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Behavior Analysis in Practice

, Volume 10, Issue 2, pp 145–153 | Cite as

Ethical Considerations for Interdisciplinary Collaboration with Prescribing Professionals

  • Mindy K. Newhouse-Oisten
  • Kimberly M. Peck
  • Alissa A. Conway
  • Jessica E. Frieder
Discussion and Review Paper

Abstract

Behavior analysts often work as part of an interdisciplinary team, and different team members may prescribe different interventions for a single client. One such intervention that is commonly encountered is a change in medication. Changes in medication regimens have the potential to alter behavior in a number of ways. As such, it is important for all team members to be aware of every intervention and to consider how different interventions may interact with each other. These facts make regular and clear communication among team members vital for treatment success. While working as part of an interdisciplinary team, behavior analysts must abide by their ethics code, which sometimes means advocating for their client with the rest of the team. This article will review some possible implications of medicinal interventions, potential ethical issues that can arise, and a case study from the authors’ experience. Finally, the authors propose a decision-making tree that can aid in determining the best course of action when a team member proposes an intervention in addition to, or concurrent with, interventions proposed by the behavior analyst.

Keywords

Interdisciplinary treatment Ethical considerations Behavioral interventions Medications 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. American Medical Association. (2007). Code of medical ethics. Chicago, IL: American Medical Association.Google Scholar
  2. American Psychiatric Association. (2001). The principles of medical ethics: with annotations especially applicable to psychiatry. Washington, D.C.: American Psychiatric Association.Google Scholar
  3. American Psychological Association. (2007). Code of medical ethics. Chicago, IL: American Medical Association.Google Scholar
  4. Bailey, J. S., & Pyles, D. A. M. (1989). Behavior diagnostics. In E. Cipani (Ed.), The treatment of severe behavior disorders: behavior analysis approaches (pp. 85–107). Washington, DC, US: American Association on Mental Retardation.Google Scholar
  5. Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts. Littleton, CO: Behavior Analyst Certification Board, ® Inc.Google Scholar
  6. Brodhead, M. (2015). Maintaining professional relationships in an interdisciplinary setting: strategies for navigating nonbehavioral treatment recommendations for individuals with autism. Behavior Analysis in Practice, 8, 70–78. doi: 10.1007/s40617-015-0042-7.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Crosland, K. A., Zarcone, J. R., Lindauer, S. E., Valdovinos, M. G., Zarcone, T. J., Hellings, J. A., & Schroeder, S. R. (2003). Use of functional analysis methodology in the evaluation of medication effects. Journal of Autism and Developmental Disorders, 33(3), 271–279.CrossRefPubMedGoogle Scholar
  8. Dawson, G., Jones, E. H. J., Merkle, K., Venema, K., Lowy, R., Faja, S., Kamara, D., Murias, M., Greenson, J., Winter, J., Smith, M., Rogers, S. J., & Webb, S. J. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 51(11), 1150–1159.CrossRefGoogle Scholar
  9. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17–e23.CrossRefPubMedGoogle Scholar
  10. Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: a comparison controlled study. Behavior Modification, 31(3), 264–278.CrossRefPubMedGoogle Scholar
  11. Fisher, W., Piazza, C., & Page, T. (1989). Assessing independent and interactive effects of behavioral and pharmacological interventions for a client with dual diagnoses. Journal of Behavior Therapy and Experimental Psychology., 20(3), 241–250.CrossRefGoogle Scholar
  12. Garcia, A. B., Sapyta, J. J., Moore, P. S., Freeman, J. B., Franklin, M. E., March, J. S., & Foa, E. B. (2010). Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 1024–1033.CrossRefGoogle Scholar
  13. Hoza, B., Pelham, W. E., Sams, S. E., & Carlson, C. (1992). An examination of the dosage effects of both behavior therapy and methylphenidate on the classroom performance of two ADHD children. Behavior Modification., 16(2), 164–192.CrossRefPubMedGoogle Scholar
  14. LaRue, R. H., Northup, J., Baumeister, A. A., Hawkins, M. F., Seale, L., Williams, T., & Ridgway, A. (2008). An evaluation of stimulant medication on the reinforcing effects of play. Journal of Applied Behavior Analysis, 41, 143–147.CrossRefPubMedPubMedCentralGoogle Scholar
  15. McPheeters, M. L., Warren, Z., Sathe, N., Bruzek, J. L., Krishnaswami, S., Jerome, R. N., & Veenstra-VanderWeele, J. (2011). A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics, 127(5), e1312–e1321.CrossRefPubMedGoogle Scholar
  16. MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086.CrossRefGoogle Scholar
  17. Murray, D. W., Arnold, L. E., Swanson, J., Wells, K., Burns, K., Jensen, P., Hechtman, L., Paykina, N., Legato, L., & Strauss, T. (2008). A clinical review of outcomes of the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA). Current Psychiatry Reports, 10, 424–431.CrossRefPubMedGoogle Scholar
  18. O’Neill, R. E., Horner, R. H., Albin, R. W., Sprague, J., Storey, R., Newton, K., & J. S. (1996). Functional assessment and program development for problem behavior: a practical handbook (2nd ed.). Pacific Grove, CA: Brooks/Cole.Google Scholar
  19. Northup, J., Fusilier, I., Swanson, V., Roane, H., & Borrero, J. (1997). An evaluation of methylphenidate as a potential establishing operation for some common classroom reinforcers. Journal of Applied Behavior Analysis, 30, 615–625.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Piacentini, J., Bennet, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., March, J., Sherrill, J., Sakolsky, D., Ginsburg, G., Rynn, M., Bergman, R. L., Gosch, E., Waslick, B., Iyengar, S., McCracken, J., & Walkup, J. (2014). 24- and 36-week outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS). Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 297–310.CrossRefGoogle Scholar
  21. Schall, C. (2002). A consumer’s guide to monitoring psychotropic medication for individuals with autism spectrum disorders. Focus on autism and other developmental disabilities, 17(4), 229–235.CrossRefGoogle Scholar
  22. TADS Team. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association, 292(7), 807–820.CrossRefGoogle Scholar
  23. Valdovinos, M. G., & Kennedy, C. H. (2004). A behavior-analytic conceptualization of the side effects of psychotropic medications. The Behavior Analyst, 27, 231–238.PubMedPubMedCentralGoogle Scholar
  24. Valdovinos, M. G., Nelson, S. M., Kuhle, J. L., & Dierks, A. M. (2009). Using analogue functional analysis to measure variations in problem behavior rate and function after psychotropic medication changes: a clinical demonstration. Journal of Mental Health Research in Intellectual Disabilities, 2, 279–293.CrossRefGoogle Scholar
  25. Vinokur-Kaplan, D. (1995). Enhancing the effectiveness of interdisciplinary mental health treatment teams. Administration and Policy in Mental Health, 22(5), 521–530.CrossRefGoogle Scholar
  26. Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Waslick, B., Iyengar, S., March, J. S., & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753–2766.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Association for Behavior Analysis International 2017

Authors and Affiliations

  • Mindy K. Newhouse-Oisten
    • 1
  • Kimberly M. Peck
    • 1
  • Alissa A. Conway
    • 1
  • Jessica E. Frieder
    • 1
  1. 1.Department of PsychologyWestern Michigan UniversityKalamazooUSA

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