Scenario

You are a new BCBA to an established case and go to meet your client and his family for the first time.  The client is a 12- year-old male evaluated using the VB-MAPP and has been a client of the company for 5 years.  You see the client run in and out of the meeting wearing only his underwear and holding up an iPad to his ear.   While meeting with the family, you learn that the previous BCBA has only been out to observe the client 1 time per quarter since starting and none of the programs have hit mastery.  The family is very happy with progress and hope that they can work on building a conversation with the client by the end of the year.  After the meeting, you look at the data with the current technicians and they say they have been working on tacting for 6 months and want him to tact 50 items before moving on to manding.  Other goals the technicians are working on are cutting, coloring and sorting shapes. As a new BCBA, how do you move to change the direction of treatment when the parent is happy with the way things are going and the amount of supervision the previous BCBA had accomplished. 

Response

• Determine if previous BCBA is still with company (it not, acquire ROI to connect) 
• Approach BCBA regarding clinical practice (investigate context) 
• Discuss dosage of supervision 
• Build rapport with family – change is difficult (explain the why, connect to values etc.) 
• Take this as an opportunity to re-assess, evaluate tx plan, set new criteria (supervision etc.) 
• Review funding source expectations 
• Loop in BCBA’s supervisor 
• Follow up and determine if elevated action should occur 
• Document actions