Self-Management

Abstract

Self-management is when an individual applies a behavior change intervention to their own behavior. Self-management occurs on a spectrum from self-managing a single component of a behavior change program while a second individual (e.g., clinician) manages the remaining components to managing all components of a behavior change program. This chapter will review how to manage antecedent and consequence components of a behavior change program as well as self-monitoring and self-evaluation. During the group supervision meeting, you will introduce the various approaches to self-management and provide your supervisees guidelines when implementing self-management or teaching others to self-manage their own behavior. Using the included guide, they will practice developing self-managed components of a behavior change program by developing a self-managed intervention for their own behavior and sharing with the group for feedback. After the group supervision meeting, they will identify a client or a client’s caregiver who wishes to implement a self-managed behavior change program. During the individual supervision meeting without a client, you will support your supervisee in developing a self-management program and procedural fidelity checklist. You will observe your supervisee teaching their client or client’s caregiver how to implement the self-management program and provide performance feedback.

FormalPara Topics Covered Within This Chapter

Topics
Introduction
Implementation Guidelines
Practical Applications
Advantages

Self-management is when an individual applies behavior change strategies to change their own behavior (Kazdin, 2012; Cooper et al., 2020). Self-management involves two behaviors. First, the controlling response is the self-managing behavior. These are the behaviors that are intended to affect a desired behavior outcome. Second, the controlled response is the target behavior the individual wants to change.

Self-management can involve controlling any component of a behavior change strategy. This includes self-managing antecedents, observing and recording one’s own behavior, evaluating one’s own behavior, and self-managing consequences. The level of self-management of any of these treatment components occurs on a continuum. On one end of the continuum, self-management may be involved in a tiny portion of a behavior change program (e.g., the individual records his own behavior, but the antecedent and consequences are managed by a clinician). On the other end of the continuum, the behavior change program could be entirely self-managed.

Management of antecedents is the most common approach to self-management. At the antecedent level, an individual may engage in a variety of self-managing behaviors including (a) manipulating motivating operations, (b) prompting desired responses, (c) performing initial steps of a behavior chain, (d) increasing the response effort to engage in undesired behaviors, and (e) benefiting from stimulus control.

Sharon is trying to lose weight for her summer beach vacation so she has created a self-management plan to increase her healthy food intake and decrease unhealthy food intake. She is attending a birthday party Saturday night and knows the host will have a delicious spread. Sharon eats a healthy dinner before she heads to the party. In this example, Sharon manipulated motivating operations. By eating a healthy meal before she left for the party, the full stomach was an abolishing operation for more food at the party, abating any behaviors previously reinforced with junk food, like walking to the kitchen and filling a plate with unhealthy food.

Blakely is a graduate student overwhelmed with the many responsibilities of her graduate program and her part-time job. On top of those responsibilities, she also recently adopted a puppy and has been volunteering at a shelter for victims of domestic abuse. With her many responsibilities, Blakely has had trouble remembering to complete her coursework assignments, like reading the assigned chapters and submitting her homework on time. To improve her completion of course assignments, Blakely purchased a new calendar. She writes each reading and homework assignment into her calendar to help her achieve the goal. In this example, Blakely is using response prompts. By writing down her assignments, she is prompting her own behavior.

Jyreese is an 18-year-old man who just moved into his first apartment. After the first few months, Jyreese realized that he wanted to improve his housekeeping skills. He wanted to increase the frequency with which he washed his clothes, swept and mopped the floor, and washed the dishes. Jyreese determined when he wanted to complete each housekeeping task. On the evenings he wanted to complete a housekeeping task, he engaged in a self-management approach that morning. In the morning before he left for work, he would set out the items needed for the task. For example, on the day he planned to do laundry, he set out his dirty clothes hamper just in front of the washing machine. Similarly, on the day he wanted to sweep and mop the floor, he would set the broom, dust pan, mop, bucket, and a cleaning solution in the kitchen. Jyreese was self-managing his housekeeping behavior by performing the first step in a behavior chain. Each response in a behavior chain serves as a discriminative stimulus for the next step. Therefore, when Jyreese comes home after class, he is immediately confronted with a discriminative stimulus to complete the next step in the chain.

There is another approach for Sharon to meet her goal of increasing her healthy food intake and decreasing unhealthy food intake. To master this goal, Sharon could increase the response effort to engage in undesired behavior of eating unhealthy food by removing all unhealthy food from her house. If Sharon craved a sugary sweet, rather than grab one from the pantry, she would have to drive to the nearest store to purchase the treat in order to consume it. This increased response effort to engage in the undesired behavior is likely to decrease the unhealthy food intake.

The final antecedent approach for self-management is to benefit from stimulus control. This could be programmed in two ways. First, the individual could limit engagement in the undesired behavior to specific stimulus conditions. With Sharon’s goal to decrease unhealthy food intake, Sharon could limit her undesired behavior, unhealthy food intake, to one night per week. She would only eat unhealthy food Saturday for dinner, for example. The other approach to benefit from stimulus control is to specify a specific environment for the desired behavior. Take Blakely who wants to increase her completion of course assignments. Blakely begins to visit her campus library three times per week to read and complete homework assignments. By pairing the campus library with assignment completion, the campus library now has control over Blakely’s coursework completion, so when she visits the library, she efficiently completes her work without being distracted by other activities.

In addition to managing antecedent interventions, an individual may self-manage behavior by self-monitoring and evaluating their own behavior. Self-monitoring is the act of observing and recording one’s own behavior (Broden et al., 1971; Cooper et al., 2020). This may also be referred to as self-recording. Self-monitoring is likely effective because of the phenomenon of reactivity. Self-monitoring is frequently paired with self-evaluation in which an individual compares their behavior to a goal or standard (Cooper et al., 2020; Kasper-Ferguson & Moxley, 2002; Grossi & Heward, 1998).

Finally, individuals may self-manage consequences to their behavior. The terms “self-reinforcement” and “self-punishment” have been criticized because they do not accurately represent the mechanisms by which behavior is changed (Skinner, 1965; Goldiamond, 1976). While a thorough discussion is beyond the purpose of this chapter, we encourage you and your supervisees to explore excellent, thought-provoking discussions found in Skinner (1965), Goldiamond (1976), and Malott (2005). For the purpose of this chapter, we will simply refer to this practice as self-managing consequences, which typically involves delivery of a reward or aversive consequence sometime after the occurrence of the behavior. For example, Cameron, who is training for a marathon, treats herself to a manicure after she completes five of her planned running workouts. Another example is Millie who is attempting to decreasing her use of swear words. Millie puts one dollar into an envelope for every swear word she says. At the end of the month, she gives the envelope to a charity.

Implementation Guidelines

Guidelines for implementing self-management (Cooper et al., 2020; National Autism Center, 2015) are no different than those for a behavior change program implemented by a clinician. However, these guidelines are valuable enough to justify a refresher. Any of the guidelines below could be self-managed or implemented by a change agent (e.g., clinician).

• 1. Operationally define the target behavior.

• 2. Specify an achievable, socially-valid goal. See Heward (1980) for guidance.

• 3. Specify a data collection method.

• 4. Include self-monitoring and self-evaluation into the self-management plan, when feasible.

• 5. Routinely check accuracy of self-monitoring.

• 6. Confirm the target behavior(s) are within the individual’s repertoire.

• 7. Choose effective rewards.

• 8. Solicit a change agent to reinforce self-management behaviors.

• 9. If the behavior change program consists of some self-managed components and others that are managed by a change agent, systematically fade the involvement of the change agent, when feasible.

• 10. Share the self-management goals and program with others. This is likely to elicit desired consequences for success (e.g., public recognition) and aversive consequences for failure in self-management (e.g., shame), thus increasing the likelihood of success (Cooper et al., 2020).

Practical Applications

Your supervisees will most likely have many opportunities to both self-manage their own behavior as well as assist clients in developing a self-management program. As a result, it is helpful to gain a better understanding of the self-monitoring literature. While research has confirmed that even preschool children can successfully self-manage behavior (Strain et al., 1994; Reinecke et al., 1999), the majority of research has been conducted with elementary, pre-teen, and adolescent participants (Aljadeff-Abergel et al., 2015). This should not necessarily dissuade your supervisees from implementing self-management procedures with younger clients, but the ratio of self-managed to change-agent-managed components may need to be decreased for younger clients. Self-management procedures have been evaluated across a number of skills. Self-management has been used to increase and/or improve academic skills (Rock, 2005; Shogren et al., 2011), task engagement (Clemons et al., 2016), communication (Koegel et al., 2014), social skills (Strain et al., 1994), play skills (Reinecke et al., 1999), self-help (Bouck et al., 2014), and vocational skills (Rouse et al., 2014). Additionally, self-management interventions have successfully reduced challenging behavior as well as restrictive, repetitive behaviors (Crutchfield et al., 2015; Fritz et al., 2012).

Children and adults with intellectual and developmental disabilities have successfully self-managed behavior change programs to increase desired behaviors and decrease undesired behaviors (Aljadeff-Abergel et al., 2015; National Autism Center, 2015; Steinbrenner et al., 2020). Moreover, a multitude of research has demonstrated the ability of individuals with intellectual and developmental disabilities to self-manage all aspects of a behavior change program. This includes setting goals, management of antecedents, self-monitoring, self-evaluation, and self-administration of consequences (both rewarding and aversive consequences).

Advantages

Self-management offers many advantages. Self-management is a pivotal skill. If an individual develops self-management skills, those skills can be used to impact positive changes on many other behaviors (Cooper et al., 2020). Similarly, once self-management skills are within one’s repertoire, they may be used to promote generalization and maintenance of behaviors.

In some cases, self-management may be the best practice for a number of reasons. For example, self-management may be the only appropriate behavior change program for behaviors that are likely not to be observed by others. For example, an individual who wishes to change their grooming or housekeeping behaviors is likely to need a self-managed behavior program because those behaviors most frequently take place at home, without the presence of others who could serve as a change agent. Similarly, self-management is necessary to change private events, such as self-talk or obsessive thoughts (see Kostewicz et al., 2000 and Kubina et al., 1994 for examples).

Self-management skills may have additional outcomes. For example, self-managing is likely to build self-accountability and self-awareness. Self-management has the inherent benefit providing the individual engaging in the behavior immediate awareness and feedback regarding their own behavior (National Autism Center, 2015). Self-management skills may be particularly helpful for individuals with disabilities. The increased reliance on self-management can have an inverse effect on the reliance on change agents (National Autism Center, 2015). In many cases, the presence of change agents can be stigmatizing; thus, decreased reliance may be a significant advantage. With the strong evidence of the effectiveness of self-management and the many advantages it brings, supervisees should develop skillsets to both manage their own behavior and assist clients in developing self-management programs.

Group Supervision Meeting

Below is a plan for activities to incorporate into a 1-hour meeting with a small group of supervisees.

Group Supervision Meeting Agenda

Time	Activity
0:00–25:00	Introduction to Self-Management
25:00–40:00	Plan Self-Management
40:00–55:00	Present Self-Management Program
55:00–60:00	Knowledge Check

Reading Assignments

At least 1 week prior to the group supervision meeting, assign your supervisees to read about the subject. Below is a list of recommended assigned readings.

• Koegel et al. (2014)

• Rosenbloom et al. (2016)

• Shogren et al. (2011)

Introduction to Self-Management

Open the meeting by asking supervisees to volunteer to share any self-managed behavior change programs they are currently implementing to change their own behavior. Ask volunteers to share the behavior they intend to change, the desired outcome, and the specific strategies they are using to self-manage. As they describe their self-management program, listen carefully for opportunities to model tacting the correct terminology (e.g., “wow, that is a great way to manipulate motivating operations to evoke the desired behavior”). Next, introduce your supervisees to important terminology: self-management, controlling response, and controlled response. Review the different components of a behavior change program that can be self-managed: (a) modifying antecedents, (b) observing and recording data (i.e., self-monitoring), (c) self-evaluation, and (d) modifying consequences. Review how each of these behavior change components can be self-managed, providing examples of each. Review the self-management guidelines. Present the first guideline and ask your supervisees why this particular guideline is important. As they provide a rationale for each guideline, confirm accurate rationale explanations and correct errors.

Next, share with your supervisees that self-management interventions have been applied to a wide variety of participants, to target a wide variety of behaviors, including increasing desired behavior and decreasing undesired behavior. Divide your supervisees into three groups. Assign each group three articles, according to Table 30.1. They should have received access to all articles via email just prior to this meeting. Distribute Article Summary Form (Appendix A). Instruct your supervisee to summarize how self-management was implemented in each study according prompts in the article summary form. Allocate about 10 minutes for the groups to review and summarize their three articles. Then ask each group to briefly share their summaries. As they share their summaries, point out the variety of participants, target behaviors, and self-managed intervention components across these nine studies.

Table 30.1 Article summary assignments

End the introduction by sharing with your supervisees that self-managed behavior change programs have many advantages. Distribute two index cards to each supervisee. Ask them to write one advantage of self-management on one of the index cards. After they write one, instruct them to pair with another supervisee and share the advantages they noted. In the discussion as a pair, they should each identify an additional advantage. Now each pair has three advantages, the two they individually identified and the two they identified as a group. Return to the full group. Ask each supervisee to share the two advantages they identified. Write down each advantage so that by the time each supervisee shares their identified advantages, a thorough list is documented. Before you close the introduction, be sure to identify any advantages that your supervisees failed to identify.

Planning Self-Management

The following activity can be completed independently or in pairs. Each supervisee will develop a self-management program to address their own behavior. If you pair supervisees for this activity, they should each write their own self-management program, but they may help one another brainstorm how to do so.

Distribute Self-Management Planning Guide (Appendix B). Instruct your supervisees that they should select a one of their own behaviors they wish to target for change. This may be related to their supervised fieldwork (e.g., arrive to work early, complete progress reports ahead of schedule) or not (e.g., increase physical activity, partake in more social activities). Remind them that they will be sharing their behavior goals and intervention plan, so to choose a behavior they feel comfortable discussing with the group.

Inform your supervisees that they will have 15 minutes to determine how they could develop a self-management program using each of the self-management components they just reviewed. Remind your supervisees that the purpose of this activity is to practice identifying how they could implement self-management with each component on this list. It is likely that some supervisees will identify certain components they prefer not to self-manage, but they should identify how to self-manage that component regardless. For example, a supervisee may know that they would have difficulty withholding rewards if they failed to meet a behavior criterion, thus suggesting this intervention component should either be eliminated or managed by a change agent. However, for the purpose of this activity, the supervisee should develop a plan for self-managing rewards for desired behavior for the practice of considering and planning all possible self-managed components.

Present Self-Management Program

After your supervisees develop a self-management program, allot 15 minutes for them to present the program to the group for feedback. This is not to be a formal presentation, but rather each supervisee reviewing each component of the Planning Self-Management form. Each supervisee will have an opportunity to present, while the other supervisees record feedback to share with the presenting supervisee on the Self-Management Feedback Form (Appendix C).

Before each presentation, distribute Self-Management Feedback Form (Appendix C) to each nonpresenting supervisee. Ask your supervisees to use this to record notes about the strengths and limitations of the presented self-management program. After the presentation, invite the supervisees to share their feedback. Begin by asking the supervisees to share at least two strengths of the self-managed antecedent components, followed by one limitation. Repeat this two-to-one ratio of strengths-to-limitations for self-monitoring and self-evaluation components and then consequence components.

Homework

Before ending the meeting, explain to your supervisees that they will develop a self-management program with client or a client’s caregiver. We anticipate that most supervisees are working directly with clients for whom self-management is well suited (e.g., general education students, children with an intellectual disability receiving services in a clinical setting). If this is the case, we recommend that your supervisees develop a self-management program to teach directly to the client that they serve. On rare occasions, your supervisee may work with clients for whom self-management is not indicated (e.g., very young children, children with extensive support needs). In such situations, we recommend they modify this activity by working collaboratively with a client’s change agent to develop a self-management program as it relates to providing care or services to the client. For example, developing a program with the client’s teacher aimed at increasing the frequency of praise statements delivered to the client. Another example is working with the client’s father to develop a self-management program to improve the accuracy with which he implements an at-home reinforcement program.

As a very last resort, a supervisee could develop a self-management program to improve their own behavior. This option should only be used if it is impossible to complete one of the two recommended activities. If the supervisee develops a self-management program to improve their own behavior, it should be a behavior related to their field experience. Examples of behavior to target include arriving to the field experience on time, improving the accuracy of implementing an intervention, improve frequency of communication with client and/or clients’ caregivers. The description of the individual supervision meetings with and without a client is designed for a self-management program with a client or a client’s caregiver. It would be the responsibility of the supervisor to adapt these activities for developing a self-management program for the supervisee. It is also unlikely that the development of a self-management program for oneself, as opposed to one’s client, would meet the supervised fieldwork requirements as outlined by the BACB (BACB, 2022). It is the responsibility of both the supervisor and supervisee to determine if such activities would constitute field experience and determine alternative acceptable activities to satisfy the supervised fieldwork requirements during this supervisory period.

Individual Supervision Meeting Without a Client

Below is a plan for activities to incorporate into a 55-minute meeting with an individual supervisee.

Individual supervision meeting without a client agenda

Time	Activity
0:00–10:00	Review Client’s/Client’s Change Agent’s Goals & Select One Goal for Self-Management
10:00–20:00	Plan Self-Management
20:00–35:00	Develop Self-Management Procedural Fidelity Checklist
35:00–55:00	Plan Teaching & Evaluating Self-Management

Review Client’s/Client’s Change Agent’s Goals and Select One Goal for Self-Management

Client Self-Management

During the first 10 minutes of your meeting, review the client’s goals. Ask your supervisee to read each goal aloud, summarize the client’s progress on that goal, and identify if the goal is well suited to self-management. Furthermore, ask your supervisee to elaborate why they believe the goal is or is not well suited for self-management to confirm that they came to this decision by applying accurate considerations. After they review all of the goals, ask them to select the top three goals for self-management. Discuss the pros and cons of each goal as it relates to being targeted with self-management. Using this information, select a goal to target.

Client’s Change Agent Self-Management

During the first 10 minutes of your meeting, review the potential goals for the client’s change agent. Ask your supervisee to summarize the conversation they had with the individual. If they identified multiple potential goals for self-management, discuss the pros and cons of each. Using this information, select a goal to target. If not already written in this format, ask your supervisee to write the goal so that it is observable and measurable.

Plan Self-Management

Provide your supervisee with the Self-Management Planning Guide (Appendix B). Ask them to complete the document, reading each prompt and response aloud. Encourage your supervisee to complete this planning guide as independently as possible, but offer as much support and collaboration as needed for success. Praise correct responses to the prompts in the guide and correct responses that are likely to hinder the success of the self-management intervention.

After completing the planning guide, collaboratively discuss which of the potential self-management components are best fit for the client or the client’s change agent. This should be a collaborative process. Your supervisee may wish to incorporate several self-managed components in order to gain more practice with self-management programs. However, the goal is to meet the client’s needs, or that of the client’s change agent. Therefore, if the client would be more successful with a single self-managed component, incorporate just one.

Client Self-Management

It is possible that your supervisee’s client will self-manage only a fraction of the intervention components necessary to reach the target behavior goal. For example, a young child may be able to self-monitor their own behavior, but would need a change agent, such as your supervisee, to manipulate antecedents and deliver consequences. Once you and your supervisee have identified the interventions to be self-managed, discuss the remaining intervention components that the supervisee will manage.

Client’s Change Agent Self-Management

It is likely that this individual will be able to implement enough self-management components to successfully master the target behavior goal. However, it might be necessary for your supervisee to manage one or two of the intervention components (e.g., rewards for meeting behavior criterion, rewards for accurate self-monitoring). Discuss what, if any, intervention components would be managed by the supervisee.

Develop Procedural Fidelity Checklist

Now that all the self-management plans have been well thought out, guide your supervisee through developing a self-management protocol. Together, complete the Self-Management Procedural Fidelity Checklist Template (Appendix D). Encourage your supervisee to develop the procedural fidelity checklist independently, but offer support, praise accurate use, and correct errors as necessary.

It is important to note that this template is designed to encompass self-managed and supervisee-managed components of an intervention program. It will also be necessary to create a self-management procedural fidelity checklist containing only the specific steps that the client or client’s change agent would perform. After your supervisee has completed a comprehensive procedural fidelity checklist that contains both the steps the supervisee and client will complete, ask your supervisee to create a second procedural fidelity checklist specific to the self-managed components of the intervention program. This second procedural fidelity checklist will be referred to as the client procedural fidelity checklist. Your supervisee may use this to evaluate the fidelity with which their client or their client’s change agent implements self-management.

Plan Teaching and Evaluating Self-Management

We have allotted 15 minutes for you and your supervisee to determine how they will teach their client/client’s change agent the new self-managed program, followed by 5 minutes to discuss collecting data to evaluate the success of the program. Inform your supervisee that they will use behavior skills training (BST) to teach their client, or client’s change agent, to implement the self-management program. Briefly review the four steps of BST: (a) instructions, (b) modeling, (c) role-play, and (d) feedback. Ask your supervisee to begin by creating instructions for the client or their client’s change agent using Self-Management Instructions Template (Appendix E). It is important to note that this template may not be suitable for all clients. For example, some clients may need instructions with line drawings or photographs. Such instructions may take more time to create than allotted in this meeting. This meeting can be extended to accommodate that additional time or you may discuss the desired outcome and ask your supervisee to prepare the instructions at a later time.

Next ask your supervisee to describe how they will model the self-management program for their client. They may consider using a live or video model. Discuss the needs of the client and select an approach to meet their needs. Engage in a similar conversation regarding role-play and feedback. Ask your supervisee to describe how they plan to implement these BST components. Once you and your supervisee have a clear plan of how they will teach the client how to implement the self-management program, transition to discussing the data collection and evaluation process.

Inform your supervisee that they will need to collect data on two behaviors: (a) the target behavior and (b) the fidelity with which the client is implementing the self-management. For the former, if data have been previously collected on this target behavior (e.g., baseline data) it is most likely that the supervisee will continue to use this data collection method. If for any reason the data collection method needs to be changed or if no data have been previously collected on this behavior, confirm that your supervisee will collect baseline data prior to implementing the self-management program so that they can determine if the self-management program is effective.

For the latter, measuring the fidelity of self-management implementation, your supervisee will have already developed a procedural fidelity checklist during the previous activity. Discuss how your supervisee can use this to evaluate fidelity of implementation and how to deliver performance feedback, if necessary. Additionally, if the client will be self-monitoring, ask your supervisee to determine how and when IOA will be measured. Most likely, your supervisee will also collect data on the target behavior in order evaluate the accuracy of self-monitored data. However, in some instances, a secondary data collector other than the supervisee may collect these data. For example, if the self-managed behavior will occur at times when the supervisee is not observing the client, or the client’s change agent, then another method for assessing IOA is necessary.

Individual Supervision Meeting with a Client, Part 1

Below is a plan for activities to incorporate into a 50-minute supervision session in which you observe your supervisee with a client.

Individual Supervision Meeting with a Client Agenda

Time	Activity
0:00–5:00	Provide Feedback Regarding Procedural Fidelity Checklist and/or Data Sheet, If Needed
10:00–40:00	Observe Self-Management Instruction
40:00–50:00	Performance Feedback

Provide Feedback Regarding Instructional Plan and Data Collection

At least 48 hours prior to your observation, your supervisee should have provided you with a procedural fidelity checklist and data sheet. Review these materials prior to your meeting, noting feedback. Prior to beginning your observation, discuss your feedback with your supervisee. If significant changes must be made, the supervision meeting with a client may need to be postponed.

Observe Self-Management Instruction

Prior to the client or the client’s change agent implementing a self-management program, your supervisee will need to teach the them how to implement the self-management program. You will observe your supervisee implementing BST to teach the client to implement self-management. We allotted 30 minutes, but we encourage you to observe the entire instruction session, even if it takes longer than 30 minutes. During the observation, record feedback using the Teaching Self-Management Using BST Feedback Form (Appendix F).

Performance Feedback

During your final 10 minutes provide performance feedback regarding your supervisee’s implementation of BST to teach their client to self-manage. Provide feedback when no clients are present, which may require you to provide performance feedback at a later time. Review each step of BST, summarizing both the strengths and limitations recorded. Provide a rationale for correcting errors in implementation and provide an opportunity for your supervisee to role-play implementing these steps correctly. End by providing your supervisee an opportunity to ask questions.

Individual Supervision Meeting with a Client, Part 2

Below is a plan for activities to incorporate into a 40-minute supervision session in which you observe your supervisee with a client.

Individual Supervision Meeting with a Client Agenda

Time	Activity
0:00–30:00	Observe Self-Management Implementation
30:00–40:00	Performance Feedback

Observe Self-Management Implementation

If possible, observe the self-management program. If the self-management program includes supervisee- and self-managed components, you will have the opportunity to observe the program because it will only occur in the presence of your supervisee. If the self-management program contains only self-managed components (e.g., the client’s parent is self-managing behaviors that only occur in their home), you will not have the opportunity to observe the program because it will not occur in the presence of your supervisee. In the latter case, we recommend your supervisee schedule regular follow-up meetings with the individual to review self-monitoring data, discuss strengths and weaknesses of the program, and modify the program as needed. If this is the case, we encourage you to observe and provide performance feedback during one of these meetings.

If you observe the self-management program being implemented, do so for at least 30 minutes. During the observation, measure procedural fidelity using the comprehensive procedural fidelity checklist that contains both supervisee and self-managed intervention components. Additionally, collect data on the client’s behavior using the data sheet your supervisee provided. This may be the data sheet used by the client to self-monitor or the data sheet your supervisee uses if the client is not self-monitoring.

Performance Feedback

Schedule 10 minutes provide performance feedback regarding the implementation of a self-managed intervention program. No clients are present during this feedback discussion. Begin by recognizing and steps your supervisee and their client implemented correctly. It is important to attribute the client’s correct implementation as a success of your supervisee as they trained the client to self-manage those components. Next, identify any steps implemented incorrectly. Provide a rationale for correcting errors in implementation and provide an opportunity for your supervisee to role-play implementing these steps correctly. Give your supervisee an opportunity to ask questions.

End by comparing the data you and collected on client target behavior and the data self-monitored by the client or collected by the supervisee. Ask your supervisee to calculate IOA. Discuss discrepancies and any possible steps to improving data collection if concerns are identified.

Mastery Criteria

In order to progress from this lesson, your supervisee must develop and teach a client (or a client’s caregiver) a self-management program in which the client (or client’s caregiver) implements the self-managed components with at least 80% fidelity. If this is not met, a second individual meeting without a client with intensive role-play and feedback should be scheduled.

Appendices

Appendix A: Article Summary Form

Instructions:

Summarize the assigned articles by answering the questions below.

Appendix B: Self-Management Planning Guide

Instructions:

Develop a plan for self-management of a self-selected behavior by responding to the questions and prompts below.

Appendix C: Self-Management Feedback Form

Instructions:

Review the presented self-management program by noting how the program aligns with each of the guidelines below. At the end of the presentation, note any strengths and weaknesses of the self-managed program.

Appendix D: Self-Management – Procedural Fidelity Checklist Template

Appendix E: Self-Management Instructions Template

This self-management program has been designed to reach the following goal: [insert goal]. Follow the steps below to reach this goal.

Appendix F: Teaching Self-Management Using BST Feedback Form

Instructions:

Observe your supervisee training their client to implement a self-management intervention. For each BST component, summarize the strengths and weaknesses of this training session.