Assessing Barriers to Effective Caseload Management by Practicing Behavior Analysts

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ABSTRACTIn the past ten years, insurance funding has become a primary source of payment for applied behavior analytic services for individuals with autism spectrum disorders. The increased accessibility of funding has come with constraints which can make caseload management complex and difficult for clinicians. The Caseload Management Support System (CMSS) was developed to assess the barriers that might contribute to difficulties in managing a reasonable caseload. The CMSS samples areas such as time management, geographic distribution of caseload, and match of clinical skills to client needs. The CMSS was conducted as an interview with the supervisors of 12 clinicians who were consistently struggling to manage their duties and with the supervisors of 12 high performing clinicians who met the criteria for performance-based pay based on excellent caseload management. The profiles and total scores of the groups differed significantly with the greatest differences observed in the areas of time management, information and understanding of funder constraints, and understanding of consequences. A multiple regression analysis indicated that 89% of a clinician’s performance can be explained by the total area average score on the CMSS. The Information and Understanding and Consequences areas are most strongly correlated with clinician performance, explaining 86% of the variance between high and low performers.