1. Identifying Your Scope of Competence in Autism Treatment
Brodhead, Cox, and Quigley (2018)

2. Chapter Overview
Understanding the need to practice within a scope of competence
Scope of competence within scope of practice
Identifying your own scope of competence
How to broaden your scope of competence
When to seek additional training and when to refer a client
A need for an honest evaluation

3. Understanding the Need to Practice Within a Scope of Competence

4. Understanding the Need
The science of behavior analysis is applicable to many populations, settings, and problems
Geriatrics
Organizations
Workplace safety
Substance abuse and misuse
Writer’s block
Landmine detection
The robust findings may support the conviction of some behavior analysts that their training relative to the principles of behavior is universally applicable

5. Understanding the Need
Although the science of behavior analysis has demonstrated success across many populations, settings, and problems, it does not indicate all behavior analysts are adequately trained to universally apply the principles.
Behavior analysts are expected to only practice within their scope of competence.

6. Understanding the Need
Three possible negative outcomes of practicing outside your scope of competence
Waste of treatment time and resources
Misuse or misapplication of behavior analysis
Impacted ability to continue to practice as a behavior analyst

7. Scope of Competence Within Scope of Practice

8. Scope of Competence Within Scope of Practice
Defined at the level of the profession
The range of activities in which members of a profession may be authorized to engage in by virtue of holding a credential or license
The range of activities might be defined by a credentialing body, certifying agency, or licensing laws
These entities might define a professions’ scope of practice differently, even in conflict with each other

9. Scope of Competence Within Scope of Practice
Allows identification of individuals who have met minimum competencies to engage in a range of activities
Funders and consumers of helping professions rely upon scope of practice to target outcomes and increase safety

10. Scope of Competence Within Scope of Practice
Defined at the level of the individual professional
The professional activities, within the professions’ scope of practice, the individual professional is competent to perform
It is defined by education, clinical training (e.g., practicum, internship), and supervised experience (e.g., number of successful cases across different settings, people, and clinical needs)

11. Scope of Competence Within Scope of Practice

12. Identifying Your Own Scope of Competence

13. Identifying Your Own Scope of Competence
The BACB Code (i.e., 1.02) and licensure laws, where applicable, indicate a behavior analyst must practice within their scope of competence
Many experiences are involved in the process of establishing one’s scope of competence. Three relevant areas are:
Coursework
Setting
Supervision

15. Identifying Your Own Scope of Competence
Coursework
Settings
Supervision

16. Identifying Your Own Scope of Competence
Coursework
Although all behavior analysts are required to complete coursework in the same content areas, the content can be presented in different contexts, which further shapes understanding
Assessment might be presented in the context of feeding disorders, severe and chronic challenging behavior, or organizational behavior management
Courses within a special education program will likely vary from courses presented in a psychology program or a stand-alone behavior analysis program
Settings
Supervision

17. Identifying Your Own Scope of Competence
Coursework
Settings
Setting specific training can alter a professional’s scope of competence.
Experience in a public-school setting is likely to result in awareness of state and federal laws unique to that setting. Whereas an individual working in a hospital program is more likely to learn about the medical model and contingencies selecting behavior in that setting.
Development of autism intervention is affected by setting also. A center-based program might focus on smaller group instruction with lower student-to-instructor ratios whereas a public- school setting might focus on classroom and school wide behavior change programs
Supervision

18. Identifying Your Own Scope of Competence
Coursework
Settings
Supervision
Although the BACB has a set standard of supervisor and supervision expectations, it does not guarantee an equal experience within or between supervisors
There is a distinction between supervision skills and clinical skills. Although a supervisor might have an awareness of the application of relational frame theory to individuals with autism and incorporate the information into office supervision, he may not be able to provide robust clinical opportunities and oversight

19. Identifying Your Own Scope of Competence
Three questions to analyze personal scope of competence. A discussion with a trusted colleague regarding these questions can also be useful.
What populations, specific behavioral topographies, and assessment / intervention procedures were covered in depth in my graduate coursework?
There is a difference between one unit of content within a course (e.g., two or three weeks of assessment within an introductory class) and entire course covering the same content (e.g., Behavioral Assessment and Treatment)

20. Identifying Your Own Scope of Competence
Three questions to analyze personal scope of competence
What populations and specific behavioral topographies have I successfully implemented assessment / intervention procedures under the supervision of a competent BCBA?
Although topographies might share similar functions, some topographies present unique challenges for assessment and treatment. The assessment of verbal behavior is uniquely different from self-injury, although both rely on functional assessment processes

21. Identifying Your Own Scope of Competence
Three questions to analyze personal scope of competence
What populations, specific behavioral topographies have I successfully and independently implemented assessment / intervention procedures with in a clinical setting?
This question emphasizes an ability to practice independently, achieve desirable outcomes, and minimize risk for the individual

22. How to Broaden Your Scope of Competence

23. How to Broaden Your Scope of Competence
Recognize that you need to broaden your competence
Find a qualified supervisor with extensive experience within the particular content area
Outline the skills and timeline for completion
Sign a contract with the supervisor
LeBlanc, Heinicke, and Baker (2009) also suggest contacting relevant literature and professional groups, and pursuing additional certifications and credentials

24. When to Seek Additional Training and When to Refer a Client

25. Additional Training and Referring Clients
Behavior analysts must make decisions about when to seek additional training or when to refer a client to another professional. This decision can be aided by answering two questions.
How much risk is there for the individual and others while seeking training?
What is the timeframe for the training that will lead to benefits for the individual?

26. Additional Training and Referring Clients
Scenarios that present minimal risk and shorter times for benefit can likely be solved through training to increase scope of competence
Scenarios that present moderate to high risk and longer times for benefit should be solved through referral to a qualified professional
An awareness of one’s evolving scope of competence can minimize these types of situations from the onset

27. A Need for an Honest Evaluation

28. A Need for an Honest Evaluation
Accepting clients outside of one’s scope of competence is a complex ethical issue
An honest evaluation of your individual skill set and the overall strengths / weakness of your employer are important

29. A Need for an Honest Evaluation
You should have an awareness of the overall strengths / weaknesses of other providers in your region to facilitate client referrals. This information should be objective.
Establish cooperative and collaborative relationships with other providers in your region

30. A Need for an Honest Evaluation
Sometimes you are the best option for the client even though it is still out of your scope of competence
Code 1.02b indicates you obtain training prior to treatment.
Section 2.0 indicates a responsibility to operate in the best interest of the client
There might be situations which create conflict between these obligations