Registered behavior technicians: behavioral intervention to assess treatment fidelity

Abstract

Risk of burnout, the presentation of physical and emotional symptoms resulting from job related stress, is high among direct care staff serving autistic clients. In order for direct care staff to deliver the most effective services to clients (i.e., high treatment fidelity), employees must be able to experience a sense of worth, happiness, and overall satisfaction in the services they are providing to others. The purpose of this study was to determine if registered behavior technicians (RBTs) can effectively recruit praise from their supervisors, with collateral impacts of increased supervisor delivered praise statements received during or after treatment sessions as well as increased RBTs treatment fidelity. A multiple baseline design was used to evaluate the impact of the independent variable (i.e., behavioral skills training (BST) targeting RBT praise recruitment) on the dependent variables related to praise (i.e., RBT recruitment of praise, incorrect recruitment, supervisor response to recruited praise and corrective statements, overall total praise). A multiple-baseline design staggers the introduction to the intervention to assess the functional relationship between the independent and dependent variables. Pre- and postintervention assessment of dependent variables included: treatment fidelity, the Maslach Burnout Inventory (MBI-HSS) and Job Satisfaction Survey (JSS), completed pre-and-post intervention by members of the dyads (i.e., supervisor and RBT). The researcher used a random number generator to select the order in which the dyads received access to intervention. Based on visual analysis of the praise-related dependent variables, RBTs trained to recruit praise from their supervisors increased RBT recruitment of praise. In addition, supervisor response to recruited praise and corrective statements, as well as total praise increased across all dyads. Treatment fidelity also consistently increased after RBTs were taught to recruit praise. No participants met the criteria for “burnout” according to the MBI-HSS at any point in the study. Overall, job satisfaction stayed within the “satisfied” range for all participants pre-and post-intervention. Limitations of the current study, with an emphasis on the impact of COVID-19, are discussed, as well as suggestions for future research.