Facilitating Treatment Adherence: Training & Advocacy Tips. Norm Dahl, Ph.D., BCBA Mount Olivet Rolling Acres’ Metro Crisis Coordination Program 612/869-6811 [email protected] Ineffective behavioral supports increases persons’ risks of: .
Med. Administration support
4-hour classroom training.
Clearly defined expectations.
In-class knowledge checks.
Instructors demo proper med passing protocol.
Knowledge is assessed via written post-test.
Analogue performance assessment.
In-situ performance assessment.
Protocol for noting & addressing errors.
Review Tx recs at IDT mtgs.
DSPs are rarely present.
A supervisor, who is not properly trained to implement the protocol, is expected to train subordinates.
Knowledge is not assessed via a written post-test.
Performance assessments, analogue or otherwise, are rarely carried out.
Procedures for assessing and addressing implementation errors are rarely in place.Common training practices
~ I like to include a treatment integrity check list or a treatment monitoring tool along with the written plan (more in this later).
~ I like to use the monitoring tool as a cheat sheet to ensure I don’t miss anything and encourage trainees to do the same.
5) The clinician demonstrates how to use the monitoring tool and provides feedback to interventionists.
6) Everyone takes turns playing the role of the consumer, the interventionist, and the monitor/feedback provider.
7) The clinician describes how monitoring is as much a part of the plan as the implementation protocol.
Equipment is available and in proper working order:
_____ _____ Door & window alarms; (similar to a fire drill, periodically set off alarms to see if they are working.
____ _ Cell phone. (is it available, is it charged?)
_____ Locks on doors work properly?
_____ Alarms are armed when ___ is on site?
_____ Doors are locked when ___ is on site?
_____ ___’s shoes are locked up?
_____ Staff are running the levels program and following his schedule?
_____ Staff immediately prompt ___ to return to living room should he stand at the doorway?
_____ If ___ did not comply within 3-s, staff escorted him to the living room?
_____ Before opening the door to the house (or a vehicle) staff remind that he needs to walk directly to
the designated location
_____ Practice (spot check on random basis or review at weekly staff meetings):
_____ Staff can paraphrase the 911 script?
_____ Staff can paraphrase the PRN protocol?
_____ Staff can identify and describe Level I (precursor) behaviors?
_____ Staff can describe and/or demonstrate at least 3 of the protocol included under Level I?
_____ Staff can describe and/or demonstrate at least 3 of the daily interaction protocols?
Data (spot check on a random basis)
_____ Collected consistently?
_____ Collected accurately?
_____ Person who assesses data collection practices should provide feedback to staff.
_____ Review data during weekly house meetings.
Date_______ Staff Observed ______ Staff Observing______
Task 1 Task 2 Task 3
1 Presented card options…… ______ ______ ______
2 Gave 15-s to choose……… ______ ______ ______
3 Presented card up to 3 x….. ______ ______ ______
4 Chose for him if necessary.. ______ ______ ______
5 Allows for an alternative.… ______ ______ ______
6 Gave 3+ w/in task choices.. ______ ______ ______
7 Gave 15-s between choices. ______ ______ ______
8 If needed, gave help to
complete 1st step of task….. ______ ______ ______
9 Ignored CB if it occurred… ______ ______ ______
10Praised choosing/task comp ______ ______ ______
11Gave token upon task comp ______ ______ ______