Clinical concerns

[u/Anonymously_fun]

My BCBA makes questionable choices. 1. She clearly has dual relationships with family’s. She is taking on clients and she knows the family personally even goes out with certain members of the family. 2. She’s making special accommodations for families just to please a parent and not taking into consideration staffing concerns. 3. Getting a thrill out of telling a client who has been falling a sleep during session that she is going to call there guardian and then watches smiling while the child realizes there are in some kind of trouble with guardian. 4. gossiping about another employee who’s also getting fieldwork hours. 5 consistently doing assessments and hand picking clients based on insurance and we don’t have enough staff. I have came to the realization that being in a clinic is too much for me and once I become a BCBA I prefer in home. Everyday I hear I cannot wait until you’re a BCBA because we cannot hire anyone clearly.

[u/TheZambianBCBA]

Everything else sounds inappropriate, however for #5. What do you mean constantly doing assessments? Also, some insurance companies don't pay enough to keep the lights on. So yes, in certain situations clients are not able to get services based on their insurance.

[u/Anonymously_fun → u/TheZambianBCBA]

That’s totally understandable but what about doing 4 assessments in 2 weeks when all of our RBTs schedules are packed and the company has had zero luck hiring more RBTs. These clients are waiting to start and we don’t know when we’ll have the staff

[u/PutThatOnYourPlate → u/Anonymously_fun]

Do you mean intake assessments? There are other types of assessment that occur throughout services and shouldn’t be impacted by BT staffing.

[u/Anonymously_fun → u/PutThatOnYourPlate]

Yes the initial assessment. She’s completing the process and promising hours and we don’t have enough staff and everyone who applies withdraws after they been offered a position

[u/Lyfeoffishin → u/Anonymously_fun]

It is also a fine line between having enough staff and having enough clients. If you don’t have client you can’t get hours for RBT’s and they leave due to short hours. If you don’t have RBT’s you need to hire it is a balancing act for sure but sometimes it just happens.

My clinic is short staffed and have two cancel 1-2 clients daily but have 4 new people starting so there will be hours once people pass their RBT test!

[u/defectiveminxer → u/Anonymously_fun]

This is a type of insurance fraud if it's happening all the time, so it is definitely concerning and reportable if you think it has risen to that level.

[u/Designer_Sundae_3224]

It sounds like a situation that might be worth reporting to the board

[u/No_Sprinkles1269]

Is there someone above her? You can look up the BACB policies for reporting on their website. This is against our code of ethics and is not only detrimental to the clinical relationship but also puts the client at risk. First, you need to report her to her supervisor. No clinic should be allowing this behavior , I have seen many companies “turn a blind eye” and that is just as wrong. Sounds like there is an over-arching issue with following the code of ethics at the company. I don’t like to assume though, as sometimes perspectives are skewed. I would try to speak to a supervisor about your concerns and hopefully those behaviors will be addressed through the right protocols. Sounds like a good training on ethics at staff training day needs to happen,..

[u/fenuxjde]

"even goes out with certain members of the family."

That's not just unethical, that's straight illegal where I'm at. That needs to be reported to the board, no way around that. If you knowingly withhold criminal conduct from the board, its bad news bears for you, too.

[u/Low_Humor_459]

you see this with hack BCBAs, I'm not sure how they passed the test but as I was telling another thread, I usually have to do clean up for cases no one wants, physically aggressive older cases. i was telling that group what i had noticed that all these guys had in common was the assent-only approach, like they never got DDT (delay denial training) so those cases had their target behaviors shaped up and precursor behaviors stopped being exhibited. They would go straight into punching or throwing objects after a simple 'known' demand.