Paying for Supervision: Barriers, Solutions, and Opportunities

Abstract

In some situations, those requiring supervision to meet Behavior Analyst Certification Board supervised fieldwork requirements, maintain certification, or get assistance with a difficult case or ethical dilemma may need to contract with a qualified supervisor and pay them directly. Although it is not considered to be a multiple relationship, the financial component does carry an inherent conflict of interest, which can create barriers to effective and appropriate supervision. In this article we propose a list of barriers that may arise in this particular supervisory relationship and potential solutions to manage each one, with a particular focus on supervised independent fieldwork. We also discuss unique learning opportunities that may arise from this situation that may be beneficial to both the trainee and supervisor.

In recent years the number of individuals certified by the Behavior Analysis Certification Board (BACB) as a board certified behavior analyst (BCBA) or a board certified assistant behavior analyst (BCaBA) has grown substantially. In fact, there was a 100% increase in the number of both BCBAs and BCaBAs from 2016 to 2021 (from 26,879 to 54,233 and from 2838 to 5623, respectively; BACB, 2022). With these recent accelerated increases in numbers comes an increased need for supervisors to support supervisees and trainees. Supervision is required to fulfill the BACB supervised fieldwork requirements to quality to sit for the exam and to maintain certification for registered behavior technicians (RBT) and BCaBAs (BACB, 2021). According to the Ethics Code for Behavior Analysts (Code; BACB, 2020), it may also be required when those certified as a BCBA and potentially as a board certified behavior analyst-doctoral (BCBA-D) need supervision in situations involving a complicated case, ethical issue, or other difficulty that is outside of one’s area of competence. When supervision hours are being completed to meet the BACB supervised fieldwork requirements, which is the focus of this article, supervisors must ensure that the hours are appropriately completed, and that the trainee demonstrates a level of competency, on the applicable BACB Task List items and the Code (BACB, 2020), required to provide high quality behavior analytic services (BACB, 2021).

In many cases, supervision hours may be accrued in one’s place of work during activities such as regular meetings and observations between the trainee and their supervisor. In what is hoped will be a rare situation, a trainee who is not certified as an RBT may find themselves working privately or at a center, school, or group home that does not have a BCBA or qualified supervisor. In other cases, a trainee may wish to supplement their workplace supervision to access a supervisor with a different scope of competence, or simply to follow the BACB recommendation to experience multiple supervisors (BACB, 2021). In such situations, a trainee will be required to identify and contract with a qualified supervisor, paying privately for supervision.

Direct payment to an independent supervisor is permitted by the BACB and is not considered to be the same as an employer paying an employee to supervise their fieldwork. However, this arrangement does have the potential to create barriers to effective supervision, making the supervision more difficult. These barriers can likely be prevented or mitigated if expectations and solutions to potential problems are clearly outlined in the supervision contract, are openly discussed at the outset, and are addressed in a collaborative and proactive manner. We recognize that those who are new to supervision or have less experience with private pay supervision may not be able to predict, and therefore, discuss or plan for potential conflicts before they arise. To support those new to providing supervision in this manner, we outline strategies for both trainees and supervisors who may be entering into private pay supervision contracts.

The purpose of this article is threefold: (1) to identify and provide some considerations for common barriers to effective supervision when the trainee is paying an independent supervisor; (2) to provide solutions to those barriers; and (3) to discuss unique opportunities that may arise from the barriers. Taken together, these three areas of focus may help prevent supervisors from contacting difficult situations and engaging in trial-and-error resolutions. The issues and recommendations will be most beneficial to those providing paid supervision to trainees conducting fieldwork to be eligible to sit for a BACB exam; however, the information contained in this article may still be applicable to any situation in which someone is directly paying for supervision for completion of an internship. For example, even though board certification will no longer be recognized in most countries at the end of 2022, training programs for behavior analysis will continue in these places and many countries may develop their own guidelines. We also recognize that a third party, such as a caregiver or employer, may pay for supervision hours, but for the purposes of this article we focus on the barriers that may arise when the trainee or supervisee directly pays the supervisor. Also, given that the focus of the article is on supervised independent fieldwork, we chose to use the term trainee rather than supervisee, even though the suggestions made throughout may also apply to supervisees and other types of supervisory relationships. Although we describe several issues that may arise from this conflict of interest inherent in conducting supervision for payment, this is not an exhaustive list. Acknowledgement of the conflict of interest is the first step and being aware of the issues is the second step that will allow the supervisor to proactively put measures in place to prevent potential conflicts of interest from occurring.

Employment versus Contracted Payment

Both the BCaBA and BCBA handbooks explicitly state that the supervisor may not be employed by or be subordinate to the trainee (BACB, 2021) because it constitutes a multiple relationship. The multiple relationship exists because both parties are required to take on more than one role with each other, and those roles can be in conflict. In particular, the employer/trainee is simultaneously in a position of power and subordinate to the employee/supervisor while the employee/supervisor is in a similarly conflicted pair of roles. For example, the employer/trainee has the power to change the employee/supervisor’s work schedule, duties, hours of employment, and pay, as well as the power to terminate their employment. In this arrangement, the employee/supervisor has control over the employer/trainee’s supervised fieldwork experience activities and the ability to withhold their signature to approve hours. As a result of these comingled and conflicting roles, the employee/supervisor may be hesitant to provide corrective feedback or assign tasks and may even feel obligated to sign verification forms when the standards have not been met.

Although being paid to provide supervision hours may be seen as a form of employment, it is distinguished from traditional employment described above. In a fee-for-supervision arrangement, the supervisor is an autonomous independent contractor only paid by the trainee to provide supervision hours. The supervisor does not report to the trainee, nor receive any of the benefits that an employment contract would provide, and the trainee does not have any control over the supervisor’s work context. For those reasons this arrangement does not constitute a multiple relationship.

Payment and the Inherent Conflict of Interest

Conflicts of interest occur any time one’s personal interests contrast with their professional obligations. In fact, many of the BACB’s guidelines regarding supervision in the Code (BACB, 2020) are meant to prevent or minimize the potential negative effects that may arise from these conflicts. These include, but are not limited to, supervising or providing consultation to friends or family members, employees providing supervision to employers, and soliciting potential clients. Unfortunately, conflicts of interest cannot always be avoided. In such situations, the conflict must be clearly identified, and advance planning should occur to mitigate any potential negative effects. For example, a behavior consultant in a rural area with no other behavior consultants may have a contract to provide services in a school that one of their friend’s children attends. The conflict of interest is that the behavior consultant may have a personal interest in their friend’s child and, if they observe something they deem to be inappropriate happening to their friend’s child at school, they may want to tell their friend about it. Or their friend knowing they are consulting at their child’s school, may try to ask them to report back to them. In this case, although the conflict of interest cannot be avoided, the behavior consultant can take steps to minimize the potential negative effects by excusing themselves from observing in that child’s classroom and by not telling their friend that they are consulting at their child’s school.

Although, for reasons outlined, contracted supervision is not considered to be employment and does not create an explicit multiple relationship, it does carry an inherent potential conflict of interest stemming from the fee-for-service arrangement. In particular, payment creates a personal interest that, at times, may conflict with both the supervisors and trainee’s professional obligation to effective and appropriate supervision. The presence of this conflict of interest, however, does not preclude contracted supervision from occurring. It simply means that proactive and collaborative steps must be taken in advance to mitigate any potential problem that may arise from it and to adhere to the ethical obligations of the profession.

One of the most proactive ways to minimize any problems that could arise through supervision by payment is to clearly outline expectations in the supervision contract (Sellers et al., 2016). Most of the issues that may arise from contracted supervision can be identified, discussed, and prevented simply by outlining contingency plans in the contract. For example, the BACB requires that the supervision contract stipulate under what circumstances the supervisor will sign the monthly and final experience verification forms, in addition to how performance issues will be addressed. We recognize that it is not possible to predict all possible issues that could arise, but many are predictable. Therefore, we outline several specific issues that may arise and present solutions to each; many of which require that specific items be added to the contract (see Table 1 for a summary). We also highlight unique opportunities that may present themselves from a fee for supervision arrangement. We also recognize that both supervisors and trainees may feel uncomfortable bringing up some of these issues in supervision meetings and therefore have also provided scripts that can be used in these situations (see Table 2).

Table 1.

Summary of Potential Barriers, Solutions, and Opportunities Related to Private Pay Supervision

Potential Issue	Barriers	Solutions	Opportunities
Supervisor “works for” the trainee	• The supervisor’s financial interest my influence their behavior (e.g., may be hesitant to provide feedback, assign homework) • The trainee may view supervision as paid consult rather than training	• Set up clear expectations in the supervision contract • Assign a neutral third party to manage conflict	• The supervisor can practice managing conflict • Both may learn to recognize and manage conflicts of interest • Both can practice communication skills • Ethics related to multiple relationships can be discussed in supervision
Payment schedule based on meeting time	• The supervisor may be less motivated to prepare for meetings • The trainee may presume payment is sufficient to meet supervision requirements • The supervisor may feel obligated to sign supervision verification forms. • The trainee may feel obligated to pay even when they have not been provided with effective and appropriate supervision	• Both the trainee and supervisor can create competency-based goals at the start of the relationship • The supervisor should outline requirements for signing monthly and final verification forms • A monthly plan and agendas can be set for meetings • It can be specified in the contract what will occur if one or more of the parties do not arrive prepared for the meeting • Other forms of reinforcement can be provided contingent upon specific behaviors	• Both the supervisor and trainee may be able to practice changing behavior with limited control over the contingencies maintaining the behavior • The effects of different schedules of reinforcement can be discussed during supervision
Gaps in the supervision schedule	• The trainee’s clients may not receive appropriate supervision • The supervisor may have difficulty tracking the trainee’s skills • The trainee may drift or lose previously acquired skills	• The trainee could do fewer hours per month to reduce cost and maintain consistency • A back-up supervisor could be identified to fill-in when the supervisor isn’t available • When gaps are unavoidable detailed notes should be kept facilitating restarting after a gap	• Both parties may be required to take extensive notes • An alternative supervisor may have expertise in different areas than the primary supervisor • The trainee can demonstrate their skills and practice communication with a new audience • The alternative supervisor may serve as a secondary observer to confirm skill acquisition
Trainee and supervisor work in different locations	• Additional consents will be required to share data and conduct observations • The trainee may not be able to perform certain tasks because their workplace does not allow it • It may be difficult to schedule in-person observations or record videos of clients	• The supervisor should ask the trainee for all consents to ensure that privacy rights are being protected • If certain tasks cannot be completed, the trainee can take integrity data from videos or role play with a colleague • Ask a third party if the supervisee may conduct certain procedures in that environment with supervision	• Having to gain consent will give the trainee experiencing talking to others about consent and collaboration • The trainee may learn what items need to be in a consent form and under what circumstances it needs to be obtained • Trainees may encounter new learning opportunities conducting hours outside of their regular workplace • Trainees may have to take clear notes and practice organizational skills
Trainee choses to have more than one supervisor	• It may be more complicated to track skill acquisition, feedback, and recommendations • It may be more difficult to track that the minimum number of meetings and observations are being conducted • The trainee may encounter conflicting information, making it more difficult to learn concepts • If the supervisor is changed partway through, the first supervisor may not know if the remainder of skills have been acquired when being asked to sign the form • The second supervisor may not agree with the first supervisor’s assessment of trainee skills and may want them to complete additional hours	• All supervisors should be put in contact with each other before each of the supervision experiences start • The trainee’s clients should be divided up between supervisors to avoid having more than one person directing their case • When supervision occurs concurrently, create a shared folder between all parties with notes, schedules of meetings and observations, and a spreadsheet of all relevant information • When supervision is consecutive, the first supervisor should provide a summary report and relative notes to the next supervisor • Subsequent supervisors should ask to be put in contact with prior supervisors to request transition documentation	• Both trainee and supervisor may have to practice communicating a trainee’s progress, describe training procedures, skill measurement, and manage potential disagreements • Both trainee and the supervisors may gain practice collaborating with others and supervisors may learn techniques from each other • Supervisors may have to support their recommendations with evidence and data, especially when it conflicts with information provided by the other supervisor • Alternate supervisors can provide interobserver agreement for skill acquisition • The trainee may have to keep adequate records and will gain practice in organization skills

Table 2.

Sample Scripts for Discussing Supervision Barriers and Solutions

Discussion Topic	Scripts
Difficult Conversation Starters (for both supervisor and trainee)	• I need to talk to you about something important. Please make sure ask any questions you might have because this is a critical task/topic. • I need to have a difficult conversation with you. I am a little nervous. At the same time, I value you and your success more than my discomfort. • I need to discuss something that is a bit uncomfortable. I know that we both value each other, so let’s just keep that in mind as we have this discussion.
Payment Related (for supervisor)	• If you remember from our contract, we agreed on specific timelines for tracking hours and for payment. I wanted to make sure that you received my last invoice, as I did not receive your last payment. • You have now missed two consecutive payments. I don’t want to impede your progress accruing your experience hours; however, I do want to review the contract again and discuss a path forward so that we avoid a situation where we need to pause supervision activities or that would result in me being unable to sign your EVF.
Need for Consent (for the supervisor)	• Because we do not work at the same company, it is critical that we comply with our profession’s ethics standards, and your company’s requirements related to client confidentiality. • Can you please show me the completed consent forms that allow me to observe you with clients? • Can you please discuss this with someone at your company and get the necessary consent forms for us to review the next time we meet? We can discuss how to approach caregivers to give them the opportunity to consent to me observing sessions.
Need for Additional Supervised Experience Hours Based on Performance (for the supervisor)	• I am concerned with our inability to get you to mastery with X skill despite having addressed it several times. I am not comfortable marking this skill as mastered until you are able to meet the specific competency we agreed on. I do think that with Y additional supervision hours we could get you to mastery, however, I want to be mindful of the cost to you. What are your thoughts? • Based on the last X performance evaluations, I am concerned that we need more time to get you to mastery for X skills. When supervision is provided in the workplace, a supervisor would typically just increase supervision contacts. However, for us, that would result in an additional cost to you. From my perspective I think X additional hours would likely be sufficient. What do you think about that?
Request to Communicate with Other Supervisor(s) (for the supervisor)	• You mentioned that you have another BCBA providing supervision for some of your experience hours. It is important that your other supervisor and I collaborate and remain in contact. Doing so ensures that we are no duplicating efforts, that we are thoughtful about who is responsible for what content, and that we can share information about your progress. Could you please send an introduction email between you, me, and your other supervisor to facilitate a meeting?

Barriers, Solutions, and Opportunities

The Supervisor “Works for” the Trainee

In the case of supervision by payment, the supervisor, to some degree, “works for” the trainee as they are contracted to provide a specified number of hours for a determined price. The acceptance of payment does create a conflict of interest because the supervisor’s motivation to maintain clients (i.e., trainees) may compete with their motivation to carry out some of their duties as a supervisor. The influence money may have over behavior is well-documented (e.g., Gingerich et al., 2012; Jenkins et al., 1998; Prendergast et al., 2006) and as such is widely recognized as a primary source of conflicts of interest (e.g., Kassirer, 2001; Thompson, 1993).

Barriers

Given that the trainee may end the supervision contract at any time, the supervisor, out of fear of losing income, may be hesitant to engage in behaviors that may be unpleasant or aversive to the trainee. For example, the supervisor may be hesitant to assign homework or bring up performance issues, especially if the trainee does not accept feedback well. Because they are paying, the trainee may also view supervision meetings as a form of consultation, during which the supervisor provides them with solutions to issues they may be having with their clients as opposed to teaching them to develop their own solutions. Another potential barrier is that the supervisor may feel obligated to sign verification forms even if the trainee has not met specific requirements such as scheduling the minimum number of observations or demonstrating competency on the task list items.

Solutions

One strategy for avoiding these barriers is to set up expectations in the contract and discuss them prior to commencing the supervisory relationship (Bernard & Goodyear, 2005; Falender & Shafranske, 2004; Sellers et al., 2016; Smith et al., 2014). This should involve discussing with the trainee that corrective feedback will be provided and asking the trainee how they would prefer to receive the feedback (Bacotti et al., 2021; Kazemi et al., 2018). It should also be decided in advance how individual supervision sessions will be structured to meet the requirements outlined by the BACB (Reid et al., 2021). For example, expectations regarding (1) what the trainee will be expected to bring to supervision; (2) who is responsible for the agenda and when it will be sent out; (3) the types of tasks the trainee may be asked to do in between supervisions; (4) how often the supervisor needs to observe the trainee and how those will be organized; and (5) what will occur if any of the expectations are not met should all be discussed ahead of time. The contract can include the expected schedule of performance evaluations and reviews along with the specific actions to address persistent performance issues and consequences if performance does not improve. It may also be beneficial to outline which activities will count as experience hours and of those activities which will meet the BACB criteria for restricted and unrestricted. Another option is to assign a neutral third party at the beginning of the supervisory relationship to whom the supervisor and trainee may go to if there is a conflict or disagreement. The third party should be another individual who is certified by the BACB, eligible to provide supervision, and does not have a personal relationship with either the supervisor or trainee. To locate a third party, either the trainee or supervisor could look on the BACB Certificant Registry for those who are willing to provide supervision, ask colleagues for recommendations, or contact former or current instructors if they have current or former students who are willing and qualified to provide supervision.

Opportunities

Although contractual payment could create barriers to effective supervision, it may also create unique opportunities to develop new skills for both the supervisor and the trainee. For the supervisor, it may provide the opportunity to practice setting expectations and potentially managing conflict, something that may also occur during consultations with private-pay clients, third-party funding sources (e.g., insurance companies), or other colleagues. For both the supervisor and trainee it may also provide the opportunity to openly discuss how to recognize and manage other conflicts of interest that will inevitably arise in professional situations, practice communication skills, and develop systems for documenting services and progress (Kazemi et al., 2018). This may also include business requirements such as developing transparent and detailed invoices for services rendered and receipts for payments made. Finally, it may create a context for a discussion regarding ethics and conflicts of interests, and how to manage both in other settings.

Schedule of Payment

When teaching new skills, a fixed ratio schedule of reinforcement is likely to be the most effective (Latham & Dossett, 1978). It ensures that reinforcement is delivered for specific target behaviors and facilitates competency-based learning, which is ideal for supervision where the goal is to teach the trainee new skills (Falender & Shafranske, 2004; Parsons et al., 2012). When supervision is contracted and paid by the hour, the result is a schedule of payment that is contingent on the occurrence, but not the contents, of a supervision meeting; the behavior that is reinforced is being present for a full hour of a supervision appointment. The reinforcer, or payment, may be provided regardless of the specific behaviors engaged in during the supervision meeting. As a result, the payment schedule not only fails to reinforce specific desired behaviors or extinguish specific inappropriate behaviors, but it may also create a conflict preventing appropriate supervision and shaping of behavior from occurring.

Barriers

The payment schedule for supervision services presents several barriers for the supervisor. This arrangement may reduce the motivation for the supervisor to prepare for the supervision meeting in advance or to be diligent about ensuring that all tasks are mastered because they will be paid regardless. In fact, in a survey by Sellers et al. (2019), lack of time was one of the most commonly reported barriers to effective supervision. Creating documentation systems to track progress or developing exercises for trainees to complete are all things that must be done outside of supervision appointments, and they are time consuming. Because the trainee is paying them for the time, the supervisor may feel uncomfortable telling a trainee that the hour the trainee paid for does not “count” toward their fieldwork supervision hours. The supervisor may feel obligated to sign the monthly and final experience verification forms even in circumstances when the trainee did not complete the required tasks or had performance issues.

For the trainee, the payment schedule may result in the assumption that their presence in the meeting will be sufficient to meet the requirements for that meeting, as opposed to being prepared and actively engaged. The trainee may assume that completion of their supervision hours will also be time based, rather than competency based. As such, the trainee may assume that being present and paying for all the hours will be sufficient to meet the BACB requirements. The trainee may feel that the payment schedule obligates them to pay whether or not the supervisor provides them with effective and appropriate supervision. If the trainee is not able to pay or does not pay, it is unlikely that the supervisor will sign the experience verification forms, even if the trainee has demonstrated competency. As a result, the time-based schedule may result in both the supervisor and trainee viewing supervision as a passive, transactional relationship rather than an active, collaborative process.

Solutions

Although payment schedule may not be ideal for a supervisory relationship and competency-based training, there are things that can be done to avoid any potential problems associated with it. One is to create a list of behavior-specific goals and use a competency-based approach and behavioral skills training (i.e., providing an explanation, models, opportunities for rehearsal, and feedback) to ensure that the goals are met (Bailey & Burch, 2010; Falender & Shafranske, 2004; Parsons et al., 2012). The supervisor should outline in the contract that all the goals must be met for both the monthly and final experience verifications form to be signed. To ensure that all the goals can be addressed in the allocated supervision hours, a monthly plan can be created for the topics to be covered during each supervision meeting. This will also hold the supervisor accountable to prepare and plan for supervision meetings to ensure that the trainee will have the opportunity to demonstrate mastery of all the required skills in the designated time frame. An agenda should be created prior to each meeting so the expectations for both the trainee and supervisor are clear (LeBlanc & Nosik, 2019). It may also be stated in the contract what will occur if one or both parties do not arrive prepared based on the agenda. For example, if the trainee is required to bring a behavior intervention plan to the meeting for review and they do not, the supervisor may be able to state that the hour is not going to count. In another example, if the supervisor is not prepared for the agenda items that they are responsible for, the trainee may be able to reschedule the meeting and not pay.

In addition to clear goals, both the supervisor and trainee may provide other forms of reinforcement, in particular positive feedback, perhaps initially on a fixed ratio schedule contingent upon the occurrence of target behaviors and move toward a variable ratio schedule over time (Bacotti et al., 2021). The supervisor can reinforce specific behaviors related to the task list and the outlined goals, and the trainee may reinforce behaviors related to effective teaching and supervision (Kazemi et al., 2018). For example, if the supervisor develops an exercise that the trainee finds helpful, the trainee could provide specific positive feedback to the supervisor. Providing positive feedback contingent upon desired behaviors may help to override some of the potential problems associated with a time-based schedule.

Opportunities

In clinical practice and research settings, behavior analysts will encounter situations in which they may need to change the behavior of an individual, without having control over the contingencies maintaining those behaviors (Bailey & Burch, 2010). Having to teach new skills and shape behavior in the context of paid supervision will provide both the supervisor and trainee the opportunity to practice these skills. For example, a supervisor in clinical practice may have to shape the behavior of a caregiver to help them manage their child’s behavior when there are competing contingencies in place (e.g., escaping problem behavior). Or, a trainee may have to shape the behavior of a manager in a work setting or an academic advisor to receive better mentorship (Bailey & Burch, 2010). It also provides the opportunity to discuss the effects that different schedules of reinforcement may have on behavior and how to manage them.

Gaps in the Supervision Schedule

When a trainee contracts with a supervisor by the hour, there are situations that may result in one or both parties being unavailable for weeks or months at a time. For example, either party could experience an illness, injury, or other life event that prevents them from meeting their contracted obligations. Another reason that might result in a gap in private pay supervision is if the trainee cannot afford to pay for supervisory services for a period of time, which is unique to this type of supervisory relationship. When supervision is provided through the trainee’s workplace, these situations may be less likely to occur. First, because the trainee is not paying, a there would be no risk of lost supervision because of financial difficulties. Second, coverage for supervisor absences is more likely to be provided by another behavior analyst for any extended leaves because the clients would require ongoing supervision, especially when a third party (e.g., a caregiver or insurance company) is paying for the services. Again, the payment involved may compete with engaging in best practices in supervision (e.g., a supervisor is unlikely to provide supervision for an extended period of time if they are not being paid).

Barriers

If a trainee cannot afford to pay their supervisor, they will likely have to suspend their training. Pauses may also occur if the supervisor gets sick and is unable to work or goes on vacation. In these cases, the trainee will also have to suspend their training temporarily. There are two distinct issues that may arise with these types of gaps. The first, and probably more minor of the two, is that with a pause in the trainee’s accrual of hours the supervisor may have a more difficult time tracking the trainee’s skills. As a result, the supervisor may have to spend additional time reviewing past feedback notes and documentation in an attempt to recall what was discussed in the last meeting. In this situation the supervisor may also miss following up on a new skill that had just been taught during the prior meeting. During the time without supervision, the trainee’s performance may begin to drift, requiring additional time (and money) to regain competencies. The second issue, and perhaps more serious of the two, is that it may prevent the trainee’s clients from receiving appropriate supervision. For example, if a trainee implements a new curricular program that is not going well and must wait two months before they can get guidance on how to fix the problem, the client’s progress may suffer. Another concerning example would be if a client’s problem behavior was increasing during the time that supervision lapsed, which could result in harm to the client or others.

Solutions

There are several actions that can be taken to prevent gaps in supervision or to minimize the potentially detrimental effects of supervision gaps. One is that a trainee could do fewer supervision hours per month, to reduce the financial burden and allow for consistent contact with their supervisor. For issues related to the supervisor’s availability, a back-up supervisor could be identified, if the trainee does not already have a secondary supervisor who can fill-in if the supervisor is unavailable. This option may be best for gaps that occur for several months or more where the trainee’s clients may suffer if supervision is not occurring. The primary supervisor and trainee should be keeping detailed records of their contacts, observations, and tasks; therefore, the secondary supervisor should have no problem identifying appropriate tasks for the interim (e.g., assessing for mastery, maintenance, and generalization). In addition to the notes and documentation regarding mastered task list items, the substitute supervisor could also be provided with lesson plans outlining what tasks or topics should be covered during those supervisions. In these cases where gaps are unavoidable, detailed notes of the tasks list items that have been covered and feedback that has been provided by both the supervisor and trainee will facilitate picking up supervision after time has passed. Contingency plans for what will occur when the supervisor becomes unavailable, or the trainee is unable to pay, should be outlined in the supervision contract (see Table 2 for ways to discuss this issue).

Opportunities

One of the opportunities that may arise from this situation is that both trainees and supervisors will be required to take notes and document what has and has not been covered during supervision meetings. No matter the context of supervision, detailed records should be maintained by both parties. However, knowing that additional documentation may be required for an alternate supervisor may increase the clarity and quality of the documentation and overall organization of records. Another possible benefit is that the alternate supervisor may have different areas of expertise than the primary supervisor and the trainee may have the opportunity to learn different skills and demonstrate their skills to a new audience. Even if the alternate supervisor does not have different skills or areas of expertise, the trainee may benefit from things being explained in a slightly different manner. The alternate supervisor may also serve as a secondary observer to confirm that the trainee has acquired the skills as documented by the primary supervisor. In the case wherein the trainee’s finances result in permanent or temporary constraints on the number of available supervision hours, this provides an opportunity for the pair to have difficult conversations and engage in structured problem solving and collaboration to develop an effective plan.

Trainee and Supervisor Work in Different Workplaces

Another conflict that may arise when a trainee contracts with a private supervisor is that the two individuals likely do not work for the same agency or with the same clients. The trainee may feel a greater obligation to the person or agency that is paying them than to the person they are paying (their supervisor). Trainees may be required to seek out a supervisor that works for a different organization or with different clients if a caregiver or center has hired a supervisor who is not eligible or does not want to provide supervision, or if a behavior technician (not registered with the BACB) works privately for someone who has not hired a supervisor. Some trainees may also not have the ability to complete all of their unrestricted hours at their place of work because they are required to spend the majority or all of their time working directly with clients, or their employer simply does not offer the opportunity, and they may have to find alternative ways to complete those hours. It is also possible that the trainee may seek out a different supervisor to gain different experiences than those provided by their supervisor in their place of work (e.g., seeking out a supervisor who specializes in feeding disorders; a practice that is recommended by the BACB in the handbooks for BCBAs and BCaBAs; BACB, 2021). When the supervisor and trainee work in the same place, not only are observations easier to schedule, but they likely also have clients in common, and the supervisor likely develops or reviews the skill acquisition programs and behavior intervention plans for those clients as part of their job duties.

Barriers

As soon as supervisors and trainees work in separate workplaces, sharing of client information and data will likely require that consents are obtained for the supervisor to be able to review data and conduct observations of the trainee’s clients (BACB, 2020). In the United States sharing of personal health information without consent violation of the Health Insurance Portability and Accountability Act and sharing educational information is a violation of Family Education Rights Protection Act (if working in schools). For those working in other countries, similar protections will be in place (e.g., Personal Health Information Privacy Act in Canada or the Privacy Act in Australia). Another difficulty that may arise when the supervisor and trainee do not share a work setting is that the trainee’s workplace may not allow certain tasks or procedures. For example, one of the items on the task list is that the trainee conduct a functional analysis and it is possible that their workplace will not allow them to do so. It may also be difficult to schedule observations if the trainee’s workplace does not allow visitors or only allows visitors at specific times. Finally, it is possible that there will be another supervisor responsible for the clinical oversight of the trainee’s clients, making it difficult for the contracted supervisor to make recommendations related to modifying programming.

Solutions

The supervisor can ask the trainee to show any needed consents prior to discussing any new clients to ensure that privacy rights are being protected. If the trainee is unable to complete certain clinical tasks at their place of work (e.g., certain procedures are prohibited, the context does not support safe implementation of a procedure), they may be able to take integrity data from videos and role play some of those tasks with a colleague to demonstrate competency. For example, if a trainee is unable to conduct functional analyses at their place of work, they may be able to role play with a colleague while their supervisor observes and provides feedback in person or online (Lloveras et al., 2022). If the supervisor is unable to conduct observations at the trainee’s place of work, the trainee could record videos of themselves. It is important to note that if the supervisor is unable to observe the trainee in-vivo or on video working directly with clients, they will not be able to provide supervision. Another option, for both barriers related to the inability to perform certain skills from the task list and observations, is to identify a third party or agency or parent and ask them if the trainee can conduct certain procedures in that environment with supervision. If another supervisor at the trainee’s place of work is responsible for the trainee’s clients, it is important that the trainee seek permission from their workplace supervisor to include their work with those clients as part of their fieldwork. If the supervisor agrees, the trainee should then invite them to supervision meetings where those clients will be discussed. If the workplace supervisor is unable to attend, the trainee should share their supervision notes regarding that client with them and seek their permission prior to making any changes to their program (e.g., changing the data collection or altering a behavior plan).

Opportunities

By having to gain consent to share information with the outside supervisor, the trainee may gain experience talking to caregivers and other parties about the benefits of collaborating and sharing data with an outside party (see Table 2 for scripts). They will also learn what items need to be in a consent form, how to appropriately speak about consent to a caregiver, and learn under which situations and why it needs to be obtained. Conducting some hours outside of their regular workplace may also give the trainee the opportunity to practice skills, learn technologies, and work with populations that may not have been available in their workplace. It will also require the trainee to take clear notes regarding their clients, especially if they have to share them with another supervisor, which can facilitate critical organizational skills.

Trainee Chooses to Have More than One Supervisor

In the BCBA handbook (BACB, 2021) it is recommended that trainees complete their supervision with more than one supervisor to enhance the breadth of skills and expertise that they are exposed to. In a situation where both supervisors are from the same organization, this practice will not likely create barriers to effective supervision. However, in situations where one or more of the supervisors are outside contractors from different organizations who do not know each other, the situation will carry additional complications that will need to be addressed. The trainee’s ability to choose their supervisors may create a conflict as they may be motivated to continue with a supervisor that is easier (e.g., provides less corrective feedback, requires less homework) than one that provides more effective and appropriate supervision.

Barriers

When a trainee has two or more supervisors providing supervision at the same time who do not know each other some of the standard logistics and organizational needs of supervision may be complicated. For example, the need to track who is addressing which skills, what skills are being acquired and how quickly, and what feedback was provided is heightened and doing so may prove difficult without careful consideration and planning. It may also become difficult to track if the minimum number of meetings and observations are being conducted for the accrued experience hours. There may also be conflicting information delivered to the trainee, which may confuse them and make it more difficult for them to learn concepts. If the trainee completes a portion of their hours with one supervisor and then switches, the new supervisor may not know what the trainee learned up until that point. The subsequent supervisor may need to conduct a skills assessment to determine which skills were mastered with the previous supervisor. If the new supervisor does not feel that the trainee will be able to master all the skills on the task list by the end of the supervision, they may adjust the scope of what they will cover or require the trainee to complete additional hours to which the trainee may be reluctant to agree.

Solutions

When there are multiple supervisors who do not naturally work together, all supervisors should be placed in contact before each of the supervision experiences start. Also, the trainee’s clients should be divided up between the supervisors to prevent any given client from having more than one person directing their case. If this is not possible, clear expectations should be established for how recommendations from the supervisor who is not in charge of a client will be made. When the supervision is conducted concurrently there are several steps that can minimize the difficulties of managing logistics. To facilitate access to relevant information they should create a shared folder that all parties can reliably access (Kazemi et al., 2018). In that folder they should house the following: (1) supervision notes from the supervisors; (2) a schedule of dates and times of observations and meetings; and (3) a spreadsheet for documenting relevant information. At a minimum, the shared spreadsheet should allow supervisors to keep track of which task list items were discussed, demonstrated by the supervisor, and performed by the trainee; experience hours (restricted and unrestricted) accrued per month; number and type of contacts; and time spent in individual and group supervision.

When supervision with two or more supervisors is consecutive, there are different considerations to solve barriers. For supervision provided only in the first half of a trainee’s work experience, the first supervisor should be prepared to pass a summary report and relevant notes and information on to the next supervisor(s) to transfer the case, just as you would with a client (BACB, 2020). For supervision occurring on the latter end of the trainee’s experience hours, that supervisor may make it a requirement that the trainee put them in contact with the past supervisor so they can request the transition documentation previously outlined. The later supervisor may also want to spot-check to determine if the skills listed as acquired by the first supervisor are in fact mastered and have generalized to another setting. If conflicting information is delivered, each supervisor should be open and listen to the other supervisor’s perspective and also be willing to provide evidence to support why the recommended what they did. The new supervisor should also carefully evaluate the remining time they will have with the trainee and identify what content will be covered.

Opportunities

As with the other barriers, managing multiple supervisors creates a unique opportunity for both the trainee and supervisor to practice certain skills. Examples include communication and interpersonal skills (Bailey & Burch, 2010), both of which have been identified as an areas that may need more training and measurement during supervision (Sellers et al., 2019). Having to discuss a trainee’s progress or potential disagreements with another supervisor will give each supervisor the opportunity to discuss what they have covered in their supervision meetings, how they are measuring the trainee’s performance, and how they are training certain concepts (see Table 2 for scripts). Joint supervision also provides an opportunity for collaboration. Supervisors may have areas of expertise that differ from one another, providing an opportunity for them to learn from each other or work together on developing new exercises or techniques to be used in supervision. It will also require each supervisor to support their recommendations with evidence and data especially when their recommendations conflict with those of another supervisor. It also provides the opportunity for interobserver agreement to be assessed on the trainee’s skills. As with the other barriers, this requires each supervisor take detailed notes and document progress in an organized manner and require the trainee to be organized and keep adequate notes and records of their various supervision meetings. Organization is another area that has been identified as not being taught or measured enough during supervision (Sellers et al., 2019). It will also provide a unique opportunity to trainees to observe how others collaborate professionally and oblige them to manage potential differences in opinions and working styles across supervisors.

Conclusion

Conflicts of interest are undesirable, but they may also be unavoidable, and, as such, behavior analysts should have strategies for managing them. Although contracted, paid supervision is an example of a common practice that carries an inherent conflict of interest, and it does not constitute a multiple relationship. Regardless, it may create challenges to appropriate and effective supervision. Direct payments to a supervisor from a trainee create a financial incentive to engage in behaviors that may compete with those required for effective supervision. For example, supervisors may feel as though they are required to sign supervision forms even if the trainee has not demonstrated competency or completed assigned tasks or may fail to adequately prepare for supervision meetings. Having to seek supervision outside of one’s place of employment may result in a trainee having multiple independent supervisors for different organizations and having a more difficult time arranging direct observations or implementing their supervisors’ suggestions. It may also lead to gaps in supervision that would be less likely to occur if all supervision was provided within the organization. Most, if not all, of these challenges can be managed with a thorough supervision contract, careful planning and clear expectations including creating an agenda for each meeting, outlining the circumstances under which supervision forms will be signed, and documenting which skills have been acquired and which topics have been discussed.

Despite the barriers that arise from this type of supervision arrangement, it may provide learning opportunities for both the supervisor and trainee. Conflicts may arise in many situations that a behavior analyst may find themselves in and, as such, this situation will allow both the supervisor and trainee to learn from collaborations and practice conflict resolution and effective communication with varying audiences. Although we have framed our examples around the specific direct payment relationship that sometimes occurs between supervisors and trainees completing supervised independent fieldwork, many of the barriers, strategies and opportunities may also apply to other types of supervisory relationships and other potential conflicts of interest. We hope that the considerations provided are useful to supervisors, trainees, and organizations navigating the important work involved in supervised fieldwork activities.

Declarations

Funding and Conflicts of Interest

No funding was received to assist with the preparation of this article and the authors have no conflicts of interest to disclose.