This page of our RBT Exam Study Guide covers professional conduct and scope of practice. This is based on Section F of the RBT Task List, which includes the following tasks related to an RBT’s professional conduct and scope of practice:
- Describe the BACB’s RBT supervision requirements and the role of RBTs in the service-delivery system
- Respond appropriately to feedback and maintain or improve performance accordingly
- Communicate with stakeholders (e.g., family, caregivers, other professionals) as authorized
- Maintain professional boundaries (e.g., avoid dual relationships, conflicts of interest, social media contacts)
- Maintain client dignity
Significance of professional conduct and scope of practice: RBTs need to understand their role and scope of practice for the safety and well-being of their clients. A scope of practice encompasses the activities and tasks a particular professional is allowed to perform based on their training and certification(s). When healthcare professionals act outside their scope of practice or competence, they risk harming their clients. As such, the BACB enacts ethical guidelines to ensure RBTs practice within their scope. Understanding and abiding by the RBT Ethics Code is vital for the success of your client’s care.
RBT Task F-1: Describe the BACB’s RBT supervision requirements and the role of RBTs in the service-delivery system
RBTs play a critical role in the delivery of ABA therapy services. RBTs typically work 1:1 with clients, though sometimes they work in groups as well, if properly trained to do so. An RBT’s primary role is directly implementing the treatment plan goals as created by the BCBA or direct supervisor. RBTs teach skills using client-specific skill acquisition programs and modify behaviors using the strategies outlined in each client’s individualized BIPs.
RBTs are required to receive ongoing supervision to maintain their certification. The supervisor must be a BCaBA or BCBA. On rare occasions, the BACB allows for non-certified individuals to supervise RBTs. However, they must be licensed in another behavioral health profession that has ABA in its scope of practice.
Ongoing supervision must occur for a minimum of 5% of an RBT’s direct hours each month. This means if you work 100 hours/month (~25 hours/week), your supervisor must supervise you at least 5 hours throughout the month. They need to supervise face-to-face at least twice per month. At least one of these contacts must consist of observing you while working with a client. It’s important to note that face-to-face means you must both be present in real-time. This could include a live video meeting (e.g., Zoom, Google Meet). Supervision can occur in a group, such as meeting with your BCBA and a few other RBTs (up to 10), but at least one of the monthly contacts must be individual (only one RBT and BCBA).
Important note: Failure to receive the required supervision can result in losing your certification. You must communicate with your supervisor if you notice you may be low on supervised hours in a given month. If you do not meet the minimum supervision requirements, you’re responsible for self-reporting to the BACB.
You do not need supervision if you are not currently working in behavior analysis. For example, if you’re between jobs or taking an extended vacation, there is no need to seek supervision during these downtimes. But if you’re not going to be working as an RBT for an extended amount of time, you can apply for a voluntary inactive status.
You must document all supervision contacts. At the end of each month, you and your supervisor will both sign your monthly supervision log. You will both keep these records for at least 7 years. If you’re ever audited, you will need these records, so be sure to maintain them somewhere safe!
RBT Task F-2: Respond appropriately to feedback and maintain or improve performance accordingly
Feedback is essential for your learners’ progress. As such, you can expect open and ongoing feedback regarding your performance, both positive and constructive. Accept feedback respectfully and use that feedback to modify or maintain your performance as directed. If you don’t agree with or understand the feedback, it’s encouraged to ask questions to gain clarification. Be sure your clarifying questions are respectful and come from a place of curiosity, not defensiveness or an attempt to argue. Feedback should occur each session, even if it’s just your BCBA confirming you’re doing everything well. Many companies also have more formal feedback processes, such as weekly, monthly, or annual reviews.
RBT Task F-3: Communicate with stakeholders (e.g., family, caregivers, other professionals) as authorized
Stakeholders are individuals who have a vested interest in the client’s care. These include parents, caregivers, other family members, and professionals such as teachers and therapists. The frequency, mode, and content of your communication with stakeholders will vary depending on the setting in which you conduct services. For example, if you work exclusively in schools or clinics, you will be much less likely to communicate with parents compared to those who work in clients’ homes.
It’s important to only communicate with individuals you are authorized to communicate with. Before discussing your client with anyone other than the client’s immediate family, you must have signed consent to do so.
The BCBA will primarily collaborate with parents and other professionals regarding the client’s care. When parents or others mention concerns to you or ask you for clinical recommendations, be sure to direct this to your BCBA. For example, you could say, “This is a great question for (BCBA name). I’ll let them know you were inquiring about it.” RBTs should never recommend intervention changes to parents, as that is within the scope of a BCBA, not an RBT.
RBT Task F-4: Maintain professional boundaries (e.g., avoid dual relationships, conflicts of interest, social media contacts)
The RBT Ethics Code outlines several guidelines for maintaining professional boundaries. Professional boundaries are necessary to ensure that a therapeutic relationship is focused on the success of the learner’s care and to allow the therapist to maintain objectivity. Professional boundaries enable the therapist to make decisions about care that aren’t altered by personal emotions or biases. Ultimately, abiding by professional boundaries leads to effective treatment and positive outcomes for the learner and family.
Dual relationships occur when there is a separate relationship between an RBT and a client, caregiver, or supervisor, which can result in a conflict of interest. For example, if you work with a client as their RBT while also being friends with their mom, this is a dual relationship and must be avoided.
Further examples of dual relationships include:
- The RBT attends family events or spends time with the client outside of therapy sessions
- The RBT works as the family’s babysitter on the weekends
- The RBT and caregiver or supervisor are friends
- The RBT is related to the client or supervisor
- The RBT works with the client’s parent at their second job
- The RBT is friends on social media with the client, parent/caregiver, or supervisor
Essentially, a dual relationship exists if the RBT has any relationship other than being the client’s behavior technician. It should be noted that once a therapeutic relationship ends (i.e., the client discharges therapy or the RBT resigns from their role), they are free to establish platonic relationships with the family. A dual relationship cannot exist if there is no current therapeutic relationship. However, RBTs must not begin sexual or romantic relationships with a client or caregiver for at least two years after the therapeutic relationship ends.
The exchange of gifts can cause conflicts of interest. The RBT Ethics Code allows for exchanging gifts with clients with a monetary value of no more than $10, as long as the gift exchange does not become a regularly expected source of income or value.
If you feel a professional boundary has been crossed or there is a reasonable likelihood of this happening, reach out to your supervisor for support right away to remedy the situation.
RBT Task F-5: Maintain client dignity
Maintaining client dignity means treating your client, their caregivers, and other stakeholders with compassion, empathy, and respect. It includes recognizing that everyone deserves to be valued and heard regardless of their abilities or needs.
RBTs can maintain client dignity by:
- Respecting client autonomy
- Paying attention to signs of assent and honoring assent withdrawal
- Prioritizing and encouraging communication and self-advocacy
- Ensuring privacy
- Respecting cultural, religious, and personal differences
- Prioritizing positive reinforcement
RBT Professional Conduct & Scope of Practice Quiz
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Question 1 of 5
Which of the following is true of your monthly supervision logs?CorrectIncorrect
Question 2 of 5
Your supervisor will provide feedback:CorrectIncorrect
Question 3 of 5
Josie is an RBT. Which of the following exemplifies a dual relationship that she must avoid?CorrectIncorrect
Question 4 of 5
How might an RBT communicate with their client’s parents professionally and within their scope of practice?CorrectIncorrect
Question 5 of 5
Aniyah resigns from her role as an in-home RBT. One of her client’s mothers asks if they can keep in touch after she leaves. How long would Aniyah need to wait before establishing a friendly relationship with this family after her last day?CorrectIncorrect
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