Maintaining Confidentiality Outside the Clinic
Many RBTs work in the community — at school, the grocery store, the park, restaurants — implementing generalization or community-based instruction. These public settings create unique confidentiality challenges that don't exist in a private clinic.
The Default Rule
The general public does not have the right to know that the person you are with is receiving ABA services. Strangers should not be told you are a "therapist" or "behavior tech" if it would identify the client. A neutral description like "I'm helping out today" is appropriate when explanation is needed.
Common Public-Setting Scenarios
The curious stranger: "Aw, that's so sweet — are you his sister?" Response: a polite smile and redirect. Do NOT confirm or deny the professional relationship publicly.
The friendly neighbor: "How's Johnny doing in therapy?" Response: "I'm not able to discuss anything about Johnny — please speak to his parents." Even confirming that therapy exists is a disclosure.
The bystander recording: If a member of the public is filming a session (often during a public behavior incident), you have no authority to demand they stop, but you should immediately move the client to a more private location, document the incident, and notify the BCBA.
Running into the client outside session: Acknowledge the client briefly and politely, but do NOT initiate prolonged conversation, do NOT mention session details, and do NOT discuss program targets within earshot of others.
Documentation Visibility
Data sheets in public should be kept face-down or in folders. Never leave them on a table at a coffee shop while you step away. Sending data sheets via personal email (Gmail, Yahoo) is a HIPAA violation — use only the encrypted agency platform.
Group Therapy & Social Skills Groups
When multiple clients are present, you must protect each client's confidentiality from the others' families. Do not discuss one client's targets or progress with another client's parent. Use private side conversations for individual feedback.