Introduction
Pat is a board-certified behavior analyst (BCBA) at present, living and working in Iowa. Recently, Juan came up to him and asked if he might have some sort of supervision. After a year on BCBA, Pat has earned the authority to oversee Juan’s supervision. However, Juan currently resides in the Dominican Republic. There being a scarcity of Board Certified Behavior Analysts in his region, he is looking to secure supervision elsewhere in order to meet the requirements for taking the BCBA exam. Juan works primarily with clients who speak Spanish, but he is fluent in both Spanish and English. It is clear that Pat is conversant in just English. Some ethical problems may arise if Pat agrees to oversee Juan, such as inefficient supervision, cultural barriers, etc.
Ethical Risks of Ineffective Supervision
Pat’s agreement to monitor Juan raises the possibility that he will not be able to make a difference because of the potential barriers in the way. As a Board Certified Behavior Analyst, Pat must adhere to the BACB’s code of ethics. Juan and Pat would likely use video calling to get supervision because of the long distances between them. There could be challenges for both parties as a result of this. This could make it difficult for Pat to make observations. It is possible that he will not see something crucial that needs feedback if he is confined to a screen.
Juan could impede his clients’ growth if he ran a program incorrectly and kept doing so since he never got the right feedback from them. That can therefore result in Juan not giving his clients the standard of care that they rightfully deserve. Additionally, safety concerns could arise in such a scenario. It would also be possible that the client will suffer physical or mental injury as a result of the Pat’s failure to recognize anything that needed to be addressed. In the end, all of this might result in Juan failing his exam, not earning the expertise he needs to be a behavior analyst, or even endangering his clients. The fact that Pat only speaks English pauses a problem because many of Juan’s customers only speak Spanish. Therefore, Pat will be unable to comprehend Juan or the client during supervision. In the same manner, he can not provide adequate therapy if he can not understand the patient. Pat is still training as a Behavior Analyst after barely a year in the field.
Challenges of Culture and Location
Already mentioned is the fact that Juan and Pat are separated by a great deal of distance. Despite the fact that this by itself is a considerable challenge, the fact that they come from different cultural backgrounds significantly complicates matters. According to the preamble, Pat is unable to communicate in any other language other than English. Contrarily, Juan is fully bilingual in Spanish and English. Juan’s clientele tends to be of the Spanish-speaking variety. It is likely that Juan will speak Spanish with his clients while Pat supervises the sessions. Pat would not comprehend the terminology being used, so he could not give useful comments throughout the sessions. The session could go on longer if Juan translated everything that was said, but that would be a lot of extra work for everyone involved. In addition to providing forms in the person’s native language, they may also consider using an interpreter (Mathur & Rodriguez, 2021). Moreover, Pat could not accept Juan’s account as true on ethical grounds without independently verifying the accuracy of Juan’s English translation.
Different cultural norms and practices present a wide range of potential difficulties for those who are not native speakers. For instance, suppose that in a certain culture, good news is marked by a cup of tea being shared between friends and family. It may conflict with ones national or cultural values or with their efforts to follow the ethics code (Mathur & Rodriguez, 2021). One may find it difficult to get along with the person they supervise if both of them are deeply religious Christians who happen to be married to partners of the same sex.
Online supervision Complications
Virtual supervision has several advantages to in-person monitoring, but it also has certain drawbacks. The initial problem could be caused by a poor internet connection. If the audio were to suddenly stop, this could cause delays in the feedback. Another possibility is that the camera is positioned in such a way that it provides an inadequate or blurry image of the service area. If Juan satisfies the prerequisites to take the BCBA exam, all of this may make him an ineffective supervisor in the long run.
A further difficulty that may arise from online supervision is a lack of proper feedback, be it good and negative. The violation of ethical code 4.08, Performance Monitoring and Feedback, occurs when employees do not receive enough feedback (BACB, 2022). Because of the nature of the internet, it is easy for things to slip between the channels, and it is possible that the person providing training to the learner may have done something that warrants negative criticism but was overlooked (BACB, 2022). Additionally, they may fail to recognize a praiseworthy aspect. This is relevant to what is going on with Pat and Juan. Pat does not have any problems with Juan’s heritage, but he can not provide useful input because he does not comprehend what Juan’s clients are saying.
Ethical Considerations for Effective Supervision
Pat must consider the ethical implications of the option of overseeing Juan before making a sound decision. Because of the great distance between them, it is likely that all communication will take place electronically. T he Health Insurance Portability and Accountability Act (HIPAA) of 1996, mandates that all parties involved in the creation, receipt, maintenance, or transmission of electronic Protected Health Information (e-PHI) uphold the information’s confidentiality, integrity, and availability at all times (Maiden et al., 2022). For Pat to fulfill his supervisory responsibilities for Juan, he will need to ensure that both he and Juan are able to participate in HIPAA compliance. Electronic document and information sharing cannot be done in a morally and ethically sound manner if Juan is unable to provide consent.
Juan needs a place where he can make video calls and talk freely about sensitive matters without worry. Whether it is in electronic, paper, or spoken form, “the Privacy Rule protects PHI in any and all forms and media” (Maiden et al., 2022). The BACB’s code 2.03 on the protection of confidential information provides similar guidance. According to the BACB, all Board Certified Behavior Analysts (BCBAs) must follow all applicable laws, regulations, and organizational rules regarding client confidentiality (BACB, 2022). Additionally, before to initiating supervision, there must be a clear and explicit written form of expectations that all sides agree upon. According to code 4.04 based on accountability in supervision, Pat, as the BCBA, bears ethical responsibility and accountability for the supervision he offers and the acts of his supervisee.
Professional Competencies
If Pat is going to take on the role of Juan’s supervisor, he should evaluate his skills and competencies to make sure he is well-versed in the areas where Juan needs help before moving forward. Competence is not a static state attained by study; rather, it is something that must be continually developed. Code 1.06 of the BACB Ethics Code states that behavior analysts actively engage in professional development activities to preserve and advance their professional competence (BACB, 2022). It would be unethical for him to accept to oversee Juan if he does not have a basic knowledge of the language, culture, and norms of the people he would be working with.
Among the many skills necessary for success in the field, a BCBA must know when they have gone beyond their training and education and into uncharted territory (BACB, 2022). Code 1.06 reinforces on the need for continuing to develop one’s skills through activities like as reading specialized publications, going to conferences, seeking out mentors. Code 2.01 explains how to efficiently treat patients (BACB, 2022). The BCBA has the responsibility to ensure that the best possible care is being offered. Code 2.02 describes punctuality where a BCBA must ensure that all work is completed in a timely manner (BACB, 2020). All billing and reporting must be done correctly in accordance with ethical code 2.06 (BACB, 2022). There is also a need to verify that they have the skills necessary to effectively convey information regarding the services they have provided in order to promote services-related dialogues.
Recommendations for Cultural Competency
The BACB acknowledges there are numerous approaches to fostering cultural and ethical competence and maintaining it. As stated in code 1.06, the professional development activities include, but are not limited to the following: “reading relevant literature; attending conferences and conventions; participating in workshops and other training opportunities; completing additional coursework; receiving coaching, consultation, supervision, or mentoring; and obtaining and maintaining appropriate professional credentials” (BACB, 2022). In light of the above discussion, it follows that Pat and Juan would benefit from exploring any of the aforementioned avenues to increase their mutual cultural understanding. Asking questions about each other’s cultures is essential to ensuring a rich and mutually beneficial relationship. Windon (2020) suggests that in order to be culturally competent, one should be accepting of differences and constantly remind oneself that people and cultures are not uniform. They should realize that change is inevitable, and adapt accordingly. They need to also acknowledge their weakness and apologize when they have made a mistake.
Conclusion
In conclusion, based on the information discussed, it is clear that Pat should not agree to take Juan on as a supervisee on ethical grounds. There is a chance he will not be able to help Juan develop the skills he needs to pass the BACB exam if he makes that decision. Juan may never develop into a competent supervisor if he is unable to acquire this skill. It is possible that a client could be harmed owing to a lack of supervision if just video calls were used. The potential outcome of the supervision is also affected by cultural and language barriers. There are a lot of reasons to be wary of a supervisory relationship, but it might be necessary anyway. It could be necessary because there are not enough BCBAs in the Dominican Republic. If that is the case, Pat and Juan need to take extra steps to learn about one other’s cultures and the difficulties that can arise from it.
References
BACB. (2022). Ethics code for behavior analysts. Web.
Maiden, R. J., Rogers, K. B., Faircloth, P. K., Driver, N. H., & Ellison, L. A. (2022). Best Practices for Security of Electronic Public Health Information on Electronic Media Storage. Alabama Counseling Association Journal, 44(1).
Mathur, S. K., & Rodriguez, K. A. (2021). Cultural responsiveness curriculum for behavior analysts: A meaningful step toward social justice. Behavior Analysis in Practice, 1-9. Web.
Windon, S. (2020). What is Cultural Competence and How to Develop It? Pennstate Extension. Web.