| Was this response problematic with regard to ethics, professionalism, or the client’s treatment program? | When/how might feedback be delivered by the supervisor? | What types of additional training might improve this supervisee's performance? |
|---|---|---|
no | Review treatment | Review other possbile scenerios |
Yes, it is problematic, and leads to an escalation of behaviors. | Immediately, at the first opportunity the supervisor should discuss/suggest alternatives to forcing the client to stay in an environment that is clearly unpleasant for that client. | Review the particular client's crisis management plan. Also teach and model alternatives to restricting client to unpleasant setting. Possible also implementing functional communication training to teach client to appropriately request to leave an area. |
It depends- if this client has a history of using coping skills, then it may have been appropriate to practice. However, if coping skills are new, this is an ethical concern because the client began showing SIB as well as the professional concern because the trainee was out of his area of competence and unable to escort the client, leading to greater escalation and possible loss of dignity. | Once everyone is safe and calm/session is over. Supervisor should use problem solving to talk through scenario with trainee and determine other possible options. | review crisis plan |
3.01 RBTs only practice under the close, ongoing supervision of a qualified supervisor and 3.02 RBTs must be competent in the areas in which they provide behavior technician services. What was the protocol in the behavior treatment plan surrounding loud sounds and tantrum behavior in the community setting? Was this something that was practiced before going out into the community? It also appears that this RBT did not have the proper training and oversight to protect this client or themselves in this situation. | The feedback should be delivered immediately, and they should step into the situation. | Antecedent behavioral strategies, such as choice giving and crisis intervention training. |
Problematic in regards to the clients treatment program | The supervisor would give examples of the ethics code violation , the rbt task list, and role play the situation | Task list adherence, ethics code, appropriate client actions/programming changes |
Yes. The trainee attempts to practice skills that have not been generalized in any way to the community, and may not have been mastered in a learning environment. | Feedback can be delivered immediately to help calm the client if feasible, but if not, during the next supervision session, retraining can take place. | Generalization techniques, dealing with difficult situations, dealing with escalating behavior |
Professionalism and ethics. The individual should not have been forced to remain in a situation that could knowingly escalate or cause behaviors. The individual has now had a public behavior and outburst of his own. There are other opportunities to practice coping skills without public exposure. | The supervisor should communicate to the RBT that public outings are not appropriate locations to teach potential high risk behavior coping skills. Scenarios could have escalated worse causing harm to the client or others. | Training on skills base training, HIPPA, self-injurious behavior. |
If working on coping skills was part of the clients treatment plan then it is not problematic. If that was not part of the plan then yes | At the next supervision meeting the supervisor can address how to handle this in a public setting and the conditions of the environment | modeling or direction with the supervisor present |
yes | as soon as possible, immediately if BCBA is present | training on who supervisee is authorized to work with and liability issues |
Yes, because the trainee used a training opportunity not in the behavior plan. | Training should include practicing different scenarios the trainee might face during community outings. | Additional training should include discussing the importance of staying within the interventions. |
Yes | Recognizing the potential for dangerous escalatory responses | Reminders |
Yes - professionalism and treatment outcome. If going into outings, we should plan for potential events that may occur and have strategies in place of how best to respond. | When the next opportunity to review the situation occurs. Preferably as soon as the situation is de-escalated and the client and staff members are safe. | Reviewing client treatment plan, roleplaying scenarios |
The response was problematic with regards to ethics. There are extraneous variables in the community setting and the trainee should only practice coping skills in that unfamiliar environment if they received proper training related to that environment. | Feedback should be delivered by the supervisor immediately. | Additional training related using unfamiliar interventions and/or familiar interventions in an unfamiliar environment should be addressed. Mitigating risk of harm to the client in an unfamiliar environment should also be addressed. |
yes. the client escalated in a community setting and dignity was not protected | before the next session during a supervision meeting | reviewing the treatment plan, adaptive protocols |
Yes the trainee uses force to move the client | promptly and immediately | BST using a dra to allow the client to mand for their needs |
I do not believe so; as long as coping skills are a target that are being worked on. If they took it upon themselves to try this then yes. | Afterwards | When is the best time and place to practice these skills and do you have reinforcement/back up ready to go |
yes | ||
Yes, the trainer allowed for the client behaviors to escalate in public and the clients privacy was compromised | Emedietly | Responding to precursors behaviors |
yes as unplanned and therefore not properly risk assessed with regard to the safety of the individual or members of the public | immediately after - incorporate feedback in debrief after and revisit at supervision session | |
having additional support with you if these behaviors are so severe so you don't have to wait for help. | Face to face | BST |
no | no | no |
Should've been primed about potential behaviors and BIP | Prime behaviors and BIP | Ask about beh and BIP |
Yes the client did not remove the client from a potentially dangerous situation according to their plan | Immediately supervisor should discuss proper intervention in the natural environment and when it is better to remove the client from that situation to avoid self injurious behaviors | How to react in vivo if there is a new sd that causes the client to react in behavior escalation or injury |
no | immediately after session of what to do better next time | training on antecedent strategies and common antecedents for the client |
The result was problematic but without all of the information regarding the situation the initial decision to stay in the store may have been the right choice. The team should review how community outings should be staffed moving forward and possibly changing treatment goals. | There should be a team meeting as soon as possible after the event to discuss all aspects of what happened and how future situations should be handled. By keeping the client as safe as possible and activating back-up staff the supervisee did handle the situation correctly once it escalated. | Supervised community outings with the client to better develop achievable short term goals and procedures. |
| Was this response problematic with regard to ethics, professionalism, or the client’s treatment program? | When/how might feedback be delivered by the supervisor? | What types of additional training might improve this supervisee's performance? |
