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A Call for Discussion About Scope of Competence in Behavior
Analysis
Matthew T. Brodhead, 1 Shawn P. Quigley,2 and Susan M. Wilczynski3
Author information Copyright and License information PMC Disclaimer
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Abstract
The field of behavior analysis has defined its scope of practice through
credentialing and licensure efforts. However, scope of competence in
behavior analysis has received little discussion. Scope of competence
refers to activities that the individual practitioner can perform at a
certain criterion level (e.g., the functional analysis is conducted
accurately and safely, a skill acquisition program includes critical
program components and establishes accurate stimulus control). Given
the successful efforts of behavior analysts in growth and recognition of
the field, it is time for a robust conversation about scope of competence
for the field of behavior analysis. This discussion can clarify how
behavior analysts self-evaluate their own scope of competence and how
they might expand their scope of competence if the needs of consumers
require practitioners to expand into new areas.
Keywords: Behavior analysis, Ethics, Scope of competence, Scope of
practice
The field of behavior analysis is growing at a rapid pace (Deochand &
Fuqua, 2016). According to a recent market analysis conducted by
Burning Glass Technologies (2015), consumer demand for behavior
analysts doubled between 2012 and 2014 alone. Furthermore, the
number of professionals credentialed by the Behavior Analyst
Certification Board (BACB) “tracks closely with demand” (Burning Glass
Technologies, 2015, p. 2), meaning more and more professionals are
pursuing, and subsequently obtaining, a credential that defines the
behavior-analytic scope of practice.
The adoption of licensure laws, credentialing efforts of the BACB, and
development of the BACB Task List represent decades of focused effort
and are well described in the behavior-analytic literature (e.g., Carr &
Nosik, 2017; Johnston, Carr, & Mellichamp, 2017; Johnston, Mellichamp,
Shook, & Carr, 2014; Moore & Shook, 2001; Shook, 1993, 2005; Shook &
Favell, 2008; Shook, Hartsfield, & Hemingway, 1995; Starin, Hemingway,
& Hartsfield, 1993). The BACB Task List and state licensure laws
describe the scope of practice in which credentialed and/or licensed
behavior analysts may engage. Licensure of behavior-analytic practice in
26 states (Johnston et al., 2017; see Green & Johnston, 2009a, 2009b, for
more information) not only helps to define scope of practice but also
provides legitimacy for behavior analysis as a profession.1
In contrast to scope of practice, scope of competence has received little
formal attention in behavior-analytic scholarship. Competence has been
discussed in the literature as it relates to the requirements for specific
credentials, such as certification and licensure (e.g., Johnston et al., 2014;
Moore & Shook, 2001; Shook, 1993; Shook et al., 1995). Competence
refers to accomplishing a task with a specific level of performance that is
deemed to meet a certain criterion. Given the successful efforts of
behavior analysts in affecting growth, policy, and recognition of the field
(see Johnston et al., 2017), a discussion about scope of competence, with
subsequent action, may be the next step for the rapidly growing and
maturing field of behavior analysis.
The purpose of this article is to initiate a discussion of scope of
competence. First, scope of competence is defined and differentiated
from scope of practice. Second, potential negative outcomes of practicing
outside of one’s scope of competence are discussed and are followed by a
description of professional activities that may improve one’s competence
or expand the scope of competence. Third, a multidimensional model of
scope of competence is introduced and described with a framework for
self-evaluation of one’s competence given a specific practice opportunity.
Ultimately, this article aims to initiate a discussion about scope of
competence in behavior analysis and to promote awareness of potential
variables that affect competence.
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Terms and Definitions
Scope of practice refers to the range of activities in which members of a
profession are authorized to engage, by virtue of holding a credential or
license. For example, professionals with a Board Certified Behavior
Analyst (BCBA) credential can operate in professional activities covered
within the scope of practice described by the BACB. As another example,
professionals with a Certificate of Clinical Competence for SpeechLanguage Pathologists can engage in professional activities within the
scope of practice described by the American Speech-Language-Hearing
Association. Each profession’s scope of practice is enforced by the
entities that regulate the profession’s credentialed or licensed
practitioners (e.g., the BACB, state licensure boards). In some cases, a
licensure law may further restrict a behavior analyst’s scope of practice
beyond the scope specified by the professional credentialing
organization. For example, New York law currently restricts licensees’
practice to serving individuals with autism spectrum disorders (ASD)
and related disorders.
Like other credentialing bodies, the BACB Professional and Ethical
Compliance Code for Behavior Analysts (hereafter referred to as the BACB
Code) includes a clause that behavior analysts only operate within their
own scope of competence (BACB, 2014). Scope of competence refers to
the range of professional activities of the individual practitioner that are
performed at a level that is deemed proficient. For example, a given
BCBA may be competent (i.e., performs at a specific level of accuracy and
safety) to assess and treat aggressive behavior of an individual with ASD
but may not have had the training (e.g., coursework, knowledge of
literature, practical experience) to competently assess and treat aphasia
of an adult who has suffered a stroke. In this case, incompetence may
result in inadequate services ranging from inaccurate assessment of the
presenting concern to a lack of understanding of the relevant treatments
and the respective social validity of those treatments with individuals
who have suffered a stroke. A different BCBA may have exactly the
reversed scope of competence (i.e., competence with stroke
rehabilitation but no experience with severe aggression).
Both presenting concerns described previously might fall within the
scope of practice of the field of behavior analysis (e.g., as described by
the BACB Task List and licensure boards) but not necessarily within the
scope of competence for the individual practitioner. Additionally, an
individual practitioner may be able to competently engage in
professional activities that are restricted in the scope of practice because
he or she developed competence resulting from education and training
occurring in other specialties (e.g., psychology, special education,
medicine). Thus, the term scope of practice is used to refer to the
activities of the profession and is determined by external oversight
organizations, whereas the term scope of competence is used to refer to
the activities of a specific individual and is determined by the individual
practitioner.
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Risks of Practicing Outside the Scope of Competence
The responsibility for determining the scope of competence falls to the
individual professional, as no one else will be as informed about the
entire learning and experience history of a person across his or her
career. Though the BACB Code 1.02 states that behavior analysts only
work within their scope of competence, practicing outside of one’s scope
of competence may occur for several reasons. First, practitioners may be
motivated to practice outside of their scope of competence when
demand for services is so great that individuals desperately needing
treatment would otherwise receive no services or experience a long
delay to accessing services. Second, a professional may accept a case
because he or she feels more qualified to serve the consumer than other
available professionals (e.g., other disciplines, noncertified
professionals) even if he or she does not feel optimally qualified. Third,
the financial reinforcers for serving consumers may compete with the
ones associated with transferring a case to a more qualified provider. In
addition, there is significant response effort and cost for obtaining
adequate supervision or consultation to be able to adequately serve that
consumer. Fourth, many behavior analysts may not have been explicitly
taught how to identify their scope of competence and, therefore, have
difficulty recognizing situations that are outside of their scope of
competence. Fifth, a behavior analyst may confuse the idea of the
universal applicability of the principles of behavior with the idea of
universal capacity to apply those principles in a competent manner.
Behavior analysts acting outside their scope of competence may produce,
or be at risk for, several negative outcomes. First, the assessment and
intervention efforts may result in poor outcomes and may increase the
risk of harm to consumers (Sellers, Alai-Rosales, & MacDonald, 2016).
Second, there may be a deleterious effect on the practitioner (e.g.,
confidence is shaken) and the field of behavior analysis (e.g., the field is
perceived as ineffective). Practicing outside of one’s scope of competence
puts the behavior analyst at individual risk for disciplinary action from
relevant regulatory bodies (Brodhead, Quigley, & Cox, 2018). Behavior
analysts practicing outside their scope of competence may also be
engaging in other unethical behavior, which increases the probability of
consumer loss, loss of funding, litigation, and damage to the field
(Brodhead & Higbee, 2012).
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Determining One’s Scope of Competence
The responsibility for determining the scope of competence falls to the
individual professional. However, most people do not have updated
performance metrics (e.g., accuracy, fluency) for every professional task.
Instead, the practicing individual typically considers the extent to which
he or she has experienced a variety of events that might facilitate
competent performance and the degree to which he or she feels
confident that success is possible. The most common means by which
people develop competence include academic coursework, independent
review of the literature, supervised practical experience, and various
forms of ongoing professional development. These experiences do not
ensure competence, but these are all viable means to establish, maintain,
and refine skill sets in a way that increases the likelihood of competent
performance.
Coursework and Literature Mastery
Prior to credential
Bailey and Burch (2010) noted that a behavior analyst’s competence
directly relates to the coursework experiences in his or her degree
program. Although students of different behavior analysis programs may
receive training in the same content areas identified on the BACB Task
List, the training differs depending on the context in which training is
provided (e.g., lecture, discussion, laboratory), the goals of the program
(e.g., producing scientists, producing practitioners), and the expertise
areas of the faculty (e.g., teaching procedures, problem behavior, school
consultation). As a result, behavior analysts leave different programs
with different competencies, and two behavior analysts might leave the
same program with different competencies depending on their own
choices. For example, many graduate courses offer students an
opportunity to select an area of interest to heavily sample the literature
and write some type of research paper (e.g., literature review, project
proposal, clinically relevant product). Students’ choices on these course
assignments, along with mentored projects with their advisors (e.g.,
thesis, capstone project), provide students the opportunity to develop a
stronger knowledge base that can facilitate competence in a specific area
(e.g., behavioral gerontology, organizational behavior management) or
procedural application (e.g., preference assessment, verbal behavior
assessment). When graduate education extends to doctoral study, even
greater heterogeneity in course selection and specialization occurs.
In addition to core courses such as concepts and principles,
measurement, and research design, faculty members often offer elective
coursework in an area of specialty. Those courses are likely to facilitate
competence in the subarea that is covered. For example, a faculty
member who specializes in interventions in schools may offer an elective
in educational systems and positive behavior interventions. Students
who take that course may be better prepared for success in any future
efforts as consultants in educational settings. Alternately, elective
coursework in functional analysis methodology for individuals with selfinjurious behavior may facilitate competence in the assessment and
treatment of self-injury, and there may be generalization of those skills
to other severe problem behavior such as aggression, tantrums, or
elopement. Although coursework does not guarantee competence in a
specific area, it can provide a foundation of information on which
students can build when accessing experiential training.
Ongoing development
Engagement with the core content of the field should not stop once
graduate training is complete and the credential is obtained. As Carr and
Briggs (2010) noted, “behavior analysts are obligated by the conventions
of the academic discipline and guidelines of professional conduct to stay
in close contact with the scholarly literature” (p. 13). Carr and Briggs
suggest subscribing to journals, following free journals and accessing
archived articles, contacting journal authors for reprints, and accessing
journals through library databases. To stay up-to-date on developments
in the field, they suggest consistently accessing journal websites,
subscribing to journal tables of contents and e-mail alerts, and joining or
creating a journal reading group (see Carr & Briggs for additional
suggestions).
Continuing education opportunities, through workshops or stand-alone
presentations, are another way to maintain ongoing professional
development. Individuals certified by the BACB must obtain a certain
number of continuing education units (CEUs) to maintain their
certification (BACB, 2018). Behavior analysts might seek CEUs in areas
that interest them because they already have significant knowledge and
experience in that domain, or they might seek CEUs in domains that
represent new content or a relatively weak area. However, attending a
training or workshop may be insufficient to expand scope of competence,
at least without additional supervision from qualified professionals in
that area.
Supervised Practical Experience
Prior to credential
Field-based or practicum experience and training are essential tools for
developing competence (Bailey & Burch, 2010). This training component
often involves directly practicing the procedures that have been covered
in coursework and literature review. For example, one may have the
opportunity to practice multiple types of preference assessment
procedures with consumers of different ages and with different
presenting concerns. As another example, one might have the
opportunity to practice conducting descriptive assessments in
organizational settings to implement the topics that were covered in an
organizational behavior management course. The supervisor plays an
important role in this experience by assessing the quality of supervisee
performance and providing specific feedback to improve performance to
a criterion level (Reid, Parsons, & Green, 2012). Fieldwork provides
perhaps the best opportunity for data-based evaluation of competence in
the skills that a practicing behavior analyst might independently use
every day in his or her ongoing practice.
Field-based experience also provides exposure to the interpersonal
(Brodhead, 2015), cultural (Brodhead, Durán, & Bloom, 2014; Fong,
Catagnus, Brodhead, Quigley, & Field, 2016; Li, Wallace, Ehrhardt, &
Poling, 2017), and legal contingencies that operate in various
employment settings, as well as the most commonly used behavioral
procedures for that setting. For example, individuals who have fieldbased experience in public schools will likely learn about individualized
education programs (IEPs), the Individuals With Disabilities Education
Act (IDEA, 2004), and Section 504 of the Rehabilitation Act of 1973.
School-based behavior analysts may observe or actively participate in
collaborative IEP meetings, which provides exposure to the dynamics
that are often in effect in multidisciplinary team settings (e.g., conflicts
between home and school, different views held by professionals
representing different disciplines). School-based behavior analysis
trainees are likely to encounter situations that are relevant to the BACB
Code items that must be uniquely addressed given the context of
treatment delivery. For example, educational professionals might view
scientific knowledge differently (BACB Code 1.01) and interpret and
approach treatment efficacy differently (BACB Code 2.09). Behavior
analysts serving individuals with ASD in clinical settings may be more
likely to turn to the National Standards Project 2.0 (National Autism
Center, 2015), whereas school-based behavior analysts may be more
likely to use the National Professional Development Center for Autism
Spectrum Disorders (Wong et al., 2015) as their source for identifying
efficacious treatments. Similarly, behavior analysts working in schools
may approach assessment (BACB Code 3.01) differently as well. For
example, school-based behavior analysts may have the teacher serve as
the experimenter in a functional analysis (Lambert, Lopano, Noel, &
Ritchie, 2017) or a trial-based functional analysis, which is designed
specifically for educational settings (e.g., Rispoli et al., 2015), rather than
implementing the functional analysis themselves. Finally, school-based
behavior analysts may have different expectations and regulations for
involving individuals in the planning and consent process (BACB Code
4.02). The consumers in schools are “students” and the teacher may be
required to implement a given treatment to meet the legal requirements
outlined in IDEA (2004).
Training opportunities provide a context for observation and guided
practice navigating professionalism and ethical scenarios. School-based
behavior analysts are also likely to have the opportunity to explain a
behavioral procedure, such as a token economy, to a teacher. Describing
a treatment in a manner that simultaneously acknowledges the
conditions necessary to produce improvements (BACB Code 4.06) and
still yields a high degree of treatment acceptability is a skill that requires
extensive practice. Without a teacher who is motivated to implement the
procedure with a high degree of integrity, the likelihood of a successful
outcome approaches null. Similarly, professionals who have field-based
experience that is heavily focused on in-home consultation will likely
have the opportunity to practice procedures with consumers (e.g.,
shaping, chaining, discrete trial training, social skills training) and use
behavioral skills training to teach parents to implement interventions.
While providing parent training, they will potentially encounter ethical
dilemmas that are likely to occur in home-based behavioral services (e.g.,
dual-relationship issues, discussions about evidence-based treatments
and alternative treatments).
These examples illustrate the contextual differences in applied training
settings that are likely to produce recognizable differences in
competence even if two individuals have had the same coursework.
Behavior analysts may become comfortable with the practical challenges
of one setting during training but may struggle when they later practice
in another context that requires different skills (e.g., conducting an
experimental functional analysis when prior practice has been with staff
training or token economy development) or the same skill applied
differently (e.g., shaping consumer motor behavior vs. shaping staff
professional behavior in conjunction with development of rule
governance; Scheeler, 2008).
Although skills obtained in one setting may generalize to another, the
extent to which this readily occurs with practitioners has not been
sufficiently explored empirically. Therefore, generalization of skills and
competence in new practice settings or with new presenting concerns
cannot be assumed. However, like most skills, multiple-exemplar
training facilitates generalization and behavioral flexibility so that
someone who has had extensive practical training in multiple settings is
more likely to be able to operate competently in a new situation. In
addition, the quality of the supervision will likely be associated with the
level of competence exhibited by the trainee (see Falender &
Shafranske, 2012). A trainee with a supervisor who frequently models
how to reason through best- and worst-case scenarios and requires the
trainee to explain assessment and treatment using both jargon and the
common vernacular, as well as to rank order the appropriateness of
different measurement systems based on consumer and contextual
variables, is likely to be better prepared to handle future situations,
including novel ones.
Ongoing development
Practical training should not be considered complete once the credential
is obtained. Behavior analysts may obtain supervision and/or
consultation from a professional or variety of professionals who
specialize in their area(s) of expertise as a means of maintaining or
expanding competence (LeBlanc, Heinicke, & Baker, 2012). Peer review
can include continued supervision from a boss and/or manager or
ongoing consultation with a more experienced professional who can
provide advice and help solve difficult problems (Bailey & Burch, 2010).
Behavior analysts can continuously improve their own knowledge, skills,
and abilities (KSAs) through peer review. Often, the purpose of the
supervision and/or consultation would be to generalize skills when
atypical symptom presentation occurs, novel environmental conditions
emerge, or organizational variables beyond usual factors associated with
the supporting environments exist. Thus, peer review may serve as a
relevant method for expanding one’s scope of competence. For example,
a practitioner who has historically provided home-based services to
children with ASD may seek peer review by a behavior analyst working
in the schools because service delivery is being expanded into
educational settings.
Another potential benefit of peer review is that skilled professionals will
have the opportunity to review a behavior analyst’s work and
performance in their shared area of competence. Bailey and Burch
(2010) noted that allowing individuals to review programmatic
outcomes may improve professional growth in two ways. First,
practitioners may more effectively identify and subsequently remove
biases in their evaluations of their own professional skills when qualified
professionals observe and comment on their work. Second, practitioners
may improve skills within an existing competence as a result of receiving
helpful feedback. The purpose of this peer review is to further increase
professional growth of behavior analysts working within a specific
setting. Collectively, continuous supervision and peer review by
experienced professionals helps to maintain and improve competence.
To identify a skilled professional to assist with peer review or additional
supervision, the behavior analyst may attend meetings (e.g., special
interest group meetings) and conferences (e.g., the Association for
Behavior Analysis International’s annual conference on substance use
and addiction) specific to the area of concern or interest (LeBlanc et
al., 2012). The behavior analyst may also review relevant published
journal articles and find names of professionals who commonly publish
those articles. A behavior analyst may also seek out formal training
opportunities (e.g., a postdoc) with skilled professionals in order to
further expand his or her competence (see LeBlanc et al. for additional
recommendations).
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A Multidimensional Model of Competence
There are likely many dimensions that affect a professional’s scope of
competence. Relative to each behavioral problem that has been
identified, a behavior analyst may consider his or her own competence in
his or her own KSAs in the domains of applied behavior analysis (ABA)
procedures and strategies, populations, and settings. A behavior analyst
may also consider his or her own confidence in achieving successful
behavior change based on past experiences and familiarity with the
literature. In addition, the degree to which available resources (e.g., a
supervisor, peer review) match those required for success might alter
the behavior analyst’s confidence. Together, these three domains of
competence and the three potential domains that contribute to
appropriate confidence constitute important variables in evaluating
one’s scope of competence. Each domain and variable are described in
the following sections, followed by a framework for self-evaluation of
scope of competence.
Domains of Competence
Procedures and strategies
With each presenting behavioral problem, various procedures and
strategies are usually employed (e.g., creating operational definitions
and assessment procedures, designing an intervention, designing a
measurement system). In some instances, a person may be able to
perform procedures and strategies competently with some consumers
and presenting concerns but not with others (e.g., the person can
successfully treat socially mediated problem behavior but not problem
behavior maintained by automatic reinforcement). The areas of
functional assessment and feeding highlight examples of such
differences.
Generally, a repertoire of functional assessment and treatment of
problem behavior involves conducting informant assessments,
descriptive assessments, and functional analyses. Ethical considerations
directly related to functional assessment are also important, as
topography of challenging behavior and safety considerations can vary
widely. Finally, identification and implementation of a function-based
treatment plan based on each individual consumer’s needs are necessary
skills as well. One might have an extensive practice history of conducting
functional analyses of behaviors such as aggression, noncompliance, and
tantrums but little experience with topographies of severe self-injury
such as eye gouging and pica or behaviors such as elopement or feeding
problems. Though the procedures for functional analyses of these
presenting problems are conceptually similar, there are several safety
considerations and practical aspects of the procedures that require
special attention and expertise.
Though assessment and treatment of feeding disorders may involve
descriptive and functional analyses, they also require strong knowledge
of physiological variables (e.g., gastrointestinal problems and food
allergies) and topics specific to feeding (e.g., food texture and volume
and food selectivity; Piazza et al., 2003). Feeding interventions may
involve collaboration with professionals from other disciplines (e.g.,
speech-language pathologists and/or occupational therapists, dieticians,
other medical professionals) to properly determine feeding goals and
how to safely implement feeding procedures (see Friman & Piazza, 2011,
for further discussion). Thus, one might have general competence with
specific procedures and strategies but still feel like the use of that
procedure for a certain presenting concern is outside of the scope of
competence.
Populations
Another important dimension of scope of competence is experience and
competence with the population (e.g., children with ASD, adults with
substance abuse problems, older adults with dementia) the behavior
analyst serves. The same procedure may need to be implemented quite
differently across different populations in order achieve treatment
success. The practitioner may also need specific information about the
population to be successful in his or her efforts. For example, along with
an understanding of core features of ASD, knowledge of human
development directly connected to diagnostic and associated features of
ASD is likely necessary (e.g., Schlinger, 1995; Schreibman et al., 2015).
Interventions may specifically be drawn from the domains of speech and
language, social skills, and adaptive functioning (e.g., Brodhead, Higbee,
Pollard, Akers, & Gerencser, 2014; Matson, Horovitz, Mahan, &
Fodstad, 2012). Finally, knowledge of various forms of treatment models
for ASD may also help inform successful treatment (e.g., Eldevik et
al., 2010; Kodak & Grow, 2011; Koegel & Koegel, 2012; Ontario
Association for Behavior Analysis, 2017). As a second example, the
application of radical behaviorism to adult mental health conditions is
known as clinical behavior analysis (Kohlenberg, Tsai, & Dougher, 1993).
Practice in this area requires training in recognizing the symptom
profiles of various mental health conditions (e.g., psychosis, hypomania),
as well as knowledge of various models of treatment. For example,
Kanter, Callaghan, Landes, Busch, and Brown (2004) discuss a behavioranalytic conceptualization of depression and corresponding treatments
(i.e., behavioral activation and functional analytic psychotherapy). Hayes
(2004) further discussed acceptance and commitment therapy, as well as
many others, as a behavior-analytic treatment for mental health
conditions. Although a BCBA may know how to assess preferences for
activities and schedule opportunities for positive reinforcement (i.e.,
important components of behavioral activation therapy), he or she may
lack training in specific strategies for conducting psychotherapy with
cognitively intact adults.
Settings
Competence in a specific setting may be affected by a professional’s
ability to independently perform the vast majority of tasks relevant to
that setting. The settings of education and business are described next to
illustrate how differences in KSAs may affect one’s relative level of
competence in these settings. Professionals skilled in educational
settings likely have knowledge specific to human development,
educational law (e.g., IDEA, 2004), instructional practices (e.g., Layng,
Sota, & Leon, 2011), educational theory, systems-wide interventions
(e.g., Horner & Sugai, 2015), and curriculum development. Dependent on
job duties, additional areas of training and experience might be
multidisciplinary collaboration and leadership. Behavior analysts
working in business settings may receive training in
industrial/organizational psychology, organizational behavior
management, personnel selection and training (e.g., Brethower &
Smalley, 1998), leadership (e.g., Krapfl & Kruja, 2015), supervision
practices (Reid et al., 2012), human resources, and business
management. Dependent on job duties, additional areas of training and
expertise might be industrial safety (e.g., Myers, McSween, Median, Rost,
& Alvero, 2010), marketing (Foxall, 2015), or behavioral engineering
(e.g., King & Cennamo, 2016).
Domains of Confidence
A behavior analyst may consider his or her confidence in whether
previously acquired skills will likely generalize to the presenting
situation. Confidence refers to one’s estimation of the likelihood of
effectiveness based on past experience, knowledge of the literature, and
availability of resources. Ideally, confidence is sensitive to a wide range
of variables that are unique to each case (e.g., population, client
repertoire, setting, resource constraints, available environmental
supports), as well as one’s own skills. One might consider past
experiences with similar behavioral problems, familiarity with the
relevant literature, and available resources as different contexts that
might increase potential confidence.
As described previously, prior supervised experience and ongoing peer
review can increase competence. However, the probability of treatment
success likely increases if a BCBA has previous experiences of success
with similar cases in similar contexts. Consider a trainee completing his
or her field-based experience in an early intensive behavioral
intervention setting. Demonstrating independence in developing and
implementing effective discrete-trial training procedures would increase
the likelihood of success with similar cases. However, if the same train
