If your organization runs like most Virginia Department of Behavioral Health and Developmental Services (DBHDS) licensed providers, your Direct Support Professionals (DSPs) most likely turned to this website to receive training, and that’s fine – a portal like this where DSPs read pages of content which they are then tested on provides a fine means of ensuring that they have been briefed on all of the regulations, practices, and beliefs which the state requires, and log-in portals like this one are used to train DSPs all across the nation.

Anecdotally, however, we all understand that hands-on experience is preferable to any understanding which is purely theoretical. As much as we can read-up on a new skill we may want to learn, like perhaps cooking or learning a new dance, nothing will teach us the finer intricacies of that skill like getting out and doing it. DSPs achieving DBHDS required training through the provided materials will surely be briefed on everything they need to know in order to meet the requirements given to their position by the state, but that isn’t entirely comparable with the real world acts of demonstration, roleplay, and practice with feedback. Certainly, it would be preferable if DSPs had the opportunity to have the instructional skills that they will need to pass onto people using their services demonstrated to them before they are providing this support independently.

So, what if there was a means of ensuring that DSPs are given direct experience with the skills they’ll be transferring to clients before they’re sent into the field? Luckily, this is something that has not only been done before, it’s something that’s been in practice since the 80’s.

What is Behavioral Skills Training?

Behavioral skills training is a process through which any action or sequence of actions is broken down into a process of steps which occur in sequential order every time the target skill is put into practice. The trainer, after performing the skill and showing the different steps to the trainee, then monitors the trainee as they perform the skill, providing guidance and encouraging the trainee until they have reached the desired level of reliable accuracy in performing the skill. Behavioral skills training is the method of teaching a skill from one person to another, but the skill that is taught can be anything. This makes behavioral skills training especially effective for DBHDS-licensed providers, not only because the skills which DSPs will need to teach their clients often have to be tailored to the specific needs and preferences of the person receiving training – but also because the process of behavioral skills training has already been found to help persons with disabilities gain mastery of a skill. While there are several articles that break behavioral skills training down for a wider market, defining it in four simple steps, this study from 2013 breaks it down into eight. In this example, “target skill” refers to whatever skill the trainer needs to use the behavioral skills training process to teach to the trainee.

The eight steps given are;

  1. Provide rationale for the target skill being trained.
  2. Vocally describe steps of the target skill.
  3. Provide trainee with written summary of target skill steps.
  4. Demonstrate the target skill.
  5. Have trainee practice performing the target skill.
  6. Observe and record trainee correct vs. incorrect performance of target skill.
  7. Provide supportive and corrective feedback (the latter if applicable).
  8. Repeat Steps 5, 6, and 7 until trainee correctly performs target skill.

The advantage to this approach is that it makes the target skill, action, or process something defined, finite, and repeatable, removing any room for confusion or ambiguity and making it so that the action or skill is something that can be understood and continually implemented the same way, each time – turning the skill into a standardized process and making it easy to pass down from trainer to trainee.

For clarity’s sake, let’s run through the steps of behavioral skills training that we’ve been given using an everyday activity as an example – using a spoon to eat.

To start, we want to provide the person receiving our training with a rationale for why the target skill is necessary, which is simple – eating with a spoon is necessary for eating soup, and everyone loves soup. Next, we’d tell our trainee the individual steps of eating with a spoon – grasping the spoon with the fingers, securing the fingers around the spoon, moving the spoon to the bowl to pick-up some of the soup, then finally bringing the spoon forward to the mouth, eating the contents, and beginning again at the third step until the trainee is satisfied with the amount of soup they’ve eaten – providing both verbal and written instructions (this sort of breaking down of a skill into individual steps, by the way, is referred to as a “task analysis”, which this article defines as “the process of breaking a skill down into smaller, more manageable components”). We would then proceed to eat soup with a spoon ourselves, calling attention to the individual steps of our procedure as we performed them, and would then ask our trainee to perform the skill as we had just done. In order to complete the remaining steps, we would then observe the trainee completing the instructions we’d given them in order, providing encouraging feedback wherever they may falter until they display mastery of the skill.

This serves to make the process digestible to the trainee, while also standardizing the skill so that it can easily be taught over and over from one person to the next and repeated faithfully each time. This element of behavioral skills training, the fact that it breaks an action down into simply-understood, repeatable steps, is what makes it applicable to a wider training approach which facilitates training for a new skill quickly and effectively throughout an organization. With minimal training time, and without the need to hire middle men or outside help, a skill can be taught directly from supervisor, to DSP, to client using. . .

The Pyramid Approach – How to Make This Work for Your Organization

Because behavioral skill training breaks a skill into sequential, repeatable steps, the skill thus becomes standardized and, through that, easy to pass-on throughout an organization. The pyramid approach to training involves a small handful of personnel learning a skill, most likely people with supervisory roles within the organization, who then are able to pass that skill down the chain of command. So, if there are three supervisors who are each tasked with training ten personnel, the number of persons within the organization who are trained on the skill increases tenfold. If those ten personnel then go forward and each train another ten persons on the same skill, it multiplies again. This process provides a labor-and-cost-effective means of easily dispersing a skill throughout an organization,

Two of the studies referenced earlier in this article involved organizations using pyramidal behavioral skills training to pass skills from supervisors to a wider number of DSPs, who then transferred those skills to a wider audience of persons with disabilities. While these studies have attested to the effectiveness of a pyramid approach to behavioral skills training, here’s another for good measure. Across all three studies, implementing a pyramidal approach to behavioral skills training showed an increased reliability in the performance of clients.

With this approach, so long as the professionals put in charge of training DSPs for the skills that clients will be using out in the field have an accurate understanding of what clients will need in order to perform those skills, the ability those clients will need training for should be spread quickly and effectively, while also being repeated faithfully – from supervisor, to DSP, to client. It doesn’t take a lot of time to train a DSP on the skill they will need to have clients practice directly, and it provides the DSP with a solid means of making sure that the client has a full understanding on what they will need to perform.

In Conclusion. . .

While leaving the training of DSPs to online portals is a fine way of ensuring that DSPs are made aware of all state-mandated standards for their field, ask yourself if these portals are in-tune with the individual needs of your organization’s clients. If you find that to be unlikely, don’t worry – research has already proven that more effective means are out there, and to enact the procedures described in this article only requires that you understand the tasks your clients will need to perform and are able to use the tools given to you to dissect and define them. With these tools, DSPs won’t be left with the burden of having to do the guesswork on how best to teach a new skill to their clients, while clients also benefit from a method proven by research to improve their performance in the skills they need. It is our wish at Branches of Life for all persons with disabilities to have access to the best strategies available in promoting their success, and we believe that these evidence-based practices can help not only us, but DBHDS-licensed providers everywhere, accomplish just that.