EDITORIAL: LICENSING BEHAVIOR ANALYSTS

Behavior and Social Issues, Fall 2008 by Mattaini, Mark A

According to a recent communication from the Association for Behavior Analysis: International (ABAI) office:

At its fall meeting in November 2008, the ABAI Council unanimously approved the Practice Board's strategic initiatives as described in the document, "Working to Meet the Needs of Practicing Behavior Analysts while Protecting Consumers, and to Assure the Alignment of the Practice of Behavior Analysis with the Science of Behavior," which is available in its entirety ... from the Practice Resources web page: http://www.abainternational.org/BA/practice.asp.

This initiative focuses among other things on the licensure of master's and doctoral level applied behavior analysts. Movement by ABAI toward licensure was probably inevitable, given the recent dramatic increase in the practice of applied behavior analysis, particularly in the autism and development disabilities area. If the primary behavior analytic organization in the world did not move in this direction, it is likely that some other organization would do so, and in the process might splinter the behavior analytic community. (As noted below, however, this initiative could splinter that community in other ways.) Based on my knowledge of similar licensing efforts by other groups (e.g., social workers, marriage and family counselors, professional counselors), we should expect that this effort will require considerable organizational resources over a significant period of time. The effort likely will succeed, but will involve substantial costs and challenges that should be acknowledged.

The primary rationale provided for licensing generally involves consumer protection, as well as providing some form of legally sanctioned recourse in the event of malpractice or ethical violations. Integrity requires acknowledgement, however, that professional self-interest and limiting competition have also been a significant factors in many movements toward professional licensure (the primary momentum for licensure has typically come from those to be licensed, rather than consumer demand).

Overall, if extremely well done, there are likely to be advantages to the licensure of applied behavior analysts. Research done in other professions has found mixed results in terms of whether licensing or certification is associated with improved outcomes; licensing may improve outcomes in behavior analysis in typical practice settings, but that remains to be demonstrated. If we are empiricists, such association should be tested over time as part of the licensing effort. There are also other significant challenges and potential costs that require serious attention. Some of those challenges include:

* Development of an adequate scope of practice. This has been handled in two general ways by professions. One is basically through title protection; a person permitted to use the professional title "licensed applied behavior analyst" is certified as competent in a specified set of skills (e.g., functional behavior assessment, acceptance and commitment therapy, community reinforcement approach) by those already licensed, and no one without such recognition can use the title. The other, much more challenging approach, is to identify actions which only licensed persons may perform (e.g., prescribing medications, performing oral surgery, serving as legal counsel). Both have challenges for behavior analysts, the first because the list of behavior analytic interventions is long (some have suggested licensing procedures rather than people). The second approach is even more difficult, because many other disciplines use and in some cases are licensed to use the interventions included in model scope of practice documents. Powerful challenges to licensing behavior analysts from psychologists, MDs, special educators, social workers and others are inevitable if behavior analysts attempt to assert that only they can provide interventions that others currently offer.

* Reciprocity. Reciprocity has proved more difficult in many professions than initially expected. The US constitution gives states the right to regulate professions, and significant differences in regulation of professions from state to state are common. Achieving relatively high levels of reciprocity in dentistry took decades (in some cases there were allegations of intent to limit competition); social work reciprocity continues to be an issue, as some states (California, notably) believe that other states' licensing requirements are weaker than their own. It is critical to bear in mind that no matter how a model statute is written, nonprofessional legislators will ultimately propose, amend, and adopt the legislation, and their own opinions and the lobbying efforts of other groups commonly result in significant changes along the way.

* Supporting other areas of behavior analytic science. As ABAI increasingly focuses its resources on licensing and other aspects of practice (particularly in developmental disabilities), other areas may be eclipsed. These include science, service, and cultural level analysis. It is possible then that by preventing the practice community from leaving, ABAI could lose the experimental, academic, and cultural communities to new organizations (this has arguably happened in both psychology [APS] and social work [SSWR]). This is not inevitable, but seems probable unless considerable attention is directed to ways to continue to strongly support these other communities, and ways are found to integrate them with the practice community.