Supporting Ethical Pre-Service Supervision: Review of a ...

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Supporting Ethical Pre-Service Supervision: Review of a Pilot

Project

ShawnP.QuigleyPhD,BCBA-DMelmarkPennsylvania

shawnquigley@melmark.org

•  JenniferRuane–DirectorofProfessionalDevelopment•  MaryJaneWeiss–SeniorDirectorofResearch

•  LighteningtheLoadFoundationgranttosupporttrainingdevelopment

Acknowledgements

•  ContextualVariables•  SupervisionexpectationsasestablishedbytheBACB•  Scopeofpracticeandcompetencerelatedtosupervisingothers•  Projectpurposeandmethods•  Initialoutcomesoftheproject•  Conclusionanddiscussion

Outline

ContextualVariablesofSupervision

•  Diener,McGee,andMiguel(2009)–Variablesoutsideandwithintheenvironmentaffectorganizationalandperformerbehavior

EnvironmentalVariables

199920002001200220032004200520062007200820092010201120122013201420152016201720182019

fCertificants

CumulativeNumberofBCBAandRBTCertificants

BACB,2019

uencyofViolatio

StandardandCodeNumbers

FrequencyofStandardandCodeViolations(2002-2018)

uencyofViolatio

StandardandCodeNumbers

FrequencyofStandardandCodeViolations(2002-2018)

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

fViolatio

CumulativeRecordofStandardandCodeViolations(2002-2018)

•  Manyorganizationsarechallengedwithneedingmorebehavioranalysts

•  Manyorganizationsarechallengedwithbehavioranalyststhathavelimitedprofessionalexperience

ContextualVariables

•  Manyorganizationsareattemptingtoaddresstheshortageofbehavioranalystsbygrowingtheirown

•  Universityworkindependent/fieldworkhoursatwork

•  Universityworkpartnership,butnofinancial/fieldworkhoursatwork

•  HopefullyretainBCBAsaftertraining

ContextualVariables

•  Challengeswithgrowingyourown

•  Time–supervisionrequirementscompetewithworktime

ContextualVariables

•  Time–supervisionrequirementscompetewithworktime•  Money–courseworkandsupervisionrequirementscost

ContextualVariables

•  Time–supervisionrequirementscompetewithworktime•  Money–courseworkandsupervisionrequirementscost•  Funderrequirements–certificationrequirementsmaynotmatchfunderrequirementscreatingcompetingprioritiesorlackoffunding

ContextualVariables

•  Time–supervisionrequirementscompetewithworktime•  Money–courseworkandsupervisionrequirementscost•  Funderrequirements–certificationrequirementsmaynotmatchfunderrequirementscreatingcompetingprioritiesorlackoffunding

•  Competition–Providerorganizationsandtrainingorganizationsarecompetingforthesameresources

ContextualVariables

BACBSupervisionExpectations

•  IdonotrepresenttheBACBoranyothercredentialingentity

•  ReachouttotheBACBforanyspecificquestionsaboutsupervisionrequirements

•  ProfessionalandEthicalComplianceCodeforBehaviorAnalysts(2014)

•  BCBA/BCaBATaskList(5thed.;2017)•  BACBNewsletter(October2017)•  SupervisorTrainingCurriculumOutline(2.0;2018)•  BCBAFieldworkRequirements(2019)

•  Globalethicalprinciples•  Relianceuponscientificknowledge/conceptuallysystematic•  Provideservices,teach,andconductresearchwithinscopeofcompetence•  Professionalrelationships(e.g.,discrimination)•  Clientrights•  Evaluatingoutcomes•  Workdocuments•  Interruptingordiscontinuingservices•  Assessment•  Promotinganethicalculture•  Researchrights

•  Specificethicalprinciples•  Professionalrelationships(e.g.,definedrole;contractualarrangement)•  Multiplerelationships(e.g.,avoid,inform,resolve)•  Exploitativerelationships(i.e.,togainadvantageorbenefit)•  Allof5.0

•  Competence•  Volume•  Delegation•  Effectiveness•  Feedback

•  5thEditionTaskList•  SectionI

•  Reasonsforsupervisionandrisksofpoorsupervision•  Clearperformanceexpectations•  Supervisiongoalsbaseduponneeds•  Competency-basedtraining•  Monitor,feedback,reinforcement•  Variablesaffectingpersonnelperformance•  Function-basedstrategies•  Evaluatesupervisioneffects

•  BACBNewsletterOctober2017•  Hours(i.e.,2000)•  Supervisionperiod(i.e.,1month)•  Supervisioncontacts(i.e.,2officeand2observations)

•  Monitoringthesuperviseesperformance•  Competency-basedtraining

•  Accountabilityofthesupervisor

•  Supervisorqualifications•  One-yearpostcertification

•  SupervisorTrainingCurriculum(2.0)•  Ongoingservices

•  Trainees•  CompliancewithBACBFieldworkStandards•  Evaluatetheeffectivenessofsupervision•  Incorporateethicsandprofessionaldevelopmentintosupervision

•  FieldworkRequirements–SupervisionRequirements•  Natureofsupervision

•  Monitor,observe,evaluate,behavioralskillstraining

•  Responsibilitiesofthesupervisor•  Demonstrate,ethics,competence,volume,evaluation,feedback,reinforcement

•  Multipleexperiences(differentsettingsandpopulations)andmultiplesupervisors

•  KeypointsofBACBExpectations•  Competence

•  ActivitiesalignedtotheTaskList

•  Evaluationofsuperviseeperformance

•  Evaluationofsupervisorperformance

•  Multiplesettingsandsupervisors

ScopeofPracticeandCompetence

•  Code5.01

•  Superviseonlywithinareasofdefinedcompetence

•  Howdoyouevaluateyoureducation,trainingandsupervisedexperienceinrelationtosupervisingothers?

•  Scopeofpractice–therangeofactivitiesinwhichmembersofaprofessionareauthorizedtoengage,byvirtueofholdingacredentialorlicense.Theactivitiesaredeterminedbyexternaloversightorganizations.

•  Scopeofcompetence–therangeofprofessionalactivitiesofaprofessionalataproficientlevel(i.e.,specificlevelofaccuracy,safety,andoutcome).Determinedbytheindividualprofessional.

•  Reasonssomeonemightpracticeoutsidescopeofcompetence

•  Demandforservicesishigh•  Assumptionofbeingbetterqualifiedthanotherprofessionals•  Financialreinforcers•  Inabilitytoidentifyscopeofcompetence•  Confusionofuniversallyapplicableprinciplesofthesciencewithuniversal

capacitytoapplytheprinciples•  “Behaviorisbehaviorisbehavior”

•  Potentialrisksofpracticingoutsidescopeofcompetence

•  Mayresultinpooroutcomes•  Mayincreasedriskofharmtoindividuals•  Deleteriouseffectsontheprofessional,andthefieldasawhole•  Riskofdisciplinaryaction•  Lossoffunding

•  Determiningscopeofcompetence

•  Code1.02indicatewedefineourcompetenceviaoureducation,training,andexperience.

•  Howdowejudgeoureducation,training,andexperiencetodetermineifwearecompetentinaparticulararea,skill,orprocesswithinthedefinedscopeofpracticeofbehavioranalysis?

•  Determiningscopeofcompetence

•  Askedtosupportanadultwithdepressivesymptoms

•  Askedtoevaluateappropriatenessofahomeplacementforateenresidinginaspecializedsextreatmentprogram

•  Askedtosupportanindividualwith“feedingneeds”

•  AskedtoprovideBCBAsupervisionforanPhDlevelpsychologistworkinginamentalhealthsetting

ProjectPurposeandMethods

•  Reducetheresourceburdenbyprovidingorganizedsupervisionmaterials

•  Increasethequalityofsupervisionofacrosssuperviseesbyprovidingorganizedsupervisionmaterials

•  Increasesupervisorsabilitytodeterminecompetencebyprovidingcompetencytools

•  Participants

•  9employeesmeetingcriteriatoprovideBCBAsupervision

•  18employeesmeetingcriteriatoreceiveBCBAsupervision

•  LearningSeries•  Aseriesofreadingsandactivitiesincontentareasandalignedwiththe4th

and5thEditionTaskList.Presentedin8to16modulestobecompletedweekly.

•  Amultiplechoiceexamusedinapre/postfashion

•  Materialstosupportactivitycompletion

•  TermsanddefinitionsforuseinaSAFMEDSformat

•  LearningSeries

•  Autism•  Behavioralgerontology•  Challengingbehavior•  Interdisciplinarycollaboration•  Organizationalbehaviormanagement•  Personneltraininganddevelopment

•  Scopeofcompetence•  Supervisorscompletethetestforeachlearningseries

•  Supervisorsaskedtoprovideevidenceofeducation,training,andexperience

•  SupervisorscompletetheCompetencyandConfidenceChecklist(Brodhead,Quigley,&Wylczynski,2018)

•  Supervisorsreviewinformationanddetermineifalearningseriesiswithintheirscopeofcompetence

•  Supervisorsdeliverthelearningseriestheyidentifyasfittingtheirscopeofcompetence

•  Dependentvariables•  Scopeofcompetence

•  Learningseriestestscore(i.e.,percentcorrect)•  Education,training,andexperiencerelatedtoalearningseries(i.e.,yes/noforany

documentation)•  ScopeofcompetencepertheCCC(i.e.,High,Med,andLow)•  Identifiedscopeofcompetenceforalearningseries(i.e.,yes/no)

•  Adherencetolearningseriesreadingsandactivities(i.e.,yes/nofor11areas)

•  Socialvaliditymeasure(i.e.,modifiedTARF;Likertscale1-7)•  Traineeperformancedata

•  Learningseriespre/posttest•  Learningseriesactivitiesperformance

57%-100%PooragreementonwhetherSAFMEDSchecksneededtooccuronweeksnotspecificallyidentifiedintheseries

•  Procedures•  Completelearningseriestests

•  Provideevidenceofeducation,training,andexperience

•  Determinescopeofcompetencebaseduponaboveinformation

•  CompleteTARF

•  Implementchosenlearningseries

•  Observesupervisionsessions

•  CompleteTARF

InitialProjectOutcomes

InitialProjectOutcomes–TestScores

Autism Beh.Ger. ChallengeBehavior

Interdisc.Collab.

OBM Training&Dev.

84% 57% 76% 84% 84% 56%

82% 55% 60% 78% 69% 66%

84% 62% 52% 82% 71% 64%

78% 62% 28% 84% 71% 70%

82% 56% 56% 84% 67% 67%

84% 57% 52% 92% 78% 73%

66% 52% 44% 82% 60% 48%

72% 44% 52% 84% 58% 64%

72% 56% 48% 86% 71% 48%

78% 56% 52% 84% 70% 62%

InitialProjectOutcomes–Education,Training,Exp

Interdisc.Collab.

OBM Training&Dev.

Yes Yes Yes Yes Yes Yes

Yes Yes No No No No

Yes No Yes Yes Yes Yes

Yes No Yes No No Yes

Yes No No No No No

Yes No Yes Yes No No

No No Yes No No No

88% 22% 77% 55% 44% 55%

InitialProjectOutcomes–OverallCompetency

Interdisc.Collab.

OBM Training&Dev.

High Med Low Low Med Low

High Low High High Med High

Med Low Med Med Med Med

Med Low Med Med Low Med

Med Low Med Med Med Med

High Low High High Med High

High Low High High Low Med

High Low Med Med Low Med

2.67 1.11 2.33 2.33 1.55 2.11

InitialProjectOutcomes–Self-IdentifiedCompetency

Interdisc.Collab.

OBM Training&Dev.

No No No No Yes No

Yes No No Yes Yes No

Yes No No Yes No Yes

Yes No No Yes Yes Yes

Yes No Yes No No No

Yes No Yes Yes No No

Yes No Yes Yes No Yes

88% 0% 55% 77% 55% 55%

InitialProjectOutcomes–All

Interdisc.Collab.

OBM Training&Dev.

Test 78% 56% 52% 84% 70% 62%CCC 2.67 1.11 2.33 2.33 1.55 2.11

E,T,&E 88% 22% 77% 55% 44% 55%Comp. 88% 0% 55% 77% 55% 55%

•  Rational–0%

•  Setagenda–74%

•  Checkedforarticlesummaryform–70%

•  SAFMEDStiming–22%

InitialProjectOutcomes–Observations

•  Followedlearningseries–65%

•  Feedbacktoolused–N/A

•  BST–N/A

•  Accurateinformation–91%

•  Appropriatevocalcommunication–100%

•  Appropriatenonvocalcommunication–100%

•  Professionalism–100%

MetCriteria DidnotMeetCriteria

AgendaArticleSummaryFormAccurateInformationVocalCommunicationNon-vocalCommunicationProfessionalism

RationaleSAFMEDSFollowlearningseriesFeedbacktoolBST

ConclusionsandDiscussion

•  Thepurposeoftheprojectwastoprovidesupervisionmaterialsthatwouldreduceburdensonthesupervisor,createauniformsupervisionprocessthatwouldincreaseconsistencyandqualityofsupervision,andsupportidentificationofscopeofcompetencewithinsupervision.

ConclusionandDiscussion

•  Useofatest,documentationofexperience,andtheCCCappearedtomatchself-identificationofcompetenceacrosscontentareas.

•  Observationdataindicatesthelearningserieshavenotbeenfollowedwithfidelity.Especiallythosecomponentsthatareperformancebased.

•  Thereisalackofdatatofurtherevaluatesocialvalidityofthelearningseriesandimpactofperformanceonsuperviseebehavior.

•  Thereisaneedforadditionalresourcestosupporttraining•  Kazemi,Rice,andAdzhyan(2018)FieldworkandSupervisionforBehavior

Analysts:AHandbook

•  Needadditionalresourcesthatprovidemorein-depthtrainingprotocolsinspecificcontentareas•  Comprehensivecurriculumregardingfunctionalbehaviorassessments

•  Researchthatbuildsuponspecifictrainingprocedures(e.g.,BST)andevaluatescurricula

•  Anecdotally,socialvalidityreportsindicateanexcitementforthelearningseriesandsupports.But,thereisaconcernregardingtheextraworkload.

•  Itwasworktocreateconductsupervisionandcreatematerials,butthatresponseeffortmighthavebeenmorepreferredthantheresponseeffortofaformalizedprogram

•  Balancebetweenthelearningseriesandtypicaljobduties

•  Fourcontactsamonth•  1groupsupervision•  1officemeetingreviewingacademiccontentoflearningseries•  2observationsthatwerealignedwithclientneedsinsteadofthelearning

seriesactivities

•  Thefocusisontheclient,notsuperviseelearningskillslistedontheTaskList

•  Isclinicalsupervision(i.e.,theneedsofclient)sufficientfortrainingTaskListitems?

•  Yesandno.

•  ActivitiesoftenalignwiththeTaskList,buttherearelimitedopportunitiestopracticeotherskillsontheTaskListortopracticeindifferentsettingsorwithdifferentpopulations.

•  AtraineethatisreallygreatatAutismearlyintervention

•  Atraineethatisreallygreatatassessingchallengingbehavioranddevelopingtechnicaldecelerationinterventions

•  Atraineethatisreallygreatatassessingemployeebehaviorandsystemsoforganizationalchange

•  Beingageneralistfirst,andaspecialistsecond

•  Identifyingareasofspecialty•  Specialtyarea(e.g.,feeding)•  Competency-basedskillsthatarespecifictothespecialtyarea•  Assessmentofthespecialtyskills•  Criteriaformaintainingcompetencyinthespecialtyarea

•  BehaviorAnalystCertificationBoard.(2014).Professionalandethicalcompliancecodeforbehavioranalysts.Littleton,CO:Author.

•  BehaviorAnalystCertificationBoard,(2017).BCBA/BCaBATaskList(5thed.).Littleton,CO:Author.

•  BehaviorAnalystCertificationBoardNewsletter.(October2017).Retrievedfromhttps://www.bacb.com/wp-content/uploads/BACB_Newsletter_101317.pdf

•  BehaviorAnalystCertificationBoard.(2018).Supervisortrainingcurriculumoutline(2.0).Littleton,CO:Author.

•  BehaviorAnalystCertificationBoard.(2019).BCBAfieldworkrequirements.Littleton,CO:Author.

References

•  BehaviorAnalystCertificationBoard.(2019).USemploymentdemandforbehavioranalysts(2010-2018).Littleton,CO:Author.

•  Diener,L.,McGee,H.,&Migel,C.(2009).Anintegratedapproachforconductingabehavioralsystemsanalysis.JournalofOrganizationalBehaviorManagement,29,108-135.

References

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