Challenges of Supervision: lazy rats, shopping math, and the internet

Transcription

1 Challenges of Supervision: lazy rats, shopping math, and the internet Rob Holdsambeck, Ed.D. LCP BCBA-D Executive Director, CCBS Founder, Holdsambeck Behavioral Health Co-Founder, Anuenue Behavioral Health 2018 Buellton CA

2 3 quick suggestions for supervisors

3 1. Know your science and your history

4 2. Know your present

5 3. Read outside your field, nonfiction (faction)?

6 Something you know that bears repeating Ø SUPERVISOR QUALIFICATIONS: During the experience period, the supervisor must be a Board Certified Behavior Analyst or Board Certified Behavior Analyst-Doctoral in good standing. The supervisor may not be related to, subordinate to, or employed by the supervisee during the experience period. Employment does not include compensation received by the supervisor from the supervisee for supervision

7 Supervising newbies Ø For those on track for BCBA s supervision contracts are required AND a great idea Ø Getting them started on the right track is much easier than getting them back on track

8 SUPERVISION CONTRACT: The supervisee and supervisor must execute a written contract prior to the onset of the experience. The purpose of the contract is to protect all involved parties and align experience activities with the purpose of supervision described under Nature of Supervision (below). The contract should: State the responsibilities of the supervisor and supervisee; and

9 ! Include a description of the appropriate activities and instructional objectives; Include the objective and measurable circumstances under which the supervisor will sign the supervisee s Experience Verification Form when the experience has ended; and Delineate the consequences should the parties not adhere to their responsibilities (including proper termination of the relationship); and Include a statement requiring the supervisee to obtain written permission from the supervisee s on-site employer or manager when applicable; and Include an attestation that both parties will adhere to the BACB Guidelines for Responsible Conduct for Behavior Analysts and the BACB Disciplinary and Ethical Standards

10 Lessons from the internet- 1. Don t compare your life to other s FB posts

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12 Dr Bondy s FB

13 Dr. Twyman and me at HABA

14 This is what my pups always look like

15 How do we learn to lie so well?

16 Fast forward 20 years- music by Biz Markie

17 What else can you learn from internet searches? Ø Anti depressants are effective approx. 20% time Ø 40 % fewer depression searches in Honolulu than Chicago during the winter Ø Take a pill or move? Ø Autofill is also insightful. Is it normal to want to kill.. Ø My family

18 More lessons from the internet Ø 25 percent of HS seniors report they are in the top 1 percent Ø 90 percent of professors report they are in the top half of professors Ø Guess the autofill Why won t my boyfriend. Ø Have sex with me?

19 New Yorker (4/23/18)- Maddie Dai And just like that, Facebook is giving us ads for used cars, optometrists, and couples counselling.

20 Be cautious when data looks too good- a tale of a very fat rat

21 Not lazy, efficient

22 More lessons from the lab Employment interview Perils of group contingencies

23 Good book for supervisors

24 Ø The 70 s great debate Ø AKA Humanistic versus Behavioral TX s Ø They got autism wrong, as did some in clinical psychology.. But they understood some things about helping people change Ø Lessons from Humanistic Psychology

25 Prepare supervisees for what they aren t seeing Ø Do you care about us? Ø Do you know anything of value? (about my child or about how to change things) Ø Can t you just fix it? Or, would you stop trying to just fix it and listen to me? Ø How long will this take?

26 What coming to grips with the Dx feels like for many families Ø You MAY encounter denial/bargaining/anger emotional incontinence /depression OR acceptance (in any order) Ø You MAY encounter some pretty bad mythologies- cultural/pseudoscience Ø Also some pretty cool mythologies- shaping resilience

27 Things to listen for from supervisees Ø Families should like me Ø Unfair Ø Can t Ø How do they select, organize and interpret?

28 Keeping it real- lesson s from cognitive psychology Ø If you do your work correctly some people will not like you. Know your values and your insecurities. Ø Life is not always fair. We tend to complain when it is unfair against us. Ø Lots of irrational statements. I can t! He won t! There is no use! Ø Have them read Glasser s Reality Therapy and Who moved my cheese - Spencer Johnson

29 Good supervision establishes a viable (cross cultural) Tx model Ø Establish Rapport Ø Build hope Ø Set realistic expectations about the process and the outcomes- chaos Ø Reliable and Valid (important) targets Ø data, real data as often as possible! Ø FA before TX Ø More data Ø Continue/ change course/ move on via careful fading Ø we teach to the limits of our abilities- not theirs - A.D.-

30 active listening is hard for some of us

31 Good beginnings may lead to happy endings Ø Start in the beginning with clear expectations and clear boundaries (therapist does not equal friend) Ø Program for persistence and generalization Ø Careful fading Ø Inclusive environments and other social supports- trap it

32 Finding peace with saying I don t know. Ø Baffled by your clients? Ø Centuries of study=4% of the universe is made up of stuff we understand Ø Dark matter/dark energy/

33 Ø Lessons from Michael Ø Stay humble Ø Prepare your folks for anger

34 Standard 3 and predictions Ø (c) Behavior analysts recognize limits to the certainty with which judgments or predictions can be made about individuals.

35 Ø Precise measurement leads to more accurate short term predictions Ø It also means that you can make clinical decisions based upon what is really happening Ø It is not hard to do but it many clinicians don t Ø For example- how many tantrums is this??

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37 PLEASE teach fundamentals Ø The number of tantrums is dictated by the definition of when a tantrum starts and when it is over (movement cycle) Ø Think marriages/partnerships Ø You might also be that duration and intensity are more important for that individual Ø Teach them to attend to record (time) floors- and chart it- it can be fun- really

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39 How much ABA leads to how much change? The dilemma of prediction- Ø Chaos theory is the field of study in mathematics that studies the behavior of systems that are highly sensitive to initial conditions. Ø the present determines the future, but the approximate present does not approximately determine the future. Edward Lorenz 1972

40 Levels of certainty Ø The world of things Ø Mathematics Ø Physics Ø Engineering Ø Mechanics/plumbers (the people you call when things don t work) Ø The world of people Ø Scientists Ø Administrators/ Professors Ø Therapists/Parents/ teachers (the people who work most directly with our kids)

41 Not everyone understands math the same way

42 The world of mathematics has begun to speak to us Well not directly to us but thanks to two great books Chaos: Making a New Science, (Gleick, 1987) who made it comprehensible to the masses and Chaos Theory in the Social Sciences (Kiel & Elliot, 1997) who helped apply the theory to behavior, they were translated for us.. They even chose a word that we who live, love and work in autism understand- Chaos Trigger Warning some math follows.. (all math slides were downloaded from the SocietyforChaostheory.org)

43 Gleick, James. Chaos: Making a New Science. (1987). Penguin Books. New York, New York.

44 Data 1 RANDOM random x(n) = RND

45 Data 2 CHAOS Deterministic x(n+1) = 3.95 x(n) [1-x(n)]

46 CHAOS and predictions Properties Sensitivity to Initial Conditions nearly identical initial values very different final values

47 CHAOS Properties Bifurcations small change in a parameter one pattern another pattern

48 3 ways Chaos helps us understand behavior Ø Dealing with behaviors that look random but are really driven by basic formulas (deterministic)-a- B-C Ø Appreciating how a small change in one part of a system can radically effect the predicted outcomes ( butterfly effect) Ø Understanding that all people are unique (sensitive dependence on initial conditions)

49 Practical tips for navigating in Chaos Ø Precise measures of where you are now (behavioral baseline) and where you want to go (behavioral goals) are essential Ø Small changes can make important differences in progress (be the butterfly) Ø Focus more on the near term (short term predictions are more accurate and midcourse corrections are inevitable) Ø Don t predict long term outcomes in individual cases

50 Help supervisee s deal with these conflicts

51 Ethical codes help set privacy expectations Ø What to expect when you see a psychologist (privacy ala medicine, honesty) Ø What to expect when you encounter a board certified (or licensed) behavior analyst (honesty, privacy ala education?)

52 Privacy expectations of psychologists

53 Now that medical insurance has hit behavioral health. We have to transition from being educators to being health care providers (there s a HIPPA in the room)

54 When it is time to say goodbye Ø On average people worked at about 12 jobs in their careers- (Balance, 2017)-caveat internet data Ø Workers held an average of 5.5 jobs during the six-year period when they were years old. Ø Workers held an average of only 2.1 to 2.4 jobs during the four-year periods of their lives that they were 25 to 29, 30 to 34 and 35 to 39. Ø During the most established phase of many workers' careers, ages 40-48, workers held only an average of 2.4 jobs.

55 Ø The 5 most common reasons that workers changed jobs include: Ø Higher Pay Ø Relocation to a Different Geographic Area Ø Career Advancement Ø Choosing a Less Stressful Job Ø Escaping an Incompetent or Negative Boss

56 Professional exit reminder forms

57 Some closing thoughts on diversity Ø We all know that running a good program requires a level of consistency through supervision Ø However, science teaches us that surviving a changing environment requires diversity Ø Therefore, if you want to run a good program supervise well. If you want your program to survive, embrace diversity! Ø Let s look locally

58 VAFB (858 households) 76 %with kids under 18

59 In closing, we know it s there, let s shape better behavior