The professional practice of behavior analysis is a domain of behavior analysis, the others being radical behaviorism, experimental analysis of behavior and applied behavior analysis. The practice of behavior analysis is the delivery of interventions to consumers that are guided by the principles of radical behaviorism and the research of both experimental and applied behavior analysis. Professional practice seeks to change specific behavior through the implementation of these principles. In many states, practicing behavior analysts hold a license, certificate, or registration. In other states, there are no laws governing their practice and, as such, the practice may be prohibited as falling under the practice definition of other mental health professionals. This is rapidly changing as behavior analysts are becoming more and more common.
The professional practice of behavior analysis is a hybrid discipline with specific influences coming from counseling, psychology, education, special education, communication disorders, physical therapy and criminal justice. As a discipline it has its own conferences, organizations, certification processes, and awards.
Defining the scope of practice
The Behavior Analysis Certification Board (BACB) defines behavior analysis as:
Another source defines it as, "a scientific approach to understanding why we do what we do. It focuses on how environmental factors, like consequences and context, influence and shape human and animal behavior. It has two main branches: a basic science called the Experimental Analysis of Behavior (EAB) and an applied field called Applied Behavior Analysis (ABA), which is used to create positive, meaningful behavior change in the real world." It is focused on the relationship between behavior and the environment, stating that actions are learned through consequences.
Behavior analysis is based on the principles of operant and respondent conditioning. Applied behavior analysis (ABA) includes the use of behavior management, behavioral engineering and behavior therapy.
Currently in the U.S. some behavior analysts at the masters level are licensed; others work with an international certification where licenses are unavailable, although this may not be allowed in some states or jurisdictions. At the doctoral level many are licensed as psychologists with diplomate status in behavioral psychology or licensed as licensed behavior analysts. Diplomate status alone, however, does not allow one to practice in every state and each state's regulatory statute must be reviewed for the appropriateness and legality of practice.
Certification The Behavior Analyst Certification Board (BACB) offers a technical certificate in behavior analysis. The American Psychological Association offers a diplomate (post PhD and licensed certification) in behavioral psychology.
The meaning of certification
BACB is a private non-profit organization without governmental powers to regulate behavior analytic practice. However, it does wield the power to suspend or revoke certification from those certified if they violate the strict ethical guidelines of practice. As many states are without a licensure act, this has been sufficient to deter violators as it removes their ability to vendor with the state, schools, and insurance companies under that certification. While the BACB certification means that candidates have satisfied entry-level requirements in behavior analytic training, certificants are able to practice independently within the scope of their practice and training. Thus, a BCBA (such as those who go into marketing, engineering, or other approved fields in which BCBAs work) who has never trained to work nor worked with autistic children are discouraged to do so independently. Most health insurance companies also recognize the BCBA credential as one conferring the capability and the right to practice independently in many states (including California with the passage of SB 946 into law).
Some states still require certificants to be licensed by their respective jurisdictions for independent practice when treating behavioral health or medical problems, and a number of states including Arizona and Nevada have created a specific BCBA licensing program. Licensed certificants must operate within the scope of their license and within their areas of expertise. Where the government regulates behavior analytic services, unlicensed certificants may be supervised by a licensed professional and operate within the scope of their supervisor's license when treating disorders if that jurisdiction allows such supervision. Unlicensed certificants who provide behavior analytic training for educational or optimal performance purposes do not require licensed supervision, unless the law or precedent prohibits such practice. Where the government does not regulate the treatment of medical or psychological disorders certificants should practice in accord with the laws of their state, province, or country. All certificants must practice within their personal areas of expertise.
Licensure The model licensing act for behavior analysts has been revised several times to reflect best practices and policy. Previous versions included provisions that would have made it in practice more difficult to obtain the necessary experiential hours for license and independent practice as a clinical psychologist.Introduction to the BACB® Model Act for Licensing Behavior Analysts. Behavior Analyst Certification Board, Inc. February 2009
Once the person is licensed public protection is still monitored by the licensing board as well as the BACB, both of which make sure that the person receives sufficient ongoing education, and the BACB and licensing board investigate ethical complaints. In February 2008, Indiana, Arizona, Massachusetts, Vermont, Oklahoma and other states now have legislation pending to create licensure for behavior analysts. Pennsylvania was the first state in 2008 to license behavior specialists to cover behavior analysts. Arizona, less than three weeks later, became the first state to license behavior analysts. Other states such as Nevada and Wisconsin have also passed behavior analytic licensure.
In California, after the defeat of a bill to create a license for BCBAs in 2011, the state government instead passed SB 946 which mandates that all non-governmental insurance agencies reimburse for BCBA for behavior therapy in treating autism, starting in 2012. Unlike many other bills mandating that autism be covered by insurance, SB 946 does not currently impose a cap on services by age or funding amount – in this it is similar to other treatments such as those for heart attacks or other chronic conditions.The full text of SB 946 can be found here: ()
Service delivery models
Definitions Behavior analytic services can be and often are delivered through various treatment modalities. These include: Consultation – an indirect model in which the consultant works with the consultee to change the behavior of the client. Therapy – (individual, group, or family) in which the therapist works directly with a person with some form of pathology to lessen the pathology. Counseling – where the counselor works directly with a person who has problems but no pathology. Coaching – in which the coach works with a person to achieve a life goal.
Primary methods The two primary methods for delivering behavior analytic services are consultation and/or direct therapy; the former involves three parties: consultant, consultee and a client whose behavior is changed (who may or may not be present for all meetings).
Consultation can involve working with the consultee (i.e., a parent or teacher) to build a plan around the behavior of a client (i.e., a child or student), or training the consultees themselves to modify the behavior of the client. Within the domain of parent–child consultation, standard intervention includes teaching parents skills such as basic reinforcement, time-out and how to manipulate different factors to modify behavior.
Direct therapy involves the relationship of behavior analyst and client, usually one-on-one, in which the analyst is responsible for directly modifying the behavior of their client. Direct therapy is also used in schools but can also be found in group homes, in a behavior modification facility and in behavior therapy (where the focus may be on tasks such as quitting smoking, modifying behaviors for sex offenders or other types of offenders, modifying behaviors related to mood disorders) or to encourage job seeking behavior in psychiatric patients.
History of behavior models Two older and less used models still exist for the delivery of behavior analytic services. These models were used mostly with normal or typically developing populations. These two models are the Behavioral Coaching and the Behavioral Counseling model. Both were very popular in the 1960s–1980s but have recently seen a decline in popularity, as proponents argued the merits of holding strictly to learning theory. The Association for Behavior Analysis International still retains a special interest group in behavioral counseling and coaching.
History of behavioral counseling Behavioral counseling was very popular throughout the 1970s and at least into the early 1980s.Hosford, R. & de Visser, L. (1974) Behavioral approaches to counseling: An introduction. Washington, DC: American Personnel and Guidance Association Press. Behavioral counseling is an active action–oriented approach that works with the typically developing population but also assists people with specific/discrete problems such as career decision making, drinking, smoking or rehabilitation after injury.
Life coaching The behavioral coaching model is sometimes referred to as life coaching. However, like counselors and psychologists, life coaches can have varied orientations/change theories (see behavioral change theories). Behavioral life coaches operate mainly from a behavior analytic orientation. Unlike therapy, this model is applied to people who desire to achieve a specific goalSimek, T.C. & O'Brien, R.M. (1981). Total golf: A behavioral approach to lowering your score and getting more out of your game. New York, NY: Doubleday. such as increasing their assertiveness with others. This model is educational and is usually presented as an alternative to therapy. Coaches use behavioral techniques such as objective setting, goal setting, self-control training and behavioral activation to help clients achieve specific life goals. Behavioral coaching was sometimes used to teach job skills to people having intellectual disability or head injury. In this area the model made extensive use of task analysis, direct instruction, role play, reinforcement and error correction. Often this approach employs techniques of direct instruction.
Goal of increasing reinforcement Behavioral counseling was largely seen as a growth model that tried to increase the individuals sense of "freedom" by helping the client reduce punishment or coercion in their lives, build skills, and increase access to reinforcement.Krumboltz, J.D. & Thoreson, C.E. (Eds.). (1969). Behavioral counseling: Cases and techniques. New York: Holt, Rinehart, & Winston. B.F. Skinner created a video discussing the processes involved and the importance of reinforcement to increase the sense of "freedom". Behavioral counseling attempts to use in-session reinforcement to improve decision-making, functional assessment of the clients problem, and behavioral interventions to reduce problem behaviors.
Social learning in behavioral counseling