10 Questions You Must Ask in Your BCBA Interview
10 Questions You Must Ask in Your BCBA Interview
October 16, 2021
The 10 questions listed below should provide a BCBA with an understanding of the workload that will be placed on them, an organization's values, and the ongoing clinical and professional support needed to ensure their success. Additionally, I highly recommend every BCBA read the Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers (Center for Autism Service Providers, 2017) which covers topics such as Treatment Models, Case Supervision, Continuity of Care, etc.
1) How are supervisor caseloads built?
BCBAs should expect to work with anywhere from 8 to 20 clients. How an organization builds BCBA caseloads will heavily influence the number of clients a BCBA is expected to manage. Caseloads can be built based on billable hours, number of clients, or the number of staff under the BCBA. Billable hours are best defined as the activities a BCBA engages in that will be paid for by the client's insurance. This is typically limited to face-to-face time with the client, report writing, parent training, and assessments. It is essential to understand which approach an organization uses to understand how often the caseload size will fluctuate as well as how many clients the BCBA should expect to manage. Some organizations will use projected billable hours to make this determination, while others will base it off how many hours are actually billed over a given period (weeks or months). If the latter approach is used, the BCBA should expect their caseload size to increase if their clients continuously cancel sessions.
2) What does initial and ongoing RBT training look like?
BCBA work-life balance is heavily influenced by the training and resources provided to the RBTs they supervise. It has become relatively common for ABA organizations to rely heavily on online training modules to prepare RBTs for the rigors of their new job. It should go without saying that 40 hours in front of a computer with only a few hours of role-play and/or practice with an actual client is hardly sufficient to recruit the level of engagement and learning required to prepare a new RBT. Consequently, BCBAs should seek organizations that provide live training to RBTs (either in-person or via video conference) and inquire as to what resources are available to RBTs after their initial months of employment.
3) What are the weekly billable requirements?
Salaried BCBAs are typically given a weekly or monthly billable quota. As mentioned in the first question, billable hours are rendered services that are funded by insurance. Weekly billable hours may range from 25 to 30 hours a week. To put this into perspective, a supervisor would need to bill approximately 5 hours a day to meet a 25 hour a week quota. If sessions are about 2 hours long, the supervisor would need to see around 2-3 clients a day.
4) What percentage of direct service sessions need to be supervised?
The BACB requires at least 5% of all behavior analytic activities an RBT engages in to be supervised by a BCBA. The client's insurance may also enforce additional regulations (typically a maximum of 20%). It is essential to point out that the minimum is just that—you will want to know whether you will have the ability to provide more supervision for clients and staff on an as-needed basis. It should be noted that organizations that set a low maximum requirement or mandate the same amount of supervision for every client may do so to allow for the BCBA to supervise larger caseloads. Ultimately, this practice can be detrimental to client progress, staff retention, and work-life balance.
5) What administrative responsibilities are placed on the BCBA?
An organization’s structure heavily influences a BCBA's day-to-day responsibilities. For example, one organization may have a central office that manages all administrative tasks such as scheduling, credentialing, and insurance, while another may provide this same administrative support locally. Localized vs. central administrative support can heavily influence cross-departmental communication, the degree of support, and how decisions are made. More importantly, smaller organizations are more likely to have team members that wear several hats. For example, a Clinical Director may serve as the Scheduler, RBT Trainer, Human Resources, Credentialing, and Authorizations Specialist while also managing their own caseload. During your interview, you will want to understand how much time you will be away from clinical tasks as well as identify how many "hats" other team members are wearing that may limit their accessibility.
Example BCBA Administrative Tasks:
Working with caregivers to ensure they pay fees (i.e., billing)
Submitting authorization requests to insurance
Managing intake paperwork
Staffing RBTs on your cases
Entering meal and rest breaks into software
6) What systems are in place to ensure quality service?
Even if you are AMAZING at your job, we all need to have checks and balances in place to ensure we stay clinically sharp and identify areas for growth. Clinical oversight and quality assurance systems can help ensure this. This might take the form of regular observations or check-in meetings with a Clinical Director, or audits from a Quality Assurance Manager. Moreover, there will come a time when you take over a case from another BCBA. The success of this transition will be heavily influenced by the organization's clinical standards and quality assurance processes.
7) How are new and seasoned BCBAs supported clinically and professionally?
Depending on your level of expertise, you may need a great deal of oversight when getting started. Always be transparent with the level of support you will need and try to identify what training is available to help support you. Additionally, it is helpful to know if you will have opportunities to grow clinically and professionally once you are proficient in the basics. These learning opportunities may take the form of in-house Continuing Education Units (CEU's) or a CEU Stipend, as well as frequent session observations by your direct supervisor and other leaders within the organization.
8) What policies are in place to mitigate client cancellations?
Client cancellations are inevitable. Our clients deserve time off just as much as we do. However, frequent cancellations significantly impact staff retention and client progress. You will want to ask what the cancellation policy is and what steps are taken to address violations.
9) What are the organization's values, and how are they reflected in current processes and procedures?
ABA organizations are not all built the same. Each has a mission, vision, and values which heavily influence the work culture and decision-making process. You should feel comfortable sharing your values and getting a sense of how well the organization lives up to what is posted on their website (so make sure to do your homework and explore the website before the interview).
10) How much flexibility are BCBAs given to individualize treatment recommendations (i.e., treatment hours, teaching protocols, etc.)?
Policies are necessary to ensure consistent services for all clients. At the same time, it is best practice to individualize treatment for each client to ensure maximum outcomes. Try to identify if the organization has pre-written curriculum that you are required to use and if you have the ability to make modifications or simply write your own. This is especially important when you consider cultural differences and social validity. I would also add that it is important to know how often the organization evaluates current practices and adjusts protocols to align with current research.
Applied Behavior Analysis (ABA) – is a science focused on the application of behavioral learning principles to socially significant behaviors. The field is widely known for its contributions to the autism community, but there are many applications (e.g., safety behavior, organizational behavior management, health, and fitness). To learn more, go to www.bacb.com/about-behavior-analysis.
Board Certified Behavior Analyst (BCBA) – is a masters-level certification in the field of Applied Behavior Analysis provided through the Behavior Analyst Certification Board. To learn more, go to https://www.bacb.com/bcba/.
Registered Behavior Technician (RBT) – is a paraprofessional certification in the field of Applied Behavior Analysis provided through the Behavior Analyst Certification Board. Registered Behavior Technicians are only authorized to provide behavior analytic services under the supervision of a BCBA or BCBA-D (doctoral-level certification). To learn more, go to https://www.bacb.com/rbt/.
Disclaimer: All views expressed on this post are my own and do not represent the opinions of any entity whatsoever with which I have been, am now, or will be affiliated.