Promoting Ethical and Evidence-Based Practice through a Panel Review Process: A Case Study in Implementation Research

Approximately 10,000 new behavior analysts entered the field in 2021 alone, accounting for nearly 20% of the current workforce. As the field of behavior analysis continues to experience exponential growth, it is critical that organizations develop infrastructure to support the professional development of novice practitioners and the delivery of high quality and ethical services for patients. Although it is ultimately the responsibility of the individual practitioner to determine and practice within their own scope of competence, research indicates that many behavior analysts do not receive the necessary training and case oversight to adequately manage some of the patients assigned to them, particularly those with severe challenging behavior (Colombo et al. Behavior Analysis in Practice, 14(1), 11-19, 2021). Practitioners with inadequate training and oversight may be at risk of adopting restrictive procedures to manage seemingly intractable behaviors when less restrictive evidence-based treatment options are, in fact, available. This article describes the development of a procedural review panel (PRP) as an organizational strategy for aligning assessment and treatment procedures with ethical practice guidelines when working with patients with severe challenging behavior. Data from the first year of implementation were evaluated within an implementation science framework indicating that, within the current sample, the PRP process successfully mitigated the use of restrictive treatment procedures in 80% of cases and promoted the adoption of additional evidence-based practices in 79% of cases resulting in reductions across 72% of target behaviors across the sample.