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Cultural responsiveness, social justice, inclusion, and a multitude of other terms have emerged during the last few years in the United States. At their root, these terms allude to the perception and equitable treatment among people. As professionals and behavioral experts, behavior analysts have the responsibility to establish clinical environments in which cultural diversity is embraced, not merely tolerated. Recent initiatives within the field have included more published research, continuing education opportunities, and clearly established ethical guidelines in the Ethics Code of Behavior Analysts, the derivative of Professional and Compliance Code for Behavior Analysts. Behavior analysts have an obligation to adhere to the Professional and Compliance Code for Behavior Analysts and will soon adhere to its derivative, Ethics Code for Behavior Analysts in 2022. Both guidelines establish guidelines for responsible behavior-analytic practice. Though wording may vary, assessment, client rights, client dignity, individualized service delivery, and promoting of an ethical culture are paramount fragments outlined in both guidelines. In fact, the Ethics Code for Behavior Analysts includes specific language about cultural responsiveness and diversity (Code 1.07). Each ideal can be directly applied to increasing the quality of services for culturally diverse clientele.
Assessment, whether formal or informal, should be used to learn the values and beliefs specific to each client to maintain client dignity and their right to effective services. Individualized services are not attainable without knowledge about the client’s culture. An ethical can only be established when client values and beliefs drive the treatment process. There may be barriers to providing culturally responsive behavior services, especially for new behavior analysts. It is imperative supervisees receive sound problem-solving training and practice opportunities. Supervisors can support their supervisees by preparing for commonly-asked questions centered on culturally-responsive practice. How do I know if someone has a different culture than me? Encourage the mentee to ask objective questions. For example, rather than asking, “What should I know about your culture” a behavior analyst could ask, “Do you have any dietary restrictions?” Instead of asking, “How can I be sensitive to your religious beliefs?” ask “Are there any days or times you are not available for services?” More specific, objective questions often open conversational channels that can allow for clients to express their values. What if my client’s culture interferes with effective treatment or the ethics code? Fortunately, the Ethics Code for Behavior Analysts includes a detailed decision-making task analysis.
Though the Ethics Code for Behavior Analysts doesn’t take effect until January 1, 2022, it’s applicable for ethical dilemmas at any time. Supervisors can model the decision-making task analysis with their supervisees. What if I unintentionally say something incorrectly or offensive? Clearly, an antecedent intervention is important. When possible, encourage the supervisee to observe an experienced behavior analyst navigate initial and ongoing interactions with clients. Role-play different scenarios the supervisee is likely to meet clients with different cultures. Undoubtedly, more barriers to culturally-responsive treatment may exist than the examples outlined above, including implicit bias and prejudice.
The first step to eliminate implicit biases is for behavior analysts to learn what biases they may have. Harvard University has created Implicit Association Tests by way of Project Implicit® to assist in learning what implicit biases a person may have (link below). The tests are designed to measure the extent to which the test-taker has implicit biases in a variety of categories (e.g., age, sexual orientation, religion, disability). After test-takers becomes aware of implicit biases, they are more equipped to eliminate their identified biases. Ultimately, culturally responsive practice is an ethical responsibility for each behavior analyst. The ethics guidelines established by the BACB® are minimum practice standards and should not be followed solely because they are published by the BACB®. The culturally responsive treatment standards establish a foundation for individualized, effective practice resulting in the best possible client outcomes.
Resources: Ethics Code for Behavior Analysts Professional and Compliance Code for Behavior Analysts https://implicit.harvard.edu/implicit/takeatest.html