Ethics: Scope of Practice vs. Scope of Competence

Scope of Practice vs. Scope of Competence

Based on a paper published in October 2018 in Behavior Analysis in Practice by Broadhead, Welch, Inski, and Quickly. Relevant to section 1.0 of the ethical and compliance code.

Scope of Practice

  • Definition: Range of activities a professional is authorized to engage in due to holding a credential or license.
    • Example: A licensed behavior analyst can conduct functional behavior assessments and create programs.

Scope of Competence

  • Definition: Professional activities performed by an individual at a proficient level.
    • Example: One analyst may be competent in treating severe aggression, while another may not.

Determining Scope of Competence

  • Factors:
    • Coursework
    • Ongoing professional development (journal subscriptions, continuing education)
    • Supervised practical experience
    • Training opportunities
  • Competencies can vary even between analysts from the same program.

Importance of Practicing Within Scope of Competence

  • Practicing outside competence can lead to:
    • Harm to clients
    • Disciplinary action

Reasons for Practicing Outside Scope of Competence

  1. High demand for services
  2. Financial reasons
    • Taking on cases despite lacking competence.
    • Avoiding the cost of consultation.
  3. Lack of explicit training in identifying one's scope of competence.

Multi-Dimensional Model for Determining Competencies

Two main areas:

  1. Domains of Competence

    • Ability to perform procedures and strategies.
    • Experience working with specific populations (e.g., autism vs. Alzheimer's).
    • Experience in different settings (e.g., school vs. hospital).

  2. Domains of Confidence

    • Confidence from past experience with similar behavior problems.
    • Knowledge of current literature.
    • Availability of resources to treat the problem.
      • Example: Access to a large team of BCBAs and BCaBAs, enabling consultation and support.

Competence and Confidence Checklist

  • A self-evaluation tool to rate confidence and competence.
  • Ratings: low, medium, high, or unknown.
  • Helps identify the need for additional resources or professional development.

Sample Questions from the Checklist

  1. Given the current behavioral problem, what is my level of competence in the procedures, strategies, populations, or settings?
  2. What is my level of confidence in treatment success based on my past experiences, familiarity with literature, and available resources?
  3. How similar is the current behavioral problem and the context in which services are delivered?