Client Dignity in ABA Therapy: Key Aspects to Know

After seeing how Applied Behavior Analysis (ABA) teams support clients daily, it is clear that client dignity is an important part of therapy. 

What is client dignity in ABA therapy?

Client dignity means treating every client you work with as someone whose preferences, feelings, and autonomy matter, regardless of how they communicate or what behaviors they show.

It means clients get a say in what happens to them, and their feelings and preferences are valid.

The BACB Ethics Code requires behavior analysts to treat others with dignity. Violating this standard can result in consequences for certification.

Client rights in ABA therapy are supported by a strict legal framework. The considerations include federal, state laws, and professional codes of ethics.

Here are the core pillars of client dignity:

Non-Discrimination

Everyone deserves the same quality of care and opportunities, regardless of their background, diagnosis severity, communication ability, or any other characteristic.

This means evaluating your practices to make sure you’re not inadvertently providing better resources, more attention, or certain interventions to some clients over others.

Equal access to materials, activities, and your best clinical thinking should be standard for everyone you serve.

Understanding

Even when a client can’t speak or struggles with complex ideas, they deserve explanations they can grasp.

You might use pictures to show what’s coming next in the session or simple words to explain why you’re practicing something. Don’t just do things to people without telling them what’s happening.

Preferences

For example, if a young client tolerates stickers as rewards but clearly dislikes them, find something they actually enjoy.

Respecting choice and autonomy improves engagement. When someone prefers working in a quiet corner rather than the busy main room, honor that preference when possible; don’t force them into loud spaces because it’s easier for your schedule.

Privacy

You wouldn’t want someone watching you learn to use the toilet or discussing your personal challenges where strangers can hear. Neither do the people you work with.

For example, a teenage client learning hygiene skills deserves closed doors. A family discussing sensitive behaviors shouldn’t have you reviewing case notes on your laptop at a cafe where anyone can see your screen.

Values

What's "appropriate behavior" in one family or culture differs in another. One family might value their children speaking up and questioning adults. Another might prioritize respect through quiet obedience.

Your job isn’t pushing everyone toward one "correct" way of acting; it’s helping people succeed in their individual lives and communities.

Legal permission vs. willingness

Yes, guardians or family members sign consent forms. But when someone keeps saying no or showing you they don’t want to participate, that matters. You can’t ignore it because their guardian signed paperwork saying services are okay.

Dignity centers on power and respect. Even though you’re the professional with the treatment plan, the person receiving services deserves respect, information, and real input into what happens to them.

Personalized Care

Interventions should fit the individual, not the other way around. This means building treatment plans around what actually matters to each person: their interests, what motivates them, and how they learn best.

When someone loves building with blocks, those blocks become part of how you teach requesting skills. When someone finds music calming, you incorporate that into transitions between activities.

Empowerment

People should develop skills to advocate for themselves. This means teaching someone how to express what they need, make their preferences known, and participate actively in decisions about their own care.

When someone learns to say "I need a break" or "Can we do this differently?" and sees that communication produces results, they gain real influence over their own experience.

Why client dignity matters in ABA therapy practice

ABA works best when clients feel valued and understood, not managed.

Dignity improves:

Learning

Research shows that when you let people choose their own rewards, pick their work environment, and have some control over the process, they learn skills faster and have fewer behavior problems during sessions. 

Think about your own life. You’re more motivated to do hard things when you’re working toward something you actually want, in a place that feels comfortable, with some control over how it happens.

Trust

When you practice client dignity, clients become more confident in you and the therapy process. They follow through with your recommendations at home, at work, and in day-to-day life. 

But when clients or families feel you don’t respect their or their loved one’s dignity, they stop trusting you. They might finish sessions, but won’t practice at home. Eventually, they may terminate therapy without telling you the real reason why.

Reputation

The Behavior Analyst Certification Board (BACB) investigates complaints of violations of clients’ dignity in therapy. They can suspend or revoke certifications.

Common issues they investigate include using harsh procedures without good justification, failing to maintain informed consent, violating confidentiality, or using methods that a professional would consider disrespectful. 

Most people become behavior analysts because they want to help. When you violate someone’s dignity, you create discomfort or even harm.

HIPAA and client information protection

The Health Insurance Portability and Accountability Act (HIPAA) establishes how ABA therapy providers must handle client information. These regulations require strict standards for collecting, using, and sharing personal health details.

In practice, this means maintaining confidentiality, getting proper authorization before sharing information with others, and implementing security measures to prevent unauthorized access.

When you protect information according to HIPAA standards, you build the trust necessary for people to share sensitive details about their lives and challenges.

Following these legal requirements isn’t just about compliance; it’s foundational to creating safe therapeutic relationships where clients feel secure enough to be honest about what’s actually happening.

Important aspects of client dignity in ABA therapy

Important aspects of client dignity include the words staff use, the choices clients are given, how privacy is protected, and how goals are created. 

When these aspects are respected, clients feel safe, involved, and valued in their care.

Right to informed consent and choice of treatment

People receiving ABA services deserve complete information about what therapy involves. This means understanding proposed interventions, treatment objectives, possible outcomes, and any risks. They should feel comfortable asking questions until everything makes sense.

Beyond simply signing paperwork, true informed consent means practitioners explain things clearly enough that clients can genuinely participate in decisions about their care. When people understand their options, they gain autonomy over what happens to them.

This extends to active involvement throughout treatment. Clients should help shape their own therapy goals, choose between intervention approaches when options exist, and express preferences about how services are delivered.

ABA therapy providers who involve clients in these decisions (considering their values, priorities, and individual circumstances) create more engaged and invested participants in the therapeutic process.

Recognizing that each person brings different preferences and needs, this collaborative approach respects individuality while building meaningful partnerships between clients and providers.

Right to effective treatment

People deserve interventions that work, based on real evidence. This means staying current with research, picking methods proven to work for the specific challenge, and being ready to try a different approach when your data shows something isn’t working.

It also means not over-treating. If someone could meet their goals with 10 hours a week of therapy, don’t recommend 40 hours just because insurance will pay for it. Respect the client’s time and their right to participate in normal activities outside therapy.

Right to treatment by a competent provider

ABA therapy providers have the right education, training, and experience for the specific services they’re providing.

Don’t take cases outside your expertise. If issues come up that you’re not trained to handle, get consultation immediately or refer to a specialist.

Incompetent practice can cause real harm.

Right to dignity and respectful treatment

This includes everything discussed so far: privacy, autonomy, and person-centered approaches. It also means using language that fits the person’s age (don’t talk to adults or teenagers like you would to children):

• Use respectful language that matches individual preferences. While some prefer person-first language (‘person with autism’), others prefer identity-first (‘autistic person’). When possible, ask the individual or family what they prefer.
• Respect cultural and religious practices
• Give people privacy for personal tasks.
• Allow reasonable accommodations for sensory issues or communication preferences.
• Explain treatment processes and activities clearly. 

It also means how you talk about people. Discussing cases in public places, sharing information on social media (even without names), or describing behaviors in inappropriate ways, violates this right even if the individual never hears it.

Right to a therapeutic environment

People deserve services in places that are safe, properly supervised, and set up for learning.

When you’re working in someone’s home, and environmental challenges make learning hard, address them respectfully. In schools or clinics, the space should minimize distractions.

This also means not being unnecessarily restrictive. When someone can safely work in typical community settings, don’t keep them isolated in therapy rooms just because it’s easier for you.

Right to confidentiality

HIPAA, state laws, and the BACB Ethics Code all require you to protect client information. 

You can do this by: Storing records securely (encrypted files, locked cabinets), only discussing cases with people directly involved in treatment, getting proper authorization before sharing information with schools or other therapy providers, and being careful where you review documents or talk on the phone about client cases.

When you violate confidentiality, even by accident, you break trust. Clients share sensitive information because they trust you’ll protect it. 

Right to freedom from harm

Clients have the right to be safe during therapy. This means avoiding any method that could cause physical pain or emotional distress.

Before using restrictive strategies, your team should carefully weigh the risks and benefits and make sure there is proper clinical oversight.

A strategy might stop a behavior quickly, but make someone less confident or create fear over time. Some approaches get compliance but lead to anxiety or new challenging behaviors.

This is especially important for challenging behaviors such as self-injury or repetitive actions. Instead of only trying to stop the behavior, teams should look at why it happens and teach safer, more helpful skills.

The primary goal is to improve the client’s quality of life, not just change what they do.

How to maintain client dignity in ABA therapy practice

Maintaining dignity in daily ABA sessions involves how you speak, offer choices, respond to behavior, and document progress.

Here are practical ways to do it:

Explain what’s happening

Start each session with a quick overview of what you’re doing that day, even with nonverbal individuals or people who struggle with language.

Use visual schedules showing the session order. Explain why you’re taking data ("I’m writing this down so we can track what’s working"). Tell people what you’re doing during transitions ("We’re moving to the table now to practice writing").

When you introduce new programs, give age-appropriate explanations. Someone new to therapy might need "We’re going to practice asking for help, and you can earn break time."

Someone with more experience deserves more context: "I’ve noticed you struggle getting help when you need it at work, so we’re working on different ways to ask. Does that sound useful to you?"

After sessions, briefly review what you worked on and the progress you made. This helps people understand the point of individual activities.

Offer choices

Offer options for activity order ("Want to start with the matching task or the sorting activity?"), work location ("Should we practice at the table or on the floor?"), break timing ("Want your break now or after one more activity?"), and materials ("Which worksheet do you want to use?").

Even when the activity itself isn’t negotiable (for instance, when you need baseline data on a specific skill), elements around it can involve choice. You might say: "We need to practice these communication skills, but you can choose whether we use flashcards or the whiteboard."

Pay attention to preference patterns. When someone always picks the same reward, check whether it’s still actually rewarding or just a habit. When someone always picks the easiest option, the tasks might be too hard.

Watch for and respond to discomfort

People communicate through behavior, especially when they can’t use words. Turning away, responding less, demonstrating more repetitive behaviors, or asking for breaks are all communication signals.

When you see discomfort, pause and figure out what’s wrong. Is the task too challenging? Is the reward not motivating anymore? Is the person not feeling well? Is something in the environment bothering them?

Distinguish between productive struggle (someone working hard on a challenging task but still engaged) and dignity violations (someone who’s shut down, distressed, etc.). The first might need encouragement; the second needs you to stop and make a change.

Protect privacy appropriately

Physical privacy is especially important for personal care skills or discussing sensitive topics. Use closed doors, privacy screens, or separate rooms when needed.

When you’re working on personal care skills in someone’s home, consider who else is present and whether that setting provides appropriate privacy.

You must be careful about how you share information. Make sure no one can overhear sessions.

Digital privacy means password-protecting devices where you access client info, being careful about viewing session information in public places, and considering how best to store information. If parents or caregivers want session videos, set clear rules about who can watch them and how they’re stored.

Use age-appropriate language

How you talk reveals your attitudes. Giving over-the-top praise for basic tasks ("Amazing job sitting down!") is condescending. But using complex jargon with someone who has language processing challenges doesn’t respect their understanding level either.

Match your tone and words to the person’s developmental level and preferences. Some people like casual conversation; others prefer more formal interaction. Pay attention to how people respond to different communication styles and adjust accordingly.

Use person-first language: "person who has trouble with transitions" rather than "problem client." Describe specific behaviors rather than labeling the person (for example, "Sarah hit when asked to turn off the tablet," not "Sarah was aggressive").

Involve people in goal-setting

Directly ask clients what skills they want to improve. "What would make work easier for you?" "What’s something you wish you could do that’s hard right now?" Most people can identify things they find difficult or frustrating.

With nonverbal individuals, involve them through observation. What activities do they seek out? What skills would give them access to things they like but can’t do now? What frustrates them regularly?

Share goal explanations even when people don’t pick the goals themselves. For instance: "Your family noticed you have trouble when plans change, and that sometimes upsets you. We’re going to practice flexibility so those situations are less stressful."

Create a predictable structure

Unpredictability can create anxiety. Establish consistent routines for how sessions start (same greeting, same first activity), transitions (warnings before changes, consistent language), and endings (review the session, preview next time).

Use visual supports showing session structure, how long activities last, and upcoming changes. Timer apps showing remaining time can help people anticipate transitions.

When you need to change the typical structure, explain why and what will happen instead. You might say: "Usually we’d do this activity now, but you mentioned you have an appointment soon, so we’re doing a shorter task."

Address cultural values

Different cultures can have different ideas about appropriate eye contact, personal space, showing emotions, communication style, and age-appropriate independence. An intervention teaching "appropriate" social skills should reflect the person’s actual culture.

Ask clients or their families directly about values and practices that should shape interventions. "What social behaviors are important in your community?", or "Are there cultural or religious practices we should consider?", and "What does independence look like in your family?"

Be especially careful with goals around compliance and emotional expression. Some cultures value obedience; others prioritize questioning and independent thinking. Some encourage emotional restraint; others expect open expression.

Professional boundaries

Your relationship with clients should remain focused on therapeutic goals, not personal connection. This means keeping conversations centered on treatment progress, skill development, and session-related topics rather than drifting into personal territory.

Avoid situations where you have multiple roles with the same person; for instance, don’t provide therapy to a friend’s family member, hire clients’ parents for your practice, or socialize with families outside professional contexts.

Dual relationships create conflicts that compromise your clinical judgment and the client’s access to unbiased care.

When families try to engage you in personal matters unrelated to therapy, redirect gently but clearly back to professional topics. Professional distance isn’t coldness; it is a boundary that protects both you and the people you serve.

Putting client dignity into practice

Protecting client dignity requires more than good intentions; it needs systematic implementation through training, policies, and education.

These three elements work together. Trained staff implement clear policies while educated families hold everyone accountable, creating a system where dignity is protected at every level.

Train your team

Staff can’t protect rights they don’t understand. Training should cover what each right means in practice, not just in theory.

This means teaching your team how to recognize when someone’s showing discomfort, how to offer meaningful choices, when to pause and explain what’s happening, and how to handle information securely.

Don’t limit training to onboarding. Rights-focused practices need reinforcement through regular professional development, case discussions where ethical questions arise, and modeling from supervisors.

When your team sees leadership prioritizing dignity consistently, it becomes part of your practice culture rather than a compliance checkbox.

Create clear policies

Written policies translate principles into actionable standards. Your policies should specify exactly how your practice handles confidentiality, obtains consent, provides choice, protects privacy, and responds when rights are threatened.

Make these policies specific enough to guide real decisions. Instead of "respect client preferences," write "when a client refuses an activity, staff will pause, identify the reason for refusal, and modify the task or environment before proceeding."

Review policies annually and update them when gaps appear between what’s written and what actually happens.

Educate clients and families

People can’t exercise rights they don’t know they have. Provide clients and/or their families with clear information about what they should expect from your services that are not buried in consent forms but are accessible in easy formats they’ll actually read and understand.

Explain these rights during intake and revisit them periodically. Let clients and/or their families know how to raise concerns, what choices are available to them, and what information they can access.

When clients and their families understand their role as partners rather than passive recipients, they become active participants in protecting dignity.

Conclusion about client dignity in ABA therapy

Client dignity is built through how you communicate, how you collect and document client behavior data, which treatment goals you prioritize, and how you respond when people indicate discomfort.

Try to involve individuals and families more deeply in decisions. Create treatment plans together instead of presenting them for approval. Review progress as a team and ask clients or their families what they notice. Let clients and caregivers help shape what goals come next.

Good systems make this easier to do consistently. Tools like Passage Health support dignity by keeping documentation clear and secure, and allow safe and discreet data collection in real-world settings.

How ABA practice management software can help protect client dignity

Client dignity comes from caring, ethical decisions made by ABA therapy professionals. But the right tools make it easier to protect dignity.

The right tools can make it easier to protect client dignity by providing:

• Secure data storage: This keeps client information private and safe. HIPAA-compliant messaging allows teams to discuss sensitive cases without using personal texts or email. This protects confidentiality at all times.
• Transparency: Correctly providing relevant information to all appropriate and authorized people involved in a client’s care supports transparency. 
• Digital consent tracking: This makes sure that permissions stay up to date. Teams receive reminders when forms need review, which helps prevent changes to plans without proper approval.

Passage Health is an all-in-one ABA clinic and practice management software that was built with client dignity in mind.

Its mobile-first design allows discreet data collection in real-world settings for Registered Behavior Technicians (RBTs) and Board Certified Behavior Analysts (BCBAs) who often work in homes or schools.

The platform guarantees HIPAA-compliant document management and keeps information secure and accessible to authorized users. Secure document storage protects private information at all times.

These tools don’t replace clinical judgment. But they create a system that supports respectful, dignity-focused care every day.

Book a demo with Passage Health.

Frequently Asked Questions

What’s the difference between client dignity and client rights?

Client rights are specific protections guaranteed by ethics codes and laws, like the right to confidentiality or effective treatment.

Dignity is the bigger principle behind these rights: treating someone as a valuable human being deserving of respect. Rights make dignity enforceable.

How do you maintain dignity when using restrictive procedures?

Use the least restrictive intervention likely to work. Document clear reasons why less restrictive alternatives won’t work.

Get informed consent that specifically addresses risks and alternatives. Explain thoroughly to the person (when possible) what will happen and why.

Implement additional oversight and review more frequently.

What should you do when clients or caregivers request interventions that violate dignity?

When clients or caregivers request interventions that may violate dignity, you should have honest conversations about your concerns while respecting parental rights. Explain why certain approaches might not align with best practices or ethical requirements.

Suggest alternatives that address the same concerns. Document your recommendations and rationale.

If clients or caregivers insist on approaches you believe are unethical, consult with supervisors or consider whether you can provide services given the conflict.

How do you balance dignity with safety when it comes to challenging behavior?

To balance dignity with safety when it comes to challenging behavior, safety always comes first.

You can’t maintain dignity if someone is hurt or at risk of being hurt. But safety interventions should still use the least restrictive methods possible and maintain maximum respect.

Physical management requires specific training and should be brief and used only when necessary. You must consider the person’s emotional state. 

Does dignity mean always letting people refuse non-preferred activities?

No, dignity does not always mean letting people refuse non-preferred activities, but it does mean responding thoughtfully to refusal.

When someone refuses, try to find out why: is the task too hard, unclear, or genuinely disliked? Modify what you can (materials, environment, difficulty). Explain why the activity matters and when it will end. Offer choices around the activity, even if the core task isn’t negotiable.

References

Behavior Analyst Certification Board. (2024). Ethics Code for Behavior Analysts. Retrieved from https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-240830-a.pdf

Behavior Analyst Certification Board. (n.d.). Behavior Analyst Certification Board. Retrieved from https://www.bacb.com/

Buijsman, R., Begeer, S., Scheeren, A. M. (2023). “Autistic person” or “person with autism”? Person-first language preference in Dutch adults with autism and parents. Autism, 27(3). Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10074744/#section9-13623613221117914

Contreras, B. P., Hoffmann, A. N., Slocum, T. A. (2021). Ethical behavior analysis: Evidence-based practice as a framework for ethical decision making. Behavior Analysis in Practice, 15(2), 619–634. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9120282/#Sec22

Dunlap, G., dePerczel, M., Clarke, S., et al. (1994). Choice making to promote adaptive behavior for students with emotional and behavioral challenges. Journal of Applied Behavior Analysis, 27(3), 505–518. Retrieved from https://doi.org/10.1901/jaba.1994.27-505

Fong, E. H., Catagnus, R. M., Brodhead, M. et al. (2016). Developing the cultural awareness skills of behavior analysts. Behavior Analysis in Practice, 9(1), 84–94. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4788642/#Sec8

Rosen, M. L., & Laubepin, F. (2022). The effect of autonomy and choice on learner engagement in an online role-playing simulation. Conference paper, School of Public Health, University of Michigan–Ann Arbor. Retrieved from https://www.researchgate.net/publication/362456922_The_Effect_of_Autonomy_and_Choice_on_Learner_Engagement_in_an_Online_Role-Playing_Simulation

U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/index.html