Yes. There was no need to keep the client in the store during the child’s loud tantrum.
| During supervision
| Role play more appropriate ways to teach and reinforce escape-maintained behavior
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not sure if this was in cleint's plan
| discuss situation
| client behavior plan training
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Yes, depending on the client's programming this method of practicing coping skills was likely not appropriate and resulted in injury
| immediate written
| ethics
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Yes all
| Immediately or as soon as possible
| Discussing client sensitivities and tolerance, as well as engaging the client in unnecessary aversive situations.
|
Yes - teaching a new skill (in this instance coping skills) in a community/public setting where not only is the client's safety compromised, but his/her dignity is also at stake. Both of these issues raise ethical concerns.
| As soon as all staff and clients are safe - back in the home or school or clinic setting - is best
| Teaching coping skills in a real-time crisis is potentially dangerous, therefore training the trainee to teach the client to use functional communication - such as request to leave the setting - would be most effective. In addition, advising the supervisee to teach the client coping mechanisms under controlled conditions and in a private setting would improve the supervises performance as well as benefit the client.
|
| | To improve the supervisee’s performance, additional training should focus on addressing both technical and interpersonal skills to ensure they are meeting the professional standards expected in the role. Here are some areas for potential training:
1. Ethics and Professional Boundaries:
Why: It’s essential for behavior analysts, including BCaBAs and RBTs, to maintain professional boundaries with clients and stakeholders. Ethical training can address issues related to dual relationships, confidentiality, and maintaining appropriate professional conduct.
Training Topics:
The BACB Ethics Code and its application to everyday practice.
Understanding and maintaining professional boundaries in various settings (e.g., with clients, caregivers, other professionals).
Handling situations like receiving personal requests from clients or engaging with clients in non-treatment settings.
Reporting ethical violations and maintaining confidentiality in different contexts.
2. Supervision and Communication Skills:
Why: Since this supervisee might have a tendency to treat direct care staff more like peers, training on effective supervision, leadership, and clear communication can help reinforce professionalism and authority in supervision.
Training Topics:
Techniques for providing clear, actionable feedback to direct care staff and other supervisees.
Managing power dynamics and maintaining professionalism in supervisory relationships.
Communication strategies for addressing both performance issues and positive feedback in a constructive manner.
Establishing and maintaining a respectful supervisor-supervisee relationship while balancing support and accountability.
3. Behavioral Intervention Design and Implementation:
Why: Since the supervisee is using specific techniques (e.g., escape extinction) in their plans, it’s important to ensure they are choosing the most appropriate interventions based on the client’s individual needs and using techniques in an ethical and effective manner.
Training Topics:
Review of different behavioral interventions and their applications (e.g., reinforcement strategies, antecedent interventions, etc.).
Understanding the principles of behavior change and the ethical considerations involved in choosing interventions.
Adjusting interventions based on client progress and responsiveness (i.e., ensuring they are individualized and flexible).
Data collection and analysis to measure the effectiveness of interventions.
4. Conflict Resolution and Problem-Solving:
Why: If the supervisee struggles with addressing challenging situations, such as when they are unsure about how to respond to difficult interactions (e.g., receiving inappropriate requests from clients or engaging in boundary-pushing behavior), targeted conflict resolution training can be valuable.
Training Topics:
Techniques for managing and resolving conflicts with clients, caregivers, and other professionals.
Decision-making models to guide ethical and professional responses to difficult situations.
Role-playing exercises to practice handling boundary issues or complex scenarios in real time.
5. Time Management and Organization:
Why: If the supervisee struggles with scheduling or staying organized (e.g., rescheduling supervision sessions), training in these areas can improve their overall effectiveness and reliability.
Training Topics:
Time management strategies to balance direct service delivery, supervision, and other responsibilities.
Tools for organizing treatment plans, client data, and supervision documentation.
Prioritization of tasks and setting clear expectations with clients and other team members.
6. Cultural Competence and Diversity:
Why: As a supervisor, ensuring cultural sensitivity in the application of interventions and in relationships with clients and their families is crucial. Understanding the cultural and personal backgrounds of clients can improve the relevance and effectiveness of interventions.
Training Topics:
Cultural competence in working with diverse families and communities.
How to approach treatment plans while being sensitive to cultural values and norms.
Building rapport and trust with clients from various cultural backgrounds.
7. Data Collection and Documentation:
Why: Accuracy in data collection and documentation is critical for making data-driven decisions and ensuring legal and ethical standards are met. If the supervisee is making errors in this area, focused training is needed.
Training Topics:
Proper data collection methods and techniques, including the use of different types of measurements (e.g., frequency, duration, intervals).
Documentation standards for treatment plans, session notes, and progress reports.
Reviewing and analyzing data to adjust interventions based on client progress.
8. Behavioral Teaching Strategies:
Why: For a BCaBA, ensuring that the supervisee knows how to teach new skills effectively to clients is essential. This could include behavioral skills training (BST) or using prompting and fading strategies.
Training Topics:
Teaching new behaviors using discrete trial teaching (DTT) or naturalistic teaching strategies.
The use of prompting and fading procedures to ensure clients can generalize skills.
Incorporating errorless learning and reinforcement into teaching sessions.
9. Self-Reflection and Professional Development:
Why: Encouraging self-awareness and ongoing development helps ensure the supervisee continues to grow as a professional and takes responsibility for their practice.
Training Topics:
Reflective practice strategies to assess personal strengths and areas for growth.
Setting goals for professional development and seeking ongoing learning opportunities.
Supervisory feedback incorporation and using constructive criticism for self-improvement.
Methods for Providing the Training:
Workshops or In-person Training: Host group training sessions for more generalized topics, such as ethics or supervision.
One-on-One Mentorship: Provide individualized guidance or mentorship in areas where the supervisee may need extra attention.
Role-playing and Simulations: Use real-life scenarios to practice applying skills, especially for complex ethical dilemmas or supervision-related issues.
Online Learning Modules: Offer flexibility for the supervisee to engage in self-paced learning for specific topics (e.g., data collection or cultural competence).
Case Studies and Group Discussions: Encourage discussions about relevant cases to deepen understanding of complex issues.
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yes
| I'd follow up at a supervision meeting about working on the skill in a controlled setting prior to working through it in the community
| Contriving situations
|
Depends if this was within the scope of competence of the trainee.
| Immediately after things have stabilized.
| |
ethics and client's treatment program
| Immediately. There should be a mastery criteria on de-escalation procedures prior to practicing in a new/public environment.
| skill generalization
|
yes. The client was not in a safe place to experiment with practicing coping skills. Was this location approved for training in the treatment plan?
| ASAP. In person
| The supervisor should review the BIP and be taught to consider the safety of the client and the supervisee
|
It was not problematic in relation to ethics as they sought back-up and transitioned the client to the a safe space as long as they are following the bip
| following deescalation supervisor can provide feedback by reviewing the plan and reviewing practice situations.
| deescalation training, used of antecedent strategies
|
This response was not problematic because the staff took the steps of reaching out for help and stopping when the client did not comply with transitioning out followed by transitioning to a safer space.
| supervisor can provide reinforcement for follow up, seeking assistance and trying to keep the client safe.
| scenario practice, review of BIP, blocking and escalation training
|
esclating behavior without the proper training
| RBT needs more supervision regarding coping skills
| coping skills
|
yes
| immediately
| crisis intervention, antecedent management, protocol/data based decision making
|
Yes, this appears to be outside of the client's treatment program.
| The supervisor would provide feedback ASAP about this scenario. While it might be a goal for the client to utilize coping skills, practicing in a setting that could have external factors was really unsafe. The supervisor should continue to review the clients plan and the ethics code. The trainee should have utilized crisis management before the escalation continued to
| ongoing review of the treatment plan and safety
|
Yes, the provider should have ensured the child has appropriate prerequisite skills before applying them in such an environment. Preferably the child should have been able to escape from environment until deescalated, then the provider could practice coping skills until mastered in contrived situations, then worked on in the natural environment with appropriate staffing and a bcba there to assist and ensure safety
| First discuss the situation, provide feedback, check for understanding, role play or discuss future scenarios
| |
Yes, the client should have been removed from the setting
| Immediately
| De-escalation techniques
|
cc
| vv
| v
|
