Bacb Experience Form – Fill Out and Use This PDF

BACB Experience Standards – ver. 10/13/2017

EXPERIENCE STANDARDS

INTRODUCTION

This document contains all of the standards and forms for experience used to qualify for certification as a Board Certified Behavior Analyst® (BCBA®) or a Board Certified Assistant Behavior Analyst® (BCaBA®).

The BACB requires that the supervisor and supervisee review this entire document together and resolve any concerns before the experience begins. Both parties must also regularly review the BACB website, newsletters, and table of recent and upcoming changes to ensure that their experience complies with the version of the experience standards current at the time of completion of the experience requirement.

In addition to the standards, this document contains two forms for documenting experience used toward BACB certification.

1.The Experience Supervision Form: This form, or equivalent, must be completed at least once during each supervision period, throughout the duration of the experience. Both parties must retain a copy of every completed Experience Supervision Form.

2.The Experience Verification Form: This form should be completed at the conclusion of the experience.

If a supervisee has multiple experiences, one form for each experience must be completed. The original forms must bear the supervisor’s original signature and be unaltered (i.e., forms with white-out, other alterations, or photocopies will not be accepted). Note: The Experience Verification Form is updated periodically. Prior to submitting an application, supervisees must ensure that they are using the then- current version. Previous versions will not be accepted.

Initial exam applications should include Experience Verification Forms only. Do not submit the Experience

Supervision Forms unless specifically requested by the BACB.

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BACB Experience Standards – ver. 10/13/2017

APPROPRIATE SUPERVISION

REQUIRED PRE-EXPERIENCE TRAINING: Supervisees and supervisors must pass an online, competency- based training module on BACB experience standards prior to the onset of experience. The module is available via the BACB Gateway at www.BACB.com. Additional supervisor qualifications include an 8-hour supervision training which must also be completed before providing any supervision. Any experience obtained after March 31, 2015 will not be acceptable if either party had not met these requirements. Supervisors are responsible for ensuring their supervisees have completed the online module prior to providing supervision.

SUPERVISOR QUALIFICATIONS: During the experience period, the supervisor must be a BCBA or BCBA- D in good standing, be a licensed or registered psychologist certified by the American Board of Professional Psychology in Behavioral and Cognitive Psychology who was tested in Applied Behavior Analysis, or be an authorized supervisor who is only providing supervision in a Verified Experience. All supervisors must meet all of the supervisor qualifications stated in the previous section. Supervisors who hold BACB certification must also meet an ongoing supervision CEU requirement in order to continue providing supervision after meeting the initial supervisor requirements.

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 services. Also, see sections 1.0 and 5.0 of the Compliance Code.

NATURE OF SUPERVISION: The purpose of supervision is to improve and maintain the behavior-analytic,

professional, and ethical repertoires of the supervisee and facilitate the delivery of high-quality services to the supervisee’s clients. Effective behavior-analytic supervision includes:

•Development of performance expectations

•Observation, behavioral skills training, and delivery of performance feedback

•Modeling technical, professional, and ethical behavior

•Guiding behavioral case conceptualization, problem-solving, and decision-making repertoires

•Review of written materials (e.g., behavior programs, data sheets, reports)

•Oversight and evaluation of the effects of behavioral service delivery

•Ongoing evaluation of the effects of supervision

The supervisor must observe and provide feedback to the supervisee on his/her behavior-analytic activities with a client in the natural environment during each required supervisory period. In-person, on-site observation is preferred. However, this may be conducted via videoconferencing or similar means in lieu of the supervisor being physically present; synchronous (i.e., real-time) observation is strongly encouraged.

Structure. Supervision may be conducted in small groups for no more than half of the total supervised hours in each supervisory period. Small groups are interactive meetings in which 2-10 supervisees who share similar experiences participate in the supervision activities described above. The number of trainees in a group meeting may not exceed 10 at any time, regardless of the number of BCBAs in the meeting. If non-trainees are present, their presence must not inhibit discussion, and they may not participate. The amount of small-group supervision may not exceed the amount of individual supervision for any given supervisory period.

SUPERVISION CONTRACT: The supervisee and supervisor must develop and sign 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.

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The contract should:

•State the responsibilities of the supervisor and supervisee, including completion of the online experience training module by both the supervisor and supervisee as well as completion of the 8-hour supervision training by the supervisor; and

•Include a description of the appropriate activities and instructional objectives; and

•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 Compliance Code.

The supervisee and supervisor are responsible for retaining and providing to the BACB, if requested, a copy of the contractual agreement.

DOCUMENTATION OF ONGOING SUPERVISION: The supervisee and supervisor are responsible for collecting documentation on the Experience Supervision Form during each supervisory period. One form should

be completed within each supervisory period, ideally at each meeting. Backdated forms will not be accepted. The BACB reserves the right to request this documentation at any time following an individual’s application to

take the certification exam. This documentation should NOT be submitted with an exam application unless specifically requested by the BACB.

Supervisors are strongly encouraged to use the BACB Experience Supervision Form to document supervision. Alternate forms will be acceptable if they include all of the following elements:

•Date of each supervisory meeting

•Duration of each supervisory meeting

•Type of experience for the supervisory period (i.e., supervised independent fieldwork, practicum, intensive practicum)

•Format of each supervisory meeting (i.e., individual or small group)

•An evaluation of supervisee performance

•The total experience hours obtained during the supervisory period, with time spent in direct implementation of behavior-analytic programs separated from other activities

•The total individual and small-group supervision hours obtained during the supervisory period

•Date lines for supervisor and supervisee indicating when the form was completed & signed

•Signature lines for supervisor and supervisee

The supervisee and supervisor are responsible for retaining and providing to the BACB, if requested, copies of supervision documentation. Supervision documentation should be retained for at least 7 years from the date of the last supervision meeting.

All applicants for certification must submit documentation of their experience using the then-current version of the Experience Verification Form.

MULTIPLE SUPERVISORS AND/OR SETTINGS: It is permissible to utilize multiple supervisors and settings within a given time frame in order to meet these experience requirements. In such cases, all parties must

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take great care to ensure that the supervision contract includes all relevant parties and clearly defines all roles and responsibilities. In cases where multiple supervisors share responsibility for a supervisee’s experience, they

may jointly sign a single Experience Verification Form attesting to the experience as a whole.

APPROPRIATE EXPERIENCE

EXPERIENCE CATEGORIES: There are three experience categories available: Supervised Independent Fieldwork, Practicum, and Intensive Practicum. In Supervised Independent Fieldwork, supervisees are typically responsible for securing an appropriate experience placement and obtaining the necessary supervision. By contrast, Verified Experience (i.e., Practicum and Intensive Practicum) requires explicit oversight and involvement by a Verified Course Sequence (VCS); these may only be offered by VCSs and only after BACB approval of an application to offer these categories of experience. The tables below outline additional critical details in each category.

Supervised Independent Fieldwork

Accrual of Experience. For all categories, no fewer than 10 hours but no more than 30 hours, including supervision hours, may be accrued per week. Supervisees may accrue experience in only one category per supervisory period.

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Combination of Experience Categories. Supervisees may elect to accrue hours in a single category or may combine any 2 or 3 of the categories above to meet the experience requirement, with Practicum having 1½ times the temporal value of Supervised Independent Fieldwork, and Intensive Practicum having 2 times the temporal value of Supervised Independent Fieldwork.

ONSET OF EXPERIENCE: Supervisees may not start accumulating experience hours until they have completed all of the following:

•Started qualifying coursework (may begin accruing hours after attending first class meeting)

•Passed the Experience Standards Training Module

•Secured a qualified supervisor

DURATION OF EXPERIENCE: The start and end dates of the experience may not be more than five years apart.

CLIENTS: Any person for whom behavior-analytic services are appropriate may be a client. However, the supervisee may not be the client’s primary caretaker or be related to the client or their primary caretaker.

Supervisees must work with multiple clients during the experience period. Also, see the following relevant sections of the BACB Professional and Ethical Compliance Code for Behavior Analysts (Compliance Code): 1.06, 1.07, 2.0, 3.01, 3.04, 3.05, 4.05, 4.0, and 8.06.

ACTIVITIES: The supervisee’s primary focus should be on acquiring the skills necessary to demonstrate competence on each of the tasks on the relevant BCBA/BCaBA Task List and the skills necessary to interact effectively with consumers, supervisors, families, and others.

Supervisees are strongly encouraged to have multiple experiences (e.g., sites, populations) with multiple supervisors and from each of the areas of activity below:

•Conducting assessments related to the need for behavioral intervention (e.g., stimulus preference assessment, functional assessment, staff performance assessment) or for evaluating behavioral interventions.

•Designing, implementing, and systematically monitoring skill-acquisition and behavior-reduction programs.

•Writing behavior/treatment plans, progress summaries, clinical notes, transition summaries, and professional correspondence.

•Overseeing the implementation of behavior-analytic programs by others.

•Training others, designing behavioral systems, and performance management.

•Communicating and collaborating effectively with caregivers and other professionals.

•Other activities normally performed by a behavior analyst that are directly related to behavior analysis such as attending planning meetings regarding the behavior-analytic program and researching the literature that is relevant to current client programming.

Only behavior-analytic activities may be counted toward experience requirements. Non-behavior-analytic job duties may not be counted. Examples of activities that will not count as experience include:

•Attending meetings with little or no behavior-analytic content;

•Providing interventions that are not based in behavior analysis;

•Performing nonbehavioral administrative activities;

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•Service-delivery activities that are not behavior-analytic in nature (e.g., crisis management techniques, CPR);

•Completing nonbehavioral assessments (e.g., diagnostic assessments, intellectual assessments), paperwork, documentation, billing, or any other activities that are not directly related to behavior analysis.

•Attending professional conferences workshops, or university courses

•Didactic coursework assignments

Although such activities might be part of any employment or experience scenario, supervisors and supervisees must be sure to count only acceptable behavior-analytic activities toward these experience requirements. The supervisor will be responsible for determining if experience activities qualify.

Restricted Activities. The delivery of therapeutic and instructional procedures is restricted. No more than 50% of the total accrued experience hours may be restricted activities. This limitation applies to the supervisee’s

entire experience; not to individual supervisory periods. Please note that this restriction does not refer to all time spent working with clients (see unrestricted activities below).

Unrestricted Activities. Activities that are unrestricted are those that best exemplify the work of a behavior analyst who develops programs and systems for others to implement. Examples of unrestricted activities that are not limited by the 50% restriction include (but are not limited to) the following:

•Observation and data collection

•Observation of others (e.g., implementers, staff, parents)

•Training staff and caregivers on behavior-analytic programs or content

•Conducting assessments related to the need for behavioral intervention

•Meeting with clients about behavior-analytic programming and services

•Performing behavior-analytic assessments (e.g., functional analysis, stimulus preference assessment)

•Data graphing and analysis

•Researching the literature related to a specific behavior-analytic program

•Writing and revising behavior-analytic programs

CONTESTED EXPERIENCE

If a supervisee is unable to obtain the signature of a supervisor on the Experience Verification Form or disagrees with the information recorded on the form, the supervisee may submit a request for a Contested Experience by submitting a Contested Experience Form along with all of the following:

a.A copy of the supervisory contract; and

b.Copies of the signed Experience Supervision Forms completed during the experience; and

c.Emails, letters, or documentation of other correspondence between the supervisor and supervisee regarding the refusal to sign and/or from third parties who observed the supervisory relationship and are able to provide verifiable support of the contested experience; and

d.Documentation of any third-party actions related to the Contested Experience.

Supervisees also must provide the supervisor with copies of the documentation they are submitting to the BACB (unless the supervisor is unreachable) and must include proof of provision of this information to the supervisor (e.g., certified mail receipt along with a letter from the supervisee to the supervisor, forwarded e-mail correspondence). The BACB will attempt to contact the supervisor to confirm receipt of this information and to provide them with an opportunity to address this matter in writing. The supervisor will be asked to provide

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documentation of dissatisfaction/concerns regarding the experience previously provided to supervisees claiming a Contested Experience.

If the Contested Experience review results in a determination that is unfavorable to the supervisee, then the supervisee will have a right to appeal the determination. Information derived from the review of a Contested Experience may be used in an ethics review in the event that a Notice of Alleged Violation is filed related to the supervised experience. Appeals and disciplinary cases that may be characterized as Contested Experience may be subject to this process.

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BACB Experience Verification Form

SECTION A

Use one form per experience. Applicants may accrue only one type of experience at a time.

Applicant’s Name:

Date Applicant Completed the Experience Standards Training Module at www.BACB.com: _____________

Experience Hours Accumulated (complete all three lines):

A)Number of independent experience hours accumulated (excluding time spent with supervisor): _____

B)Number of supervision hours accumulated: _____

C)Total experience hours accumulated (add lines A and B): _____

Of the hours listed above, state the number spent in direct implementation of behavior-analytic programs: _____

Experience Type Obtained (check only one):

Supervised Independent Fieldwork

BACB Verified University Practicum (transcript must show passing grade in verified courses)

BACB Verified University Intensive Practicum (transcript must show passing grade in verified courses)

Experience Time-Frame:

Starting date (MM/DD/YYYY) ___ / ___ / _____ - Ending date (MM/DD/YYYY) ___ / ___ / _____

(Must NOT be prior to April 1, 2005) (Indicate specific date; do not write “present”)

Supervisor’s Name:

Date Supervisor Completed the Supervisor Training Requirements: ______________________

By signing below, I hereby attest that:

•The applicant completed the experience as specified in this policy document under my supervision and in compliance with all of the stated requirements.

•I am the responsible supervisor designated in the supervision contract with this supervisee.

•During the applicant’s experience I was:

Oa BACB authorized supervisor for Practicum or Intensive Practicum experience within VCS #

____________. I was authorized by the BACB on ___________; OR

Oa licensed or registered psychologist certified by the American Board of Professional Psychology in Behavioral and Cognitive Psychology who was tested in Applied Behavior Analysis, license/registration # _________________

Supervisor: By signing below, you attest that ALL of the information contained on this Experience

Verification Form is true and correct to the best of your knowledge.

Printed Name of Supervisor:

Signature:Date:

This document must bear the original signature of the supervisor. Photocopies, faxed, or emailed copies of this document will not be accepted. Original documents that have been altered (white-out, strike-through, etc.) will not be accepted. Incomplete documents will not be accepted.

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