An except from Sorah Stein, MA, BCBA, CSE
A concerning number of BCBA and BCaBA appear to be addressing sexuality education and sexual behavior as falling within the scope of practice for BCBA and BCaBA, as merely topographies of behavior. This paper will present the steps one can take towards additional training and expertise in this realm and suggest this is the ethical approach towards behavior analyst practice in sexual behavior.
When one wants to earn status as a Board Certified Behavior Analyst (BCBA) or Board Certified Assistant Behavior Analyst (BCaBA), there is an extensive process of coursework and clinical experience that must be completed before one can apply to take the certification exam. This process includes completing a qualifying degree and a required number of course hours (270 until 2022) covering five specific content areas as established by the Behavior Analyst Certification Board (BACB; BACB, 2018). Additionally, one must complete, under supervision (at 5% of hours) a number of clinical hours covering a range of tasks (BACB, 2012, 2017) typically done by those with board certification (1500 for BCBA, 1000 for BCaBA until 2022). Following certification, one must obtain continuing education units every certification cycle in order to maintain certification.
Within behavior analysis, many clinicians pursue additional training to establish expertise in specialty areas of practice, such as feeding, organizational behavior management, fitness coaching, ACT, and gerontology. Most of these involve attending conferences, certification programs, and boot camps, for example. However, few seem to pursue similar depth of training in human sexuality to address sexual behavior and provide sexuality education for their learners.
When one wants to become a certified sexuality educator, the process is not wholly dissimilar to that of the BCBA or BCaBA. The certifying organization is The American Association of Sexuality Educators, Counselors and Therapists (AASECT). AASECT requires 90-hours of core education (only 75 of which can be completed online), covering 17 core areas, plus 60-hours of coursework in how to provider sexuality education (only 30 can be completed online). Additionally, one must complete at least 1,000 hours of professional experience, with the constraint that these hours be completed within 2-5 years and a 10% supervision requirement. Following AASECT certification, continuing education is required as well. One could easily argue that this is a rigorous process that should produce a clinician extremely well-versed in the range of human behavior.
Attempting to address sexual behavior in learners with intellectual and developmental disabilities without extensive knowledge of hormones, human development, anatomy and physiology, normal range of sexual function and medical issues that can impact said functioning, etc. can result in a behavior analyst missing a crucial contributing factor to the topography of concern and result in an intervention that might be ineffective at best and unethical at worst.