship with a client or family (e.g., provider and friend)
  • Ethical Concern: Can compromise objectivity, create conflicts of interest, and potentially harm therapeutic relationship
  • Risk Factors: Power differential, vulnerability of client/family, potential for exploitation or confusion
  • Common RBT Scenarios: Requests for babysitting, social media connections, attendance at personal events, providing transportation

Examples of Boundary Concerns:

  1. Social Relationships: Friendships, social gatherings, non-clinical activities
  2. Financial Relationships: Selling products, borrowing/lending money, special pricing
  3. Digital Relationships: Social media connections, personal communication channels
  4. Caretaking Beyond Services: Babysitting, transportation, weekend assistance
  5. Gift Exchanges: Accepting substantial gifts, frequent gift-giving
  6. Physical Boundaries: Inappropriate physical contact, session locations

Boundary Maintenance Strategies:

  • Clearly explain professional relationship parameters at service outset
  • Consistently redirect boundary-crossing requests
  • Maintain same boundaries across all clients/families
  • Consult with supervisor about boundary questions
  • Document boundary discussions and decisions
  • Recognize cultural variations in relationship expectations
  • Acknowledge boundary issues directly when they arise

Example Boundary Clarification Statements:

Social Media Request: “Thank you for the friend request. To maintain professional boundaries and follow ethical guidelines, I maintain separate professional and personal social media accounts. I don’t connect with clients or families on my personal accounts. This helps ensure our therapeutic relationship remains clear and focused on supporting your child.”

Babysitting Request: “I appreciate your trust in me, shown by asking me to babysit. However, our ethics code advises against taking on multiple roles with families we serve professionally. This helps maintain clarity in our therapeutic relationship and ensures I can remain objective in my professional role. I’d be happy to discuss other resources for finding qualified childcare if that would be helpful.”

Gift Offering: “Thank you for this thoughtful gift. I genuinely appreciate your kindness. Our professional ethics guidelines recommend against accepting gifts of significant value to maintain appropriate professional boundaries. I can accept a token gift like a handmade card, but I need to respectfully decline more substantial gifts. Please know that I value our professional relationship and am committed to providing the best services possible.”

Social Media and Electronic Communication

Social Media Boundaries:

  • Maintaining separate professional and personal accounts
  • Declining client/family connection requests
  • Avoiding posting any client-related information
  • Setting private account security settings
  • Not searching for or viewing client social media
  • Following agency social media policies
  • Consulting supervisor about boundary questions

Example Social Media Policy Statement: “To maintain professional boundaries and confidentiality, I do not connect with current or former clients/families on personal social media platforms. This policy helps ensure clear professional relationships and protects your privacy. If you wish to follow our agency’s professional page for resources and information, that would be appropriate.”

Electronic Communication Guidelines:

  • Using only approved communication platforms
  • Maintaining professional language and tone
  • Communicating during designated business hours
  • Responding within established timeframes
  • Avoiding excessive familiarity in communication
  • Including appropriate signature/credential information
  • Following agency documentation requirements for electronic exchanges

Example Electronic Communication Boundary Setting: “Our agency protocol is to communicate through our secure client portal or agency email for all client-related information. For urgent matters during business hours, please contact our main office at [number]. For emergencies outside business hours, the on-call supervisor is available at [number]. I check messages during business hours and will respond within 24 hours on weekdays.”

Self-Care and Professional Boundaries

The Importance of Self-Care:

  • Maintaining capacity to provide quality services
  • Preventing burnout and compassion fatigue
  • Ensuring objective clinical decision-making
  • Supporting ethical and professional practice
  • Modeling healthy boundaries for clients
  • Sustaining long-term professional practice
  • Protecting personal well-being

Self-Care Strategies for RBTs:

  1. Physical Self-Care: Adequate rest, nutrition, exercise, medical care
  2. Emotional Self-Care: Stress management, emotional processing, supportive relationships
  3. Professional Self-Care: Ongoing learning, peer support, supervision utilization
  4. Boundary Self-Care: Clear work/personal life separation, time management
  5. Environmental Self-Care: Creating supportive, organized work spaces

Signs of Boundary Concerns:

  • Thinking about clients during personal time
  • Sharing excessive personal information with clients/families
  • Feeling unable to say “no” to requests outside scope
  • Experiencing increased stress about specific clients
  • Making exceptions to policies for certain clients
  • Feeling responsible for client outcomes beyond professional role
  • Receiving feedback about boundary concerns from colleagues

Example Self-Care Implementation: “To maintain professional effectiveness, I’ve established a personal routine of debriefing difficult sessions with my supervisor, maintaining a 15-minute transition time between work and home activities, and practicing a ‘leaving work at work’ visualization at the end of each day. When I notice myself thinking about clients during personal time, I acknowledge the thought and consciously redirect to present activities.”

F-5: Comply with Applicable Legal, Regulatory and Workplace Requirements

Legal and Regulatory Compliance

Key Regulatory Areas:

  1. Mandatory Reporting: Child/elder abuse, neglect, exploitation
  2. Privacy Regulations: HIPAA, FERPA, state privacy laws
  3. Education Laws: IDEA, IEP compliance, school regulations
  4. Insurance Requirements: Billing regulations, service documentation
  5. Licensing Laws: State behavior analyst/therapy regulations
  6. Credential Maintenance: RBT requirements, renewal, ongoing training
  7. Workplace Safety: OSHA, emergency procedures, incident reporting

Mandatory Reporting Requirements:

  • Legal obligation to report suspected abuse/neglect
  • Reporting suspected harm rather than proving occurrence
  • Following specific state/regional reporting procedures
  • Maintaining documentation of reports made
  • Understanding reporter protection provisions
  • Recognizing various forms of reportable conditions
  • Differentiating between behavioral issues and abuse indicators

Example Mandatory Reporting Process: “If you observe suspicious bruising and the client reports physical punishment, immediately document your observations objectively, using the client’s exact words. Inform your supervisor of your concerns. Follow your agency’s reporting procedure, which typically includes calling the designated child protective services number. File the report within the legally required timeframe (usually 24-48 hours). Document that you made the report, including the date, time, who you spoke with, and report number if provided.”

Privacy and Confidentiality Regulations:

  • Protected health information (PHI) safeguarding
  • Appropriate information disclosure procedures
  • Consent requirements for sharing information
  • Secure data storage and transmission
  • Electronic communication security
  • Breach reporting requirements
  • Minimum necessary standard application

Example Privacy Protocol Implementation: “Client data must be stored in locked cabinets or password-protected electronic systems. When discussing clients, use initials rather than full names in emails. Obtain written consent before sharing information with schools or other providers. Never discuss clients in public areas or on social media, even without names. Transport data in opaque, secure folders or encrypted devices. Report any potential data breaches to your privacy officer immediately.”

Workplace Requirements

Agency Policy Compliance:

  • Familiarity with employee handbook/policies
  • Adherence to documentation requirements
  • Following session billing procedures
  • Maintaining required certifications/trainings
  • Observing attendance and scheduling protocols
  • Complying with dress code/professional appearance standards
  • Following communication chain of command

Example Agency Policy Application: “According to agency policy, all client notes must be completed within 24 hours of service delivery using the standard electronic template. Notes requiring supervision must be submitted as ‘drafts’ for review before finalization. Time sheets must be submitted by noon on Fridays. All client cancellations must be reported to the scheduling coordinator within 1 hour. Annual bloodborne pathogen training certificate must be current and on file with HR.”

Safety Procedures:

  • Emergency response protocols
  • Crisis intervention procedures
  • Incident reporting requirements
  • Infection control practices
  • Environmental hazard management
  • Transportation safety procedures
  • Specialized client safety protocols

Example Safety Protocol Implementation: “In case of behavioral crisis, follow the client’s individualized safety plan. If physical intervention is authorized, use only approved techniques from your certified training. After any crisis incident, complete an incident report within 24 hours including antecedents, specific behaviors, interventions implemented, and resolution. Report any staff or client injuries to supervisor immediately and follow medical attention protocols as needed. Participate in required post-incident debriefing.”

Specialized Setting Requirements:

  1. School Settings: Visitor protocols, classroom rules, IEP compliance
  2. Home Settings: Family household rules, cultural considerations, guest etiquette
  3. Clinic Settings: Material organization, shared space protocols, scheduling procedures
  4. Community Settings: Public behavior standards, location-specific rules, transportation regulations
  5. Telehealth Settings: Technology requirements, privacy considerations, session security

Example Setting-Specific Compliance: “When providing services in the school setting, sign in at the front office upon arrival and wear visitor badge visibly at all times. Obtain teacher permission before removing student from classroom. Follow school schedule including respecting bell schedule and avoiding service delivery during standardized testing periods. Adhere to school’s cell phone policy and dress code. Review and follow any school-specific safety procedures including lockdown and evacuation protocols.”

Professional Presentation

Professional Appearance Standards:

  • Clean, neat, appropriate clothing for setting
  • Agency-specific dress code compliance
  • Appropriate coverage and fit
  • Setting-appropriate footwear for safety
  • Minimal distracting accessories
  • Personal hygiene maintenance
  • Consideration of client-specific sensory needs

Example Professional Appearance Application: “For clinic-based services, staff must wear agency polo shirts with clean, intact khaki or black pants (no jeans, leggings, or shorts). Closed-toe shoes are required for safety. In school settings, follow the school’s employee dress code. For home-based services, maintain professional appearance while respecting the casualness of home environments (agency shirt with neat jeans acceptable). Consider client-specific factors such as sensitivity to scents, bright colors, or certain textures when selecting attire.”

Professional Communication Standards:

  • Respectful, person-first language
  • Appropriate formality level for context
  • Clear, concise information delivery
  • Active listening demonstration
  • Non-judgmental discussion of sensitive topics
  • Avoidance of technical jargon with laypeople
  • Culturally sensitive communication approaches

Example Professional Communication Application: “When communicating with parents, use their preferred names and titles. Avoid technical terminology without explanation (e.g., say ‘teaching in small steps’ rather than just ‘chaining procedure’). Demonstrate active listening by summarizing information and checking for understanding. Present information objectively without judgmental language. When discussing challenging behaviors, focus on function and intervention rather than just behavior topography.”

Time Management and Reliability:

  • Punctual arrival for scheduled services
  • Complete session duration delivery
  • Adherence to break schedules
  • Timely documentation completion
  • Meeting deadlines for assigned tasks
  • Appropriate notice for unavoidable absences
  • Efficient session transition management

Example Time Management Application: “RBTs are expected to arrive 5-10 minutes before scheduled session times to prepare materials and be ready to begin promptly. Sessions must start and end at scheduled times. Documentation must be completed within 24 hours of service delivery. Schedule changes require minimum 48-hour notice except in emergencies. If running late due to unavoidable circumstances, contact the office and client family immediately. Maintain awareness of billable time requirements, ensuring all billed time involves direct client service.”