09. Ensuring Staff Competence Flashcards
Treatment Integrity
The degree to which a treatment plan is implemented as is written
Providing Good Quality Services
Significant clinical outcomes
The individual has acquired new skills
Challenging bx’s are reduced
Service providers and administrators are motivated and reinforced
The individual is motivated and reinforced
Behaviorally Anchored Rating Scale
Evaluation system that uses narrative description, incident reporting, and measurable ratings
Overseeing the Implementation of a Plan
The person who wrote the plan is involved in the supervisory/monitoring process.
They are most equipped
Overseeing Implementation (Things to consider…)
Your resources.
-Write a plan that can be carried out by your resources.
Staff Deployment.
-Where are your staff located? Can they be where they are needed?
Onsite presence of a supervisor.
-Frequent supervision ensures proper implementation.
Staff Absenteeism and Turnover.
-Although difficult to control, must be considered.
Ensuring Success and Support
a) Involve guardian and supportive staff in the creation of the plan for support.
b) Consider how the individual’s new skills will be reinforcing to family etc.
c) Will there be natural reinforcers
d) Determine what skills or bx’s the client should acquire to contact natural Sr+
e) Consider input from paraprofessionals as they have personal contact with the client
f) Collaborate with other professionals to achieve clinical outcomes
Ensuring Meaningful Activities
Ensuring that an environment has a lot of available meaningful activity options can help reduce challenging Bx.
Including Functional Skills in Treatment Plans
- Critical therapeutic component
- Without functional training, challenging Bx’s are likely to be continuous
- Should be systematically and frequently
Functional Skills Guidelines
1) Involves activities that someone else would have to do for an individual if the individual could not do the activities
2) The more frequently the individual is likely to perform a skill, the more functional the skill is to teach
3) Choose skills for which an individual can be paid to perform as part of a job
4) Choose skills that allows an individual to get something wanted or to get out of something unwanted without displaying challenging Bx’s
4 Essential Components of a Bx Support Plan
1) Behaviors: Specification of Bx’s for increase and Bx’s for decrease
2) Antecedents: should be clearly identified as they can aid stuff in prevention of Bx-evoking antecedents
3) Consequences: Description of what to do when target Bx occurs
4) Environmental Set-Ups: Setting up the environment to prevent or reduce challenging Bx. What should and should no be in place
Ongoing Documentation of Bx Services
Must start to provide documentation of behavioral services
Ethics Warning: Documentation
To know when Bx treatment will end with your client, you want to constantly be assessing the current levels of the target Bx’s to see if your data tells you that you have accomplished your goals
Ethics Warning: Supervision
- Must provide supervision for the Bx-charge agents from the start
- Need proper training, supervision, and safety precautions
- Take reasonable steps to see that staff perform services responsibly, competently, ethically
4 Ways to Create a Procedural Integrity System
1) Specify: clearly specify what staff must do to implement the plan
2) Train: Train staff on procedures using competency and performance-based strategies
3) Monitor: Routinely monitor staff performance
4) Reinforce: Reinforce correct performance
Competency-Based Training (For Staff)
The staff implementing Bx support plans and interventions are crucial to the outcome of the client’s success
Ethics Warning: Reinforcing Staff
Use positive reinforcement as frequently as you can on the Bx of the student/supervisee
Measuring Treatment Integrity
2 Methods a) Direct Observation b) Indirect Self-reports, Questionnaires, Behavior rating scales
How to Use Competency-Based Training for Mediators
1) A precise description of the skill to be taught
2) A written description of the skills to be taught (acts as permanent product)
3) A trainer demonstrates the skill in the closest approximation to the condition
4) Learning through video models
5) Opportunities to practice through role-play
6) Observe the individual performing the job (rehearsal)
7) A trainer providing immediate positive-minded performance feedback
8) Repeat the aforementioned process until mastery
Protocol for Providing Feedback
a) A positive empathetic statement
b) Identify skills performed correctly
c) Identify skills performed incorrectly
d) Specify how to change or improve performance problems
e) Allow individual to ask questions
f) Describe what should be done next
g) End with positive and supportive statement
Systematic Performance Monitoring
- How supervisors can ensure that their staff is carrying out the procedures as intended
- Involves systematic data collection in order to provide objective performance measurement. Staff will receive feedback more openly
- A way for supervisors to determine if the plan is working to help the client
Accomplishes 2 goals
1) Provides means for evaluating staff performance and program implementation
2) Exhibits a program’s effect on the individual’s target Bx
Performance Monitoring (Looking At…)
1) Knowledge of the target Bx
2) How environment is arranged
3) Understanding of antecedents
4) Use of consequences
5) An understanding of Bx’s to increase and staff response to these Bx’s
6) An understanding of Bx’s to decrease and staff response to these Bx’s
4 Ways to Effectively Monitor Staff Performance
1) I - Inform
- Inform staff key are being monitored and why
2) F - Friendly
- Be friendly, polite, and courteous to staff
3) O - Overt
- Monitor staff overtly as covert monitoring brings negative feelings
4) F - Feedback
- The feedback should be given to staff ASAP
Choice Measures
A tool given to employees to have them evaluate if they like how their employers are monitoring and supervising
Measuring Staff Performance (Data-Based)
1) Time-sampling: Brief Obx periods
2) Evaluate Data Collection: Correct procedure, daily, on time, etc.
3) Permanent Product: Bx measurement through permanent change in the environment, video recording
Staff Performance Data Measures…
- Rating Scales: scores for specific tasks for staffs responsibility
- Ranking: Least preferred method. Competitive, ill feeling
- Point Systems: Help to determine specific reinforcement and can be used to evaluate an individual’s progress over time
