Becoming a BCBA is just the beginning

Let me tell you about a time where I was ruled by fear – the fear of failing the BCBA exam. It wasn't just about passing a test; it was about my entire sense of worth. When I failed the first time around, it’s difficult to put into words the sense of worthlessness I felt. I had tried the usual routes, applying behavior analytic principles: task analysis, study groups, and the works. But something was missing. The breakthrough came when I realized I needed to look deeper, to embrace a more holistic approach. In my second round of studying, that sense of worthlessness stirred something in me. I dissected my emotions like behaviors, dove into trauma-informed therapy, and confronted the ghosts of my past. I unearthed the driving forces behind my fear – childhood wounds, past traumas, and my current relationships. It wasn't linear. It was messy, years of probing, testing, and letting go of previous parts of myself. I learned the power of vulnerability and self-awareness, but more shockingly, I passed that second round.

A small part of me believed the letters 'BCBA' would magically fix everything. I imagined a balanced life with clarity, confidence, and mastery in my skill sets. But the truth is, the letters alone didn't change everything. They were a beginning, not an end. The real transformation happened when I integrated compassionate, non-traditional ABA principles, emotional regulation, and my own lived experience into the work that I do. That's the passionate transformation I want to offer you, a focus on professional development and self-care.

I know what it's like to feel trapped by fear, to desire a life where work isn't a burden, but a passion. My journey may be unique, but my struggles are universal. We all have barriers, but few have the courage to face them head-on, to learn the art of resilience. I've walked the path of making mistakes, confronting uncomfortable truths, and rebuilding myself from the ground up. Now, I wake up every day excited for my work, and confident in the work I do, a feeling I never thought was possible. I've learned to be my own best advocate and I feel alive. 

Imagine a life where you're not just a BCBA, but a truly empowered clinician or therapist. A life where you conquer your fears, find your purpose, and practice what you love. That's the transformation I offer you through mentorship and coaching. It's not a quick fix; it's a journey, a deep dive into yourself. But the freedom, the fulfillment, the 'I love what I do' feeling is worth every step.

Shaping your Relationships: Reinforcement vs. Punishment

Wouldn’t it be nice to have more control over your relationships? Albeit, there are some things we inevitably do not have control over, such as our partner's behaviors or how a stranger treats us. But here is what we can control: our own responses and our own actions. This is powerful because our own actions can influence and shape our partners or strangers behaviors in the way that we desire them to be.

If you want to take more control of your life, here is a different take on how to influence your interactions' direction. One of the most important concepts from behavior analysis is the concept of punishment and reinforcement and understanding how it applies to everyday life. If you aren’t familiar with applied behavior analysis (ABA), it is the scientific study of behaviors (both internal behaviors such as emotions and external behaviors such as our daily actions). Those who have studied in the field use a data and analytical approach to create positive change in a person or animal's life through individualized strategies catered to them.

Let’s review a quick recap of the difference between reinforcement and punishment from a behaviorally scientific perspective. See below:

Positive Reinforcement (adding something pleasant): A mother gives her son praise (reinforcement added) for doing homework (behavior)
Negative Reinforcement (taking away something aversive): Bob does the dishes (behavior) in order to stop his mother’s nagging (nagging is taken away)
Positive Punishment (adding an aversive stimuli): Making a child do an unpleasant task when they misbehave (positive punishment)
Negative Punishment (taking away something pleasant): A wife tells her husband that she is feeling frustrated with him, and the husband ignores her (attention taken away)
*Key Note: Negative punishment AND positive punishment both provide negative results and can increase an undesired behavior, and should always be used as a last resort

With reinforcement, a behavior or action is likely to increase because they are motivated by either something unpleasant that was removed, or something they desire is provided in response to the behavior. However, the consequences of punishment can result in…

• A harmful emotional response ( feelings of shame, fear, anxiety, guilt, self-punishment, or low self-esteem)

• potentially increase aggressive behavior (because it models aggression)

• Suppress a behavior (i.e. they may stop communicating to you because you don’t respond to them anyway or they don’t feel safe)

• It does not teach a replacement: It does not teach, replace, or model to them the appropriate alternative, so they are likely to repeat the behavior

• Temporary Boomerang effect: once the punishment is withdrawn, the behavior will come back again

Punishment doesn’t just come in the form of actions, but also in words. Verbal punishment can look like this..

• “If you don’t do X then I’m leaving you” (negative punishment)

• “You’re grounded because you didn’t study hard enough/get straight A’s” (negative punishment)

• “That’s not good enough” (positive punishment)

• “You’re not listening” (positive punishment)

• “Why can’t you get this right?” (positive punishment)

Does any of it sound familiar? Typically, we do better when we are offered reinforcement such as acknowledgement or praise for something we did “Wow nice job I can tell you’ve been working really hard”. However, punishment can make us feel less of a person, feel like we are not good enough (or never will be good enough), and frustrated– which can lead to suppression of emotions and unhealthy emotional responses. This is the cross-section of where we tend to encounter harmful or frustrating behaviors from others. In children, unhealthy responses can look like tantruming, grabbing, hitting, screaming, biting or simply refusing to listen. In adults, unhealthy responses can look like yelling, road rage, slamming doors, getting defensive, shutting down, blaming, or verbal name calling.

It’s important to think about if our own actions and responses offer reinforcement or punishment to those we interact with daily. The more we engage in punishment behaviors, the less likely we are going to gain access to what we want from a person, which is someone who reciprocates in a cooperative, loving and respectful way. The good news is every response is a skill, and new skills can be acquired, shaped and changed. 

Here are some ways we can influence what we want in a relationship, whether that is with a friend, family, stranger or partner. 

• Think of replacements for toxic responses.  Instead of nagging, learn how to share a need or boundary. Instead of throwing a dangerous item, is throwing is helpful, learn to throw soft pillows.

• Avoid attention or reinforcement for undesired behavior. This is especially big for children who learn at an early age to behave in ways to get their needs met. Instead of giving attention or reacting to the behavior, respond to the child’s underlying needs. A child is throwing a tantrum? An underlying need may simply to be comforted and held by mom (the item they are tantruming about will eventually fade if the parent knows how to meet their needs, believe me).

• Be consistent with your reinforcement and responses (and mean what you say). Consistency is linked to trust. So if you are say one thing but do another, or you say you will doing something but you only do it occasionally, it will be difficult for parent, child, colleague to believe what you say. This is where challenging responses come in.

• Model what you want. If you want your husband to emotionally support you, how well are you offering that yourself? If you want your child to stop responding a certain way, are you modeling that response in any way?
  
  Consider self-reflecting: How are you responding to yourself? Are you reinforcing or punishing yourself, when bad things happen? What about things that happen that are not in your control? How are you responding, and how is the world responding to you? What is that teaching you?
  
  If you feel you have healthy relationships, here is a challenge:
  How are your actions and responses reinforcing or shaping those around you? In other words– what behaviors are you reinforcing on social media, at work, in friend circles, children, etc? Are you reinforcing the right ones?
  For example, say person A posts a comment on an article Person B posts and person A writes “That’s stupid, they have no idea what they are talking about”. If person A gets a response (thats not a reprimand), or even a “like” to their comment, people just socially reinforced that behavior. Therefore, that person is going to think it is appropriate and okay to respond to just about anything that way.
  Another example: say your friend is stating “wow I don’t think that girl showers, she has a bad smell”. And you respond “oh yeah I see what you mean”, just to appease and go along with your friend. What you just did was reinforce a behavior for speaking badly of others and thinking lowly of others. Therefore, those types of statements will continue with others.
  
  One of my own personal goals that I made was that I was going to stop acknowledging and responding to negative comments pro-actively. If it’s a self-pity comment, a condescending one, a blaming one towards me– I’m going to do my best to provide a response that does not encourage or continue the conversation. However if they are showing vulnerability, they are communicating their needs, they are apologizing or acknowledging differences, I’m ALL in and I’m going to reinforce that to its fullest.
  
  This is why it’s important to reinforce appropriate behaviors for kids at a young age, they are our future generation!

What to be vigilant about with insurance-based ABA Companies

What are insurance-based ABA companies? They are ABA companies that provider services to families who are eligible to receive behavior intervention services under their insurance due to a diagnosis of their child. Below, are just some of the facts and information that may assist you if you have ever had services from a company.

Insurance-based ABA Companies are typically dictated by what insurance is willing to pay for. Insurance however, can limit some of the quality services that may be necessary for a family to receive. This can include (but not excluded to): in depth behavior technician trainings, team meetings outside of session to communicate, or additional admin work such as creating content and resources for families. Most of you already know what the pro’s are to receiving ABA services from an insurance-based company (just read the companies motto!), however most will not tell you the possible side effects of behind-the-scene operations from the employee or company perspective. If you have been a victim of an ABA company or worse, traumatized by the lack-of-quality of one, below are some important notes that might help:

• It is important to note that insurance providers who decide what services are billable to insurance by the ABA companies are not educated, trained, or necessarily well versed in the field of applied behavior analysis

• Insurance providers expect an X number of programs to be run at the same time, oftentimes this could be up to 30+ programs being run simultaneously in one session by the behavior technician. It is important to ask, is this something you are okay with? Does this set your child up for success?

• Insurance companies require an assessment and goals that stem from those assessments. The problem with that is while assessments can be helpful, not every individual needs one (much less 30+ programs) to be successful. Ask yourself, Are all these goals relevant and socially valid for your child? If utilized for the wrong reasons, this can set the entire ABA team (including the client) up for failure or trauma. 

• It is important to note that many individuals may be more motivated by the compensation aspect than maintaining top notch quality services. That may mean ABA companies are not willing to pay out of pocket for their employees for important aspects of quality service such as in-depth training, meetings outside of sessions, and additional administrative time when needed. If they did, they would lose money.  This leaves their employee’s (BCBA’s/RBT’s) less motivated and uncompensated, which may result in high turnover rate. Furthermore, this creates a toxic dynamic of untrained therapists and BCBA’s who are not held accountable for possible unethical decisions or actions that are being implemented with a client.

• Many ABA companies get stuck in a cycle of accepting more families/clients before they have hired enough RBT/BCBA’s for these families. That means either the family gets their hopes up by the company only to go several months without services, or there is high turnover rate from the company due to the urgency to hire, and the family can go through as many as 3-4 different RBT’s/BCBA’s within a 6 month period, This can result in frustration and a bad experience with the ABA field, making long term support for their child become unattainable, or potential for trauma if the behavior technician is not adequately trained due to the urgent need for staff by the company.

• Insurance providers require company staff to check mark “communication and social skill deficits and repetitive and restrictive behaviors” (since this is considered part of the diagnosis) in order to submit notes. There is a current shift where many individuals see those with autism (and other diagnosed labels) as individuals who are wired differently and learn differently, rather than having skill deficits or restrictive behaviors-because this directly affects how we perceive the services we offer. For families or trending BCBA’s in the field who do not possess these traditional beliefs about individuals with autism, you need to ask, what does this say about the company or staff who are following insurance protocols such as these?

This does not mean that all insurance-based ABA companies approach services like this, although it may be difficult to find a quality company. Receiving quality services from an insurance-based ABA company is going to depend on many factors: the individuals who take your caseload (not necessarily the company) and their training experience, the values of the company (and if they actually follow those values), how the company compensates and treats their employee’s, and so much more. Furthermore, having the ability to receive free behavior intervention services for families who cannot afford it is as a service is very necessary. At the end of the day, the conclusion should not to veer away from insurance-based companies, but to be vigilant, do your research, ask questions, and reach out for advocacy services when you aren’t certain if you are receiving quality services. Please refer to my advocacy services to learn more.