BA285 Unit 5 Confidentiality and Records Paper Example

Data Sheets on a Personal Phone and a Laptop in the Kitchen: A BA285 Unit 5 Confidentiality and Documentation Paper

[Student Name]

Purdue University Global

BA285: Ethics in Behavior Analysis

Unit 5 Confidentiality and Documentation Paper

[Instructor Name]

[Date]

The writer, her agency and the families are composite; the code, rule summary and article cited are real.

Three Habits

Most of my working day is spent in other people's houses, delivering behavior therapy to their children under supervision. Until this spring, I did three things without thinking much about them. I photographed paper data sheets on my personal phone at the end of each session, so I could finish notes at home if I ran out of time. I answered, briefly and kindly, when a neighbor at church asked how "the little Pruitt boy" was doing. And when our agency added video coaching sessions for parents, I connected with one family on a laptop that sat on their kitchen table, where older children and visiting relatives came and went.

A supervision meeting about our agency's privacy training made me look at each habit again.

What the Standards Require

The Behavior Analyst Certification Board's ethics code directs behavior analysts to protect the confidentiality of clients and stakeholders, to share information only with consent or when legally required, to store and transmit records securely and to keep documentation accurate and complete for at least seven years, or longer if law requires (Behavior Analyst Certification Board, 2020). The RBT ethics code applies these expectations to technicians, who handle much of the day-to-day information about clients (Behavior Analyst Certification Board, 2021).

Behavior-analytic agencies that bill health insurance also fall under the federal HIPAA privacy rule. The rule limits how protected health information, meaning health-related details tied to a person who can be identified, may be used and disclosed, and requires covered organizations to safeguard it (U.S. Department of Health and Human Services, 2003).

The Phone

Photographs of data sheets on a personal phone are protected health information stored outside the agency's systems. They include the child's name, behaviors and session times. Every photo on my phone syncs to my own cloud storage, is not encrypted by the agency and is sometimes used by my younger sister. If it were lost, stolen or shared, a family's information would go with it.

The photos were meant to save time on notes; they also meant a child's behavior data lived in my personal cloud next to my vacation pictures.

The fix was straightforward. I deleted the photos from the phone and the cloud, confirmed with our compliance officer that nothing had been shared, and switched to the agency's secure data collection app on an agency tablet. Finishing notes on time became a scheduling issue I raised with my supervisor rather than a reason to take data home.

The Neighbor

Answering "he's doing great" to a neighbor seems harmless. But it confirms that the Pruitt family receives behavioral services, which is information the family has the right to control. In a small community, confirmation alone can spread. The code does not allow even general disclosures without consent.

I now answer such questions the same way every time: "I can't talk about anyone I work with, but it's nice to see you." Mrs. Pruitt, when I told her about the change, said she was glad, because she had not told her own sister about Caleb's diagnosis yet.

The Kitchen Laptop

Video coaching is now part of our services, and it brings its own risks. Pollard et al. (2017) analyzed ethical issues in designing telehealth services in behavior analysis. They identified concerns about the security of the platform, privacy at the client's location, informed consent that covers telehealth-specific risks, the competence of practitioners in remote delivery and the quality of supervision, and recommended that agencies address each before launching services.

In the kitchen, privacy was the problem. The family's teenage son and a visiting aunt heard parts of a session in which we discussed the younger child's toileting and aggression. The platform itself was secure; the room was not. I raised the issue with my supervisor, who updated the telehealth consent form to explain who might overhear sessions, and we worked with the family to schedule coaching during school hours in a bedroom with the door closed. For families without a private space, the agency now offers phone coaching with a headset.

Why Small Lapses Matter

Habits like these can look like harmless technicalities. In practice, they matter for three reasons. First, families share private information with us because they trust that it will stay with the team. A grandmother who has not told her own sister about a diagnosis is relying on that trust. Second, information about behavioral services can affect how a child is treated at school, at church or in the extended family, and once shared it cannot be taken back. Third, small lapses become habits, and habits spread. When I mentioned the phone photos at a team meeting, two other technicians admitted they did the same thing. A lapse that seemed personal turned out to be part of how our team worked.

Agency Changes

After the team meeting, our clinical director made three changes. All technicians now use agency tablets with the secure app, and personal phones may not store any client information. Privacy training, previously a single online module at hiring, now includes a short scenario discussion each quarter, using situations technicians actually face, such as neighbors' questions and shared rooms. And the telehealth consent form now includes a checklist families complete before the first video session, covering where they will sit, who else is home and how to pause the session if someone enters.

Documentation

The review also touched on documentation. I sometimes completed notes a day or two late, reconstructing details from memory. Late notes are less accurate, and inaccurate records can mislead the next technician, the supervisor or an insurer. My supervisor and I adjusted my schedule to include fifteen minutes after each session for notes, and I now complete them before leaving the family's driveway.

Conclusion

None of my three habits involved a dramatic breach, and all came from good intentions: saving time, being friendly, serving families more flexibly. Each still put client information at risk. The ethics code, the federal privacy rule and an analysis of telehealth ethics explain why, and the changes were simple once the risks were visible: secure devices, a consistent answer to neighbors, private space for video sessions and notes completed on time.

References

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Author.

Behavior Analyst Certification Board. (2021). RBT ethics code (2.0). Author.

Pollard, J. S., Karimi, K. A., & Ficcaglia, M. B. (2017). Ethical considerations in the design and implementation of a telehealth service delivery model. Behavior Analysis: Research and Practice, 17(4), 298-311. https://doi.org/10.1037/bar0000053

U.S. Department of Health and Human Services. (2003). Summary of the HIPAA privacy rule.