Week 1. Supervision in the ABA Therapy Center

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Today’s main goal is to provide supervision for our therapists in the Center. Before describing what methods we use for supervision, please allow me to share the steps that lead to developing our Center and the rationale behind making the decision to work mainly in a center-based setting.

Why center-based?

My wonderful colleague, Krisztina Merényi established a non-profit organiztation (Kis Lépések Alapítvány) to support children with autism and their families while I spent more than four years in the UK working on my ABA MSc and collecting my independent fieldwork hours to be able to sit the BCBA exam. Combined efforts of practitioners in countries with no or little infrastructure of ABA often involve some of them moving abroad while others staying in the home country to establish the foundations of dissemination.

Thanks to the foundation, we have the possibility to apply for national and EU grants to support families. ABA in Hungary would be 100% self-funded without the support of such grants. It is still not much support, but we are trying our best to help as many families access services as possible. Kis Lépések Alapítvány (“Small Steps Foundation”, www.kislepesek.hu) opened the ABA Therapy and Methodology Center in Budapest in 2018. This is the only ABA Center in Hungary at the moment. Before opening the Center, we were all working in home settings, first as ABA therapists, then as consultants. We came across many challenges in home settings, such as families not being able to afford enough supervision, therapists lacking treatment fidelity, not collecting sufficient data, or, in some cases, not collecting data at all. This was one of the reasons why we started thinking about establishing an ABA center. We also felt that there was a need for a place where we can show what “good ABA” looks like. Another downside of home programs is that lacking treatment fidelity can strengthen misconceptions about our field. Long story short, we have come to the conclusion that we needed a place!

Our face-to-face supervision model

We know from the literature and our experiences that training and supervision are vital parts of reaching treatment fidelity goals. We began searching the literature for possible training models. It was obvious that our training will involve the steps of Behavioral Skills Training. I present the components of our therapists training before and after the COVID situation in one of my CEU courses.

As for supervision, we are trying to incorporate as much BCBA supervision as possible for our therapists working in the Center. It is not an easy job to develop an effective schedule, especially this year, as we did not have human and financial resources to apply for grants. This meant that we had to develop the most time efficient model possible.

Let’s get started!

So, what am I going to do today?

  1. I will observe one of our therapists (therapist 1) working with a child for one hour, while the other therapist (therapist 2) of the child observes the session, too.
  2. I will provide immediate feedback in a separate room for therapist 1 for 30 minutes, while therapist 2 will be staying with the child.
  3. Therapist 1 will try to implement the strategies discussed within our feedback session in the remaining 30 minutes.
  4. After the session, therapist 1, therapist 2, the lead therapist of the child and the BCBA (myself) will discuss the BCBA’s suggestions for the child’s tuition program.
  5. The BCBA will provide written feedback and goal setting for the next 3 months for therapist 1, one week before the supervision session the latest.
  6. This document will be reviewed with therapist 1 during a separate meeting within 1-2 weeks following the supervision session.

We go through these steps for each therapist in every 3 months. Therapists also receive feedback from their lead therapist on a daily basis and receive additional ongoing training from the BCBA during all-hands meetings and other training events.

Today is the first test of this new, very time efficient method. We will discuss as a team the experiences and effectiveness of this method and change components if needed.

As you can see, our model does not involve the BCBA being on site all the time. This is not only the questions of not having sufficient funds. We only have 4 BCBAs who live and practice in Hungary, so we all have several different types of jobs to juggle, to be able to make the most out of our dissemination efforts. We are trying our best in taking small, but efficient steps toward our goal.

Let us know what models you use in your center for BCBA supervision! I would love to read about your experiences.

References

Dixon, D. R., Burns, C. O., Granpeesheh, D., Amarasinghe, R., Powell, A., & Linstead, E. (2016). A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder. Behavior analysis in practice10(3), 307–312. https://doi.org/10.1007/s40617-016-0155-7

www.kislepesek.hu

Useful articles

Sellers, T. P., Valentino, A. L., Landon, T. J., & Aiello, S. (2019). Board Certified Behavior Analysts’ Supervisory Practices of Trainees: Survey Results and Recommendations. Behavior analysis in practice12(3), 536–546. https://doi.org/10.1007/s40617-019-00367-0

Sellers, T. P., Alai-Rosales, S., & MacDonald, R. P. (2016). Taking Full Responsibility: the Ethics of Supervision in Behavior Analytic Practice. Behavior analysis in practice9(4), 299–308. https://doi.org/10.1007/s40617-016-0144-x

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