Multiple Relationships, Transitions, and Discontinuing Services
Key Takeaways
- Multiple relationships are risky when they impair objectivity, exploit a power difference, or harm the client.
- Boundaries should be planned before conflicts appear, not repaired only after harm occurs.
- Transitions and discontinuation require advance planning, documentation, and coordination when possible.
- A BCBA should not abandon a client because services become inconvenient, unpaid, or uncomfortable.
Multiple Relationships
A multiple relationship exists when the BCBA has another role with the client, caregiver, supervisee, employee, student, or stakeholder. Examples include friend, landlord, business partner, romantic partner, paid consultant, evaluator, or family connection.
The ethical issue is not just that two roles exist. The issue is whether the second role could reduce objectivity, create pressure, exploit the person, disrupt services, or make consent less voluntary.
Boundary Risk Questions
| Ask | Why it matters |
|---|---|
| Is there a power difference? | The client or trainee may feel unable to refuse. |
| Could objectivity change? | Assessment, feedback, billing, or discharge could be biased. |
| Could private information be misused? | Service data may affect personal or business roles. |
| Can the role be avoided? | Avoidance is often safer than management. |
| If unavoidable, can safeguards work? | Document limits, consent, oversight, and review. |
Transitions and Discontinuing Services
Ethical discontinuation is planned. It includes notice when feasible, data review, caregiver or stakeholder communication, referral options, records transfer with consent, crisis planning when needed, and documentation.
Valid reasons can include goals met, no clinical benefit, lack of required resources, unsafe conditions, conflict of interest, loss of competence fit, or client relocation. Even then, the BCBA should avoid abrupt abandonment unless immediate safety or legal requirements demand it.
A caregiver offers a BCBA a discounted lease on an apartment while the BCBA is deciding whether the child should continue services. What is the best response?
A BCBA plans to leave an agency in two weeks. Several clients still need behavior support plans and caregiver training. What is the most ethical action?
A client's family repeatedly cancels sessions and does not implement agreed safety procedures. The BCBA believes services cannot be effective under current conditions. What should the BCBA do?