Here we all are, in the midst of an unprecedented life event and trying our best to continue providing ABA services to the clients who need our help now more than ever.

So yeah, no pressure or anything. :-)


Prior to this pandemic, maybe you had some clinical telehealth experience, maybe you didn't, but either way I hope to provide either a review of information you already know, or a crash course in Telehealth 101. 

I suspect that for many of us even after the current crisis ends, telehealth could become the New Normal as far as the way we do our jobs. Don't you think? 
If so, then it's pretty important to get your skill set up to speed with using technology to serve consumers.


So take a breath, relax, and let's dive in to some strategies for implementing your ABA magic remotely!

You can listen to the audio presentation here.



* HUGE* resource file for this presentation: Click Here to Download
Sharing is caring, pass this resource along to your ABA colleagues! We're in this thing together.



Today's quote of the day is from ..... Me!


See below for an excerpt about knowing your identity as a clinician, from my newest book, The Practical ABA Practitioner:




*Recommended Reading:

Runnin' on Empty












If you haven't experienced it yet as a supervisor/Program Lead/BCBA, you will: Being in charge of those who want no one in charge of them.

Sounds like a riddle or something. But in real life, it's much less humorous.

As someone in a leadership position (regardless of your actual title), you probably imagined your job would include lots of mentoring, providing support and encouragement, staying available to your team, selflessly putting their needs before your own, and definitely.. absolutely.. NOT being like that one supervisor you had who was just the worst.
You probably imagined your team or supervisees would accept your teaching and support with gladness, gratitude, and a huge "Thank you so much, you're the best!".

So it can be a pretty big let down when instead your efforts are met with disdain, condescension, irritation, or just flat out insubordination.
When no one is implementing your behavior plan.
Or no one on the team ever replies to your emails.
Or your supervisee requests to work with a different BCBA.

Again, if you haven't experienced this yet, just give it time. It's darn near impossible to move into a position of leadership and never have to deal with difficult people. Actually, I would say the higher up in leadership you climb, the more opportunity you have to deal with difficult people.

So if I may, I'd like to offer some tips for this daunting challenge. Here is what I've found helpful in the past:



First, check yourself -

1.      Are you making a difficult situation worse by being overly offended, getting all wrapped up in your feelings, and assuming the person hates you just because they don’t listen to you? Guess what? When you are the boss, everyone won’t like you. There really is no way around that. Stop taking things so personally.
2.      Have you calmly and clearly communicated your expectations, specified the areas where they aren’t being met, and helped the difficult person create an action plan? No? Why not?
3.      Do you spend more time at work complaining about the difficult person, rather than talking to the difficult person? Come on, be honest.
4.      Have you lost your objectivity? Do you get tense, sigh heavily, and roll your eyes every time this person calls you or sends you an email? If so, then your irritation is likely coming through in your interactions with this person.



After you have honestly looked at your own behavior (do not skip that part, it’s really important), now it’s time to take a good look at your supervisee/employee -

1.      Is this an issue of poor fit? Sometimes you have to taste the food to know you don’t like it. Similarly, some people need to start working for the company, or hold the position, before realizing it isn’t for them. Have an open conversation with the difficult staff about their current contentment with their role/the company.
2.      Look at the reinforcement history: has this person had good supervision/leadership experiences before? How do you compare to their previous leaders? Are they simply not used to having high expectations placed on them? It's hard to follow when you've never been led.
3.      What career goals does this person have? One of the most effective ways I have found for dealing with difficult supervisees is to help them connect their personal career goals to their current work performance. For example, if you know the staff is pursuing their BCBA then help them connect the dots between being able to accept feedback now, and how much more challenging it will be to accept feedback you don’t agree with as a BCBA. These clinical “soft skills” only become more important the higher up you go in this field, so it’s important to learn professionalism and humility now.
4.      Lastly, are you dealing with a toxic employee? If so, then move straight to GO, and collect $200. 😊 Unfortunately, a toxic employee has the potential to bring so much harm to staff morale, client satisfaction, and work culture, that it may be a better decision for the sake of the whole team to part ways, and wish them the best of luck with their next employer.





** Helpful Resources:








"Bad bosses compel good employees to leave"
www.Forbes.com

"The way your employees feel is the way your customers will feel. And if your employees don't feel valued, neither will your customers"
Sybil F. Stershic

"The only thing worse than training your employees and having them leave not training them and having them stay"
Henry Ford

"Strive not to be a Success, but rather to be of Value"
Albert Einstein

"You don't get paid for the hour. You get paid for the value to bring to that hour"
Jim Rohn





Get Excited!

For those of you out there, laboring away, giving your all to your clients, working from 8am to 8pm every day (and getting paid for 1/2 that time), typing up 25 page reports at 2 am, laminating flashcards until your fingers are sore, putting hundreds of miles on your car, going to work bruised, discouraged, and exhausted, and eating your lunch in your car...I have something for YOU.

My newest book, 'The Practical ABA Practitioner', uncovers and openly discusses all aspects of ABA practitioner life, as in the good, the bad, & definitely the ugly. ;-)
This book is all about the practitioner experience working in this field, the day-to-day reality, how to plan out a successful career, and what common pitfalls to avoid. Especially for those of you brand new to the field, or newly certified.


If you want to work in this field, you need to read this book.
If you're tired of working in this field, you need to read this book.
If you LOVE working in this field, you need to read this book.

In preparing to write this book, I talked to lots and lots of practitioners about their experiences working in this field, reached back into my own early days as an in-home ABA therapist, and I also perused the resources out there about ABA as a career: What's it like being a BCBA? What are the pros and cons to becoming an RBT? What are the joys, the pressures, and the challenging to meet expectations of this industry?


Dying for some specific details about the book? Sure!
 "The Practical ABA Practitioner" addresses:

  • Professional Burnout. Yup. I dedicated an entire chapter to discussing loving what you do, but hating the way you have to do it, and being eternally exhausted. You're welcome.
  • The end of the book is a huge treasure trove of practical practitioner tips and resources (handouts, job performance tips, staff satisfaction surveys, suggested parent policies, etc.) that will help you do your job better. Seriously, its just pages and pages of stuff. :-)
  • Work-Life balance as a busy full-time BCBA: Fiction or Reality?
  • Developing and refining your clinical identity as an ABA practitioner.
  • What are employers looking for when hiring RBT's? What about BCBA's?
  • Should you pursue BCBA certification? Is it really for you?
  • How to revitalize your passion for this field.
  • What kinds of pitfalls should newbie BCBA's watch out for (because they're vulnerable to these issues)?
  • Why are the staff retention rates in this field so terrible? To put it another way, why are so many ABA companies bleeding staff?
  • Tips for choosing between various employment options, and red-flags to look out for.
  • How to BE the change when working in less-than-ideal conditions.
  • Holding this field accountable for the way we treat direct staff/ABA implementors.
  • How to to develop your personal value system in this field, and practice with integrity.
  • How to be truly successful as a practitioner, for years and years to come.
  • What are some of the main reasons why quality practitioners walk away from this field, and don't look back. And how we can keep them from walking away.




Treat yourself, and do something GREAT for your career... get this resource and be encouraged and strengthened.

Click here to find this brand new resource on Amazon!







ABA employers: You listening?


'You don't build a business, you build people.
And then people build the business'

Zig Ziglar






"Burnout is the process of spending too much time doing things that don't properly utilize your unique Tool Kit" - Runnin' on Empty


If you are new to this field or perhaps if not new, recently became a BCBA, you may not have a very strong understanding yet of who you are as a clinician.

It's ok, it took me time too... Lots and lots of time.

It's hard to solve a problem you don't realize you have, so this is something I didn't even think about for many years in this field. I accepted work opportunities based on what was available, and when those opportunities didn't work out or left me feeling quite underwhelmed I just moved on to a new opportunity.

But, doesn't it make more sense to intentionally and strategically map out your career based on who you are and how you want to practice? Then why aren't are more of us doing that?


Burnout, which is known fact of life in this field, can very much be connected to a lack of goodness-of-fit. Think about a vegan who works full-time at a BBQ restaurant. Or a pacifist working for a guns manufacturer. Or a daycare teacher who can't stand kids.

How much personal satisfaction and enjoyment do you think those employees would report after a work shift? I'm guessing low to none.

It's easy to just tell someone working in this field that Clinical Identity is important, but how many of us really understand how to ~discover~ our clinical identity?

Expect this process to take some time (I know, waiting is the worst), as knowing who you are not doesn't happen in the blink of an eye. It will also take perspective, which means you need to do more than one thing. If you've always worked with adult populations, or always worked in school settings, then how do you know what else might be a good fit for you? You kind of can't know that, if you only do one thing over and over.

Let's start at the beginning by first defining what is meant by a clinical identity: Defined as one’s professional self-concept based on attributes, beliefs, values, motives, and experiences (Ibarra, 1999; Schein, 1978).

Basically, your clinical identity is a combination of why you entered this field in the first place, combined with what keeps you in it. There you go, nice and simple definition :-)


Still struggling to put your finger on the unique clinical identity that fits YOU? Here are some tips:

  •    Take money off the table (no, I’m serious). If you had to work for free, what would you choose to do?
  •    Think about the last time you were truly passionate about work. What were you doing?
  •   What part of the work you do makes you full (energizes you, excites you, lifts you up)? What part empties you (depletes you)?
  •    Seek feedback: ask people who have worked with you, alongside you, or for you, to honestly list your best and worst clinical attributes
  •   Does your current work allow a place for your unique personality, or does it require minimizing or turning off parts of your personality? *If you’ve never taken a personality inventory before, I super recommend doing that.
  •   Write down your value system. Use this list during interviews to determine if your personal values and the values of the organization are complementary, or if they clash.
  •   Anger can be highly educational. Identify the things that make you the most angry/frustrated/annoyed about your work. Honestly examine why these things bother you so much (they likely conflict with your value system).
  •  What is your ‘niche’? What is it that you bring to the table that no one else can?




*References:

Slay, H.S., & Smith, D.A. (2011). Professional identity construction: Using narrative to understand the negotiation of professional and stigmatized cultural identities. Human Relations, 64(1), 85-107.   

Michael Tomlinson & Denise Jackson (2019) Professional identity formation in contemporary higher education students, Studies in Higher Education


*Recommended Resource:

Carving out your Clinical Identity





Impairments in social communication are a key deficit of Autism, and can be seen across the varying range of the spectrum.

Social communication is a big word that can include many difficulties, such as making friends, maintaining friendships, being appropriate near peers, sharing or turntaking, empathy or perspective taking, initiating peer play, joining ongoing peer play, responding to peers, self-advocacy, conflict-resolution, etc. 
When clinicians throw around the term "social skills", we are really talking about a lottttt of skills!

Some people have the mistaken belief that ABA therapy only focuses on 1:1 instruction, and therefore isn't appropriate to target peer social interaction. Nope, not true.
ABA therapy can absolutely include targeted social skills instruction. Depending on the age of the learner and their specific social deficits, that will impact how social goals are assessed and selected. 

Parents of very young children usually want to work on: sharing, playing with peers instead of isolating, playing with toys instead of hoarding toys, reducing aggression towards peers, etc.

Parents of teens or young adults usually want to work on: initiating conversation, increasing MLU (jargon translation= you want your child to use more than 1-2 words to make a statement or answer a question), buying items in the community, talking to community helpers (e.g. a police officer), etc.


There are also many ABA programs that offer formal social skill groups to families, where learners are grouped together based on interests, abilities, age, or other factors, to participate in games and activities as a group. But the games are far more than just "games", they are actually carefully designed to target specific social skill deficits. If you are already receiving ABA therapy services, ask if your child can participate in a social group with other clients.


Behavior Analysis has many empirically validated strategies to add to the social skills conversation, and also (depending on the funding source) the ABA provider can target social skills in a group format, at school, or out in the community, to ensure proper generalization. For example:


  • Reinforcement for the win! Social skills training should include reinforcement individualized to the learner, and also should work to pair (transfer) reinforcement to peers, as pre-intervention the learner may not find interacting with peers to be all that fun ;-(
  • Data collection. If no one is collecting data, reviewing that data, and evaluating that data to make treatment decisions then what is happening is not ABA.
  • Generalization. Also known as, "real life". Learning social skills in the ABA clinic, or at school, or on the playground, will not necessarily generalize to other settings and other kids. Intentional generalization into real-world, real life scenarios is a must.
  • Structure. This may sound weird, but it does NOT mean that the learner must do the same thing, in the same order, for each peer interaction. It means that the learner should be able to predict what will happen in social group today, they know the rules of social group, and they understand what rewards they contact during social group. These things should be somewhat predictable, from the perspective of the learner.
  • Break down concepts visually or tangibly. Help learners understand abstract concepts through video modeling, games, visuals, or manipulatives, that they can touch, see, etc.
  • Follow an evidence based curriculum.....just not too closely. While it is important to have a tool to create the lesson plan for social instruction, I'd also recommend individualizing the curriculum as much as possible across learners. Modifying the curriculum to make the content more relevant to the learner will go a long way to helping social instruction gains "stick".
  • Behavior management. So obviously, challenging or disruptive behaviors will interfere with learning during social interaction time. These behaviors can also frighten, intimidate, or annoy other children present, which works against the goal of interacting with peers. This is why ABA providers are a qualified to implement these kinds of interventions, because we already have the tools to decrease inappropriate behaviors and increase appropriate behaviors, and keep the social interaction on track.




*Resources:


Crafting Connections (I love this book!)

Social Skills Training for Youth with Autism Spectrum Disorders, Otero, Tiffany L. et al. Child and Adolescent Psychiatric Clinics, Volume 24, Issue 1, 99 - 115

A Review of Peer-Mediated Social Interaction Interventions for Students with Autism in Inclusive Settings, Watkins, L., O’Reilly, M., Kuhn, M. et al. J Autism Dev Disord (2015) 45: 1070


Baker, J.E. (2004). Social Skills Training: For Children and Adolescents with Asperger Syndrome and Social-Communication Problems. Shawnee Mission, KS: Autism Asperger Publishing Co.



"Confidence is Key"
Guest Post written by: Emily Lauren Beard



Much of what I have learned over the last year working as a Registered Behavior Technician (RBT for short) has changed my life completely. I found my job as an RBT mostly by accident. I knew that I wanted to work with children, and I knew I wanted to make a difference
I began a Master’s program for Mental Health Counseling, but I knew that ultimately, I wanted to work in a field that provided therapy for children with disabilities. After a semester of graduate school, unhappy and confused, I decided to go a different direction and look for a different career path.  After months of research, I found ABA therapy and immediately knew that was where I needed to be. I connected with a local behavior therapy clinic outside of my hometown near Jackson, MS, received a job offer, and began training to become a Registered Behavior Technician. As I approach my 1-year anniversary working at Blue Sky Behavior Therapy in Ridgeland, MS, I have begun to think about all the ways I have grown as a therapist.

I want to tell you a story about a few of the most important lessons I have learned about myself, my life, and my job as a helping professional:


This job is about the children, not you.  
 Ouch, that hurt. At least it did the first time I heard it.

My supervisor had just finished taking notes about the session I had just run with a particularly challenging client. This kiddo was sweet, no doubt, but I learned very quickly that if you didn’t have it together – your emotions, a plan for task presentation, control over the situation – the session could take a nosedive quickly.

What I realized during this session in my first few months of training is that being prepared is a must. Adaptability – the quality of being able to adjust to new conditions (Lexico.com, 2019) is a skill that is most definitely learned on the job. One minute we were at the table working hard at sorting pictures by their category and the next, my sweet kiddo was hurling a giant spit wad at my face from across the room. Chairs were knocked over, cards and toys were scattered all over the room, and my client was standing on top of the table.

All the sudden, my heart rate increased, my palms began sweating profusely, I couldn’t breathe and the whole room became blurry and it was as if time had stopped. I began asking myself, “What is my boss going to think of me?”, “Am I going to get fired?”, and “How could I possibly let this happen? I am so stupid!”

Yep. You read that right.

Not once in that moment did I even think about the client and how I could deescalate the entire situation. I was not thinking about the child’s safety or what he could have needed. I was thinking about me.

Luckily my supervisor was there and was all too familiar with the disruptive and problematic behaviors this child engaged in. She quickly deescalated the situation and had him sitting back at the table, working on identifying common objects, compliant and calm as could be, in under 10 minutes.

Looking back on this and discussing with my supervisor, I realized that this job is a selfless one. Walking into a session means leaving yourself – your fears, anxieties, stress – at the door. This job is not about you. It is about the client and what he/she might need to be successful at the skills that we are teaching.


This job requires confidence – a trait that unfortunately, you do not possess.
Over the next few months as I trained with a variety of clients with very specific skill deficiencies and behaviors, I learned that confidence means having the ability to go into a session believing in the work that has prepared you for this moment. Confidence means knowing you’ve got the skills, you are good at what you do, and that you are prepared for the unexpected....and believe me when I say this – kids can smell fear from a mile away. 

If you go into a session afraid of looking silly or not being quick enough, the child will know. They may possibly use it to their advantage. If you look like you don’t know what you are doing or can’t be quick on your feet, your session could go poorly. The session could end in tears, a torn-up room, and sometimes worse, a broken relationship with your client.


You can reach your goals.
Luckily, my boss saw my potential and believed that I could become a successful and confident RBT. Eventually I began to believe it, too. The more sessions I sat in on, the more trials I ran, the more confident I became.

Now don’t get me wrong, this was a long and grueling process. Some days it felt as if I was just tossed to the wolves. I learned to think on my feet and adjust as I went along. I learned that the work that I do is not about me. Sure, I earn a paycheck and have financial stability and that’s great. However, when I walk into my office, the client lobby, the therapy rooms, my goal is to help my client be successful and learn life skills that will make them happier and healthier. The joy that I feel when I see my client finally master a goal that has taken them weeks to understand outweighs any fear or anxiety that I might carry with me deep inside.

I am here to tell you that being an RBT is not an easy job. It is not for the faint of heart or the ones just in it to make money. This job is for the compassionate, hard-working, selfless individuals who wish to see others achieve their goals.

If you are one of these compassionate go-getters, believe me when I say: You can do this!
You can gain confidence in your skills. 
You can be successful. 
You CAN see lasting change in your own life, and the life of your clients.





*References:
Adaptability. 2019. In lexico.com
Retrieved November 29, 2019, from https://www.lexico.com/en/definition/adaptability




Guest Post Author:

Emily Beard is an Registered Behavior Technician at Blue Sky Behavior Therapy, a clinic with locations in Ridgeland, MS and Winona, MS.

Find out more at www.blueskybx.com or email Emily directly at emilybeard.proofreader@gmail.com


For truly any child, the sibling relationship can be a combination of great/horrible, best friends/worst enemies, play partner/nemesis.
Anyone with a sibling knows this is the truth, especially when you and your sibling(s) were young kids.

BUT, when a child with ASD is tossed into the mix then totally normal sibling hi-jinks can take a more drastic turn.

A big concern of the families I work with is sibling interaction, or lack thereof. Usually, the issues fall into one of these categories:

- The typically developing children ignore the Autistic child, and have learned it's easier to just leave them alone
- The typically developing children fully give in to whatever the Autistic child wants, and have learned that letting their sibling bully them is better than making their sibling upset
- The typically developing child IS the bully, and has learned that their Autistic sibling won't put up much of a fight/won't stick up for themselves


As a professional, I see it as a great benefit when my clients have siblings living in the home because now I have a built-in pool of peers to reach for whenever we are targeting social-emotional or play goals. Win-win!
Usually though, the sibling relationship is so strained and broken that we can't include the brother or sister in the session until we work on sibling interaction first.

So there is the 1st tip: until the sibling relationship is repaired, just tossing the kids together to work on skills will likely not end well.

Need more tips? Okay:


  1. Step back from the problems, and focus on what you DO want to see - Are there issues with name-calling and teasing? Then you want to see respect. Are there issues with hitting or kicking? Then you want to see calm bodies. Are there issues with always having to win every game? Then you want to see playing by the rules. When it comes to behavior: focus on what you DO want, rather than what you don't want.
  2. Start small- Baby-step your way to success rather than jumping into the deep end. If your children start attacking each other 5 minutes into playing Candyland, then let's play the game for 3 minutes. Or 2 minutes. Start at a level where everyone can be successful, and gradually increase your expectations over time.
  3. Teach functional communication - Ensure that your children are able to communicate (vocally or non-vocally) what they do and do not want. Usually when functional communication is lacking, there will be lots of aggression instead. Make sure the children are taught how to communicate "I don't want to play", so there will be no need to hit, punch, or kick. 
  4. It's OK to dislike your sibling - Sometimes my clients just don't seem to like their siblings very much. Especially if the sibling is much younger. While we can't force "like", what we can do is maintain an expectation of respect. It is not okay to throw blocks at your baby sister because she's annoying. Nope.  Instead, how about taking a break from the situation, asking to wear headphones, or practicing patience and self-calming? 
  5. Remember, relationships evolve over time - This should be good news for someone! As adults, we tend to forget that in our childhood we felt differently about our siblings at different ages. This is completely normal. I have some clients I have worked with for years, and I have seen the ebb and flow in their children's relationships. From "I can't stand you!" to "I want to sit next to Erica!". This will happen. Just because your children have a terrible relationship right now does not mean it will always be that way.


Lastly, any quality ABA provider can include sibling interaction goals into the treatment plan, provide parent training to help you generalize strategies when the therapists are not around, and intentionally plan for play dates or community outings with all the siblings (basically, moving from rehearsal to a live show).





*Resources:






BCBA Position Summary: 

The primary function of the Board Certified Behavior Analyst (BCBA) is to plan, develop, and monitor a variety of behavioral support service delivery options to meet the needs of individual clients. The BCBA also consults with and teaches staff/client caregivers/team members regarding pro-active, educational, programming, and behavioral supports; develops and implements comprehensive treatment plans; and collaborates with related services providers as appropriate. The BCBA also provides direct staff supervision, and evaluation of staff performance both verbally, and in writing.

Essential Duties: 


  • Use appropriate assessment instruments and data to develop and implement teaching programs that reflect behavioral outcomes and objectives 
  • Ensure the accurate implementation of treatment plans, document contacts and observations; use professional knowledge and independent judgment to strategize continuous improvements.
  • Establish and maintain data measurement, collection, and analysis systems for clients
  • Maintain appropriate documentation and prepare and complete reports as required
  • Ensure that all treatment plans and programs comply with contract requirements, satisfy all relevant insurance certification and other expectations, and meet or exceed professional standards
  • Maintain highly organized, consistent, thorough, and systematic recordkeeping (session notes, data sheets, etc.)
  • Seek creative options for ensuring the continuity and consistency of treatment and support services across settings for the lifespan of the client
  • Develop strategies for the stability of quality services when clients experience transitions
  • Conduct structured periodic service reviews to monitor the effectiveness of treatment programs and their implementation; modify and document plan changes as needed
  • Provide staff development, training, and modeling for team members (including client caregivers) in strategies and methodologies for successful implementation of the treatment plan
  • Provide consultation regarding crisis interventions and critical incident supports; complete Incident Reports as needed 
  • Participate in Individual Education Program (IEP) team meetings for clients as appropriate; advocate for client needs in school settings 
  • Participate in professional growth activities such as conferences, classes, team meetings and program visitations; remain a lifelong learner
  •  Accept all other responsibilities as assigned.



This is a real job description for a BCBA position, and it's fairly accurate to most online job postings.

Yes, the typical day-to-day role of any BCBA will vary greatly depending on where they live, which setting they work in, the population they serve, etc. So to keep things simple and brief, I will focus on clinicians who primarily manage cases and supervise direct staff (as this is overwhelmingly what most BCBA's do).

The problem with most job descriptions (that may be written by administrative staff, not clinicians) is they leave out important details about the actual job.
I hear fairly often from people pursuing their BCBA, full of misinformed ideas about what it will be like on the other side. Or, I hear from current BCBA's who have been working in the field for years and are now burned out and exhausted because they weren't prepared for the realities of the job.

-- If you think you may be at a point of professional burnout, my 1st recommendation to you would be to stop & assess: When was the last time you felt passionate about your work? When was the last time you felt valued by leadership/your employer? Has your dissatisfaction at work started to seep into your personal/family life?
If so, please check out the resources below about dealing with burnout. It's a serious problem in many human service fields, and as BCBA's we are not immune.


While there are some great resources out there about professional burnout, my 2 cents is that clinicians would need triage to "stop the bleeding" much less if they enter the field with a realistic picture of what they're getting into. Let's prevent the bleeding, not patch it up.


Using the example job description above, I'll just sprinkle some fresh reality on top of it ;-) :


Position Summary: 

The primary function of the Board Certified Behavior Analyst (BCBA) is to plan (always planning....most clinicians are continuously monitoring the effectiveness of their interventions which requires intentional thinking about what will come next), develop, and monitor a variety (what works for Mickey will not necessarily work for Minnie, so this requires staying abreast of current research and trends within the field to best serve your clients) of behavioral support service delivery options to meet the needs of individual clients (no matter how impressive your intervention is, ultimately if social validity is low then you have more tweaking to do). The BCBA also consults with (this can be translated as 'remains available to', or in other words 'on top of your regular duties') and teaches staff/client caregivers/team members regarding pro-active, educational, programming, and behavioral supports; develops and implements comprehensive (comprehensive is key, and this is why we spend so much time planning and thinking--> the more deficits the client needs assistance with, the more comprehensive your intervention) treatment plans; and collaborates with (again, this is best translated as 'remains available to') related services providers as appropriate. The BCBA also provides direct staff supervision (it is common that direct contact with the client or with staff is billable time, but not so much the other important components of the position that still must happen), and evaluation of staff performance (this could include staff feedback, written evaluations, meeting with each supervisee monthly, or a mixture of all of the above. Again, this may not be considered billable time).



Essential Duties: 





  • Use appropriate assessment instruments (Some companies do not provide business equipment/tools for you, so you will have to purchase these) 
  • Ensure the accurate implementation of treatment plans, document contacts and observations; use professional knowledge and independent judgment to strategize continuous improvements (Being a quality BCBA requires excellent self-analysis skills....you must seek to continually improve your skillset)
  • Establish and maintain data measurement, collection, and analysis systems for clients (Some companies provide access to data management systems, others do not)
  • Maintain appropriate documentation and prepare and complete reports as required (Keeping in mind that what is required will change)
  • Ensure that all treatment plans and programs comply with contract requirements, satisfy all relevant insurance certification (Credentialing is a PROCESS, and an employer with top-quality billers is a must) 
  • Maintain highly organized, consistent, thorough, and systematic recordkeeping (As needed, you must be able to produce accurate, timely, complete client documentation)
  • Seek creative options for ensuring the continuity and consistency of treatment and support services across settings for the lifespan of the client (The 'across settings' part can  be challenging, especially for school or center based services where you don't see the client's home life)
  • Develop strategies for the stability of quality services when clients experience transitions (As the BCBA, you are responsible for successful client transition. This could include if hours decrease, if the program decreases in intensity of goals, or if services terminate)
  • Conduct structured periodic service reviews to monitor the effectiveness of treatment programs and their implementation; modify and document plan changes as needed (Everything you create as a BCBA must be open to revision as needed. Much of your time will be spent editing protocols, programs, or revising systems) 
  • Provide staff development, training, and modeling for team members in strategies and methodologies for successful implementation of the treatment plan (You must make time for this, which can be challenging)
  • Provide consultation regarding crisis interventions and critical incident supports; complete Incident Reports as needed (When working with severe behavior or populations in crisis, your employer should provide adequate training, protective equipment, and support. Also, ethically you must practice within the boundaries of your clinical competence)
  • Participate in Individual Education Program (IEP) team meetings for clients as appropriate; advocate for client needs in school settings (See why time-management skills are critical?)
  • Participate in professional growth activities such as conferences (Your employer may or may not pay for this)
  •  Accept all other responsibilities as assigned. (Pretty  much a vague and blanket statement isn't it? I would add the following reality check to this section: Accepting an insane caseload does not make you Superman/Superwoman, it will make you a very miserable BCBA. Understand that owning an ABA company does not qualify someone to actually be a good/ethical/honest employer, and hating the boss is the #1 reason why employees quit. Understand that staff turnover is scary high in this field..... there is a reason for that.  Understand that as a clinician there are many tasks you will complete that you just can't bill for. Understand that when you get home at the end of the day you likely still are not done with documentation/tasks. Understand that 'work life' may creep into your weekends too. Understand that many ABA employees report feeling underappreciated, devalued, and ignored by their employers, particularly at the RBT level.  Understand that there is a mental fatigue that comes with this type of work, and the more dissatisfied you are with your employer the more it increases. Understand that as clinician you will get frustrated by ever- changing funder requirements, and increased time-sensitive demands upon clinicians. Understand that employment offers for ABA positions often come with more strings attached than Pinocchio.... if you don't agree with something in the offer letter, do not sign it) 





*Resources:

Preventing Burnout 

Running on Empty

BCBA Burnout

Battling Burnout

Stress in the ABA Workplace

Addressing ABA Employee Turnover

Waldman, J. D., Kelly, F., Arora, S., & Smith, H. L. (2004). The shocking cost of turnover in heath care. Health Care Management Review, 29, 2–7

Griffith, G. M., Barbakou, A., & Hastings, R. P. (2014). Coping as a predictor of burnout and general health in therapists working in ABA schools. European Journal of Special Needs Education, 29, 548–558.

Gibson, J. A., Grey, I. M., & Hastings, R. P. (2009). Supervisor support as a predictor of burnout and therapeutic self-efficacy in therapists working in ABA schools. Journal of Autism and Developmental Disorders, 39, 1024–1030



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