Counseling and Social Work Degrees are Teaching Strategies to Avoid Practitioner Burnout… Should ABA Degree Programs Do the Same?
7 Steps To Help Prevent Burnout in Applied Behavior Analysis
If you haven’t heard it yet, you will… any time a crew of BCBA®s or RBTs get together for drinks, start up a text chain, or gather up in an online forum, the topic of burnout is going to come up.
Burnout is an unfortunate reality in all sorts of behavioral and health care services. These are emotionally demanding jobs with big investments in clients and very draining interpersonal interactions. That means the field is becoming known for high turnover rates… not great for either clients or therapists.
While it’s not a diagnosable medical condition, the stress and exhaustion that come with burnout can lead to other genuine health issues including:
- Depression
- Fatigue
- Sickness
Just as concerning is the impact it can have on your professional behavior and on your clients. You become detached, unavailable, and unmotivated. Those are all factors that make any ABA far less effective than they should be.
Should ABA Degree Programs Teach Strategies for Avoiding Practitioner Burnout?
While it’s becoming common in other, similar professions such as mental health counseling or clinical social work, self-care training isn’t a routine part of ABA education today.
Within the 405 required hours of instruction ABAI sets out as the standard for accrediting master’s programs in ABA, exactly zero cover therapist self-care.
A research project in 2019 found that BCBA®s have, at best, informal exposure to self-care strategies. Yet the same project suggests that better self-care routines could lead to improved outcomes for clients and better continuity of care.
Why Isn’t There a More Organized Effort Behind Self-Care For Applied Behavior Analysts?
Part of the reason that self-care is routinely neglected in professional preparation for a career in applied behavior analysis may be that it hasn’t actually been a recognized profession for all that long.
In fact, in a handful of states, you still don’t need to undergo any sort of evaluation or professional preparation to work as a behavior analyst. No licensing laws exist. Only the demands of insurance companies for qualifications for reimbursement make earning the BCBA® a de facto requirement.
At the same time, an explosion in demand has surged throughout the country. As the only scientifically validated treatment for Autism Spectrum Disorder (ASD), applied behavior analysts are needed to cope with the explosion of diagnoses. In schools, in private practice, and in healthcare facilities, ABAs are thrown into various silos without the benefits of a larger community of supports already in place.
This uneven career landscape has left BACB as the primary source for guidance in ABA education. But you’ll only find any reference to self-care in the organization’s guidelines for supervisor training.
How To Find the Self-Care Strategies You Need To Avoid Burnout as an ABA
This is a state of affairs that pretty much leaves the average behavior analyst on their own for dodging burnout. But although there’s not a lot in the way of official guidance, the community is organically coming around to providing information and resources for self-care.
In fact, much of what we know about self-care strategies for practicing applied behavior analysts has come from doctoral students in ABA, who have taken the opportunity to explore the subject as part of their doctoral dissertations.
Some of those findings feed the suggestions in the list below.
In other cases, supervisors and instructors in ABA have taken the initiative to develop self-care routines and share them, either freely on websites or as courses you can take as part of your required continuing education studies.
Even though it’s a little extra work on top of a caseload that may already seem overwhelming, it means you have the resources to craft self-care and mental wellness routines yourself.
Here are 7 ideas to get you started.
1. Start Early, Set Priorities, Set Boundaries
Every new BCBA® is eager to get engaged in the exciting day-to-day process of working with clients. The newest therapist in the clinic is always the one showing up early, looking for the most challenging cases, going the extra mile to deliver the best service.
Those are all commendable qualities, and we can all hope that the enthusiasm and dedication stay with you through the course of a long and productive career.
But you should learn to be cautious about overcommitting to your job right from the start. Setting expectations about your availability and intensity right away can keep you from getting into unhealthy patterns that will be hard to shake.
In the same way, developing good habits about boundaries between your personal life and needs and professional demands can be one of the keys to avoiding burnout. Ensuring that your off hours are truly off is important. Even when your position doesn’t demand it, there’s often a tendency among new BCBA® therapists to take their work home. But that’s not good for either you or your home life. Avoid falling into the tendency to put work over your personal life.
Your Own Outside Interests Will Be Key to Balanced Burnout Prevention
One reason many new BCBA®s end up thinking and performing work almost all the time goes beyond simply a demanding case load. The fact is, right out of college and excited about the position, a lot of graduates don’t really have a lot of other things to focus on in life.
So one of the best ways to set yourself up to avoid burnout can be to give yourself equally interesting things to focus on outside of work.
It’s impossible to randomly recommend a hobby to start in on without knowing your interests, but sometimes exploring new things is the path to finding one.
Getting out of the office to join a meet-up group for board games, or taking a hike with a local club, or volunteering with a local gardening group may not end up being your cup of tea in the end… but they are all ways to broaden your interests and give you a shot at finding something worthwhile to do to take your mind off of work.
2. Don’t Settle for Less Supervision Than You Need
Clinical supervision, the process by which more experienced, more highly trained therapists review, coach, and guide the work of ABAs and RBTs (Registered Behavior Technicians) is baked into the certification and licensing process in every state.
As a BCBA® candidate, you’ll have to go through between 1,500 and 2,000 hours of supervised fieldwork to qualify for certification. Your actual supervisory contact hours, depending on whether you are going with regular or concentrated supervision, will range from between 5 percent and 10 percent of that total.
But these are minimums, and too many trainees and supervisors alike treat them as such. Supervision is the best way to get direct mentorship and guidance in exactly the sort of material that comes up in practice that isn’t covered in class—such as self-care. A 2009 study found that perceived supervisor support played a big role in predicting burnout.
If you’re in the process of qualifying for your full BCBA®, or in an assistant or tech position that requires ongoing supervision, don’t hesitate to talk do your supervisor as often as you need, and about your own state of mind and needs.
3. Connect With ABA Peers Outside the Workplace
Getting supervision from more experienced providers is valuable professionally, but it’s still a kind of work… which can itself contribute to burnout.
It’s equally valuable to make connections with other providers who are on your level, experiencing the same challenges, going through the same difficulties. For that, it’s almost always to your benefit to look up local organizations designed to connect and support behavior analysts.
And while you might have professional supervision from a senior therapist on the job, it can also be valuable to connect with ABAs with more experience in less formal settings. Forging a lasting relationship with a senior ABA through meet-ups outside the daily grind allows you a chance to bounce issues off of them and pick up sage bits of wisdom that for one reason or another won’t really come up in an official relationship.
Local chapters of ABAI, the Association for Behavior Analysis International, are almost always the first place to start your search for comrades in arms. There is also the APBA, or Association of Professional Behavior Analysts, which includes members of related professions including:
- Psychologists
- Occupational and Physical Therapists
- Social Workers
- Educators
- Medical Professionals
- Compliance and HR Professionals
That can offer some valuable outside perspective that may help you understand and deal with pressures that come from parts of the job you can’t directly control.
You can also find some ABA-adjacent organizations that may be valuable therapist community resources for well-being and support, depending on your practice area. For example, the Council of Autism Service Providers may connect you with a range of professionals dealing with similar clients or similar environments. Any of them may be useful in helping you keep your head straight in those circumstances.
4. Accrue Continuing Education Hours in Self-Care Subject Areas
Fortunately, even though your master’s program in ABA might not come fully stocked with self-care tactics, a lot of the people designing ongoing continuing education courses for behavior analysts have their fingers on the pulse of the problem. So you can often find CEU options that will both stack up toward your license renewal and help you understand and deal with burnout risk factors.
These can be found at all the usual suspects in ABA continuing education:
- National and local ABA associations
- For-profit private education providers
- Government agencies
There are also more general resources in the healthcare world to help workers avoid burnout, such as the SAMHSA Self Care for Healthcare Workers Modules, freely available online. These may count toward CE hours depending on the source, but offer important training in an under-covered aspect of ABA practice either way.
5. Establish a Routine That Includes Exercise, Nutrition, Rest, and Reflection
Many people are surprised to find that self-care against work burnout is actually also work. You need to put in the hours and find the time to perform the basics that guard against stress and mental exhaustion.
Much of that comes back to the basics, simple stuff that really every individual in every kind of position needs in their life:
- Exercise – It’s a recommendation that American see almost constantly and very rarely accept, but getting out and moving around regularly really is a key feature in staying mentally sharp and engaged. Research backs it up—the Journal of Occupational Health found strong evidence that physical activity lowers exhaustion, one of the key components of burnout.
- Nutrition – A diet of coffee and candy bars from the office vending machine is the natural one for many ABAs, but it’s not the kind of fuel your system needs to keep you in top form. A balanced, healthy diet both improves your exercise potential and helps stave-off burnout symptoms.
- Sufficient Rest – Almost 40 percent of Americans report not getting enough sleep each night, so there’s a good chance you aren’t clocking the seven to eight hours needed, either. But almost more than any other factor, getting sufficient rest is how you fuel up with resilience and energy for the next day, so find the time to get your Zs.
- Mindfulness – Mindfulness can be the hardest step to qualify in anti-burnout practices, but one of the most useful. It’s essentially about developing the mental discipline to be present in the moment, to keep your brain from starting to spin from the many distractions and stressors that the ABA workplace has to offer. Meditation, breathing techniques, or even yoga can all count toward improving your mindfulness.
6. Get Professional Support and Counseling To Back You Up
Even though you should be well-connected with peers who can listen to your woes and offer support and advice, that’s no substitute for getting actual professional services to help your mental wellness. Just like ABA therapists are the go-to resource for behavioral healthcare, licensed mental health counselors and psychologists are the place to turn for your mental health needs.
It can be important to engage with a counselor before you think you need one. Just like behavior analysis, counseling isn’t like flipping a switch. A counselor needs to get to know you as an individual, to understand your personality and your baseline, to really be able to get to the bottom of burnout issues.
So it’s a good idea to connect with a professional counselor before you get to the point where your head is about to explode.
It’s possible that you have or can find connections to these resources through contacts in your local behavior analysis community, but if not, resources like the American Counseling Association or the National Alliance on Mental Illness can start you down the right path.
7. Don’t Let Your Stress Impact Your Client Interactions
Maybe the most important step, and the goal behind all the others, is to avoid letting your personal challenges impact the effort and expertise you put into client services.
This is a specialized subset in burnout prevention, common in human services and healthcare fields where professionals are regularly working with patients in tremendous need. A combination of exhaustion and exposure lead to a condition called compassion fatigue.
Basically, this is when you become so accustomed to seeing people with severe needs that you lose the ability to empathize. It’s a contributor and an outcome of burnout both… it adds to burnout factors as a secondary stress reaction from seeing so many people in need, but it also can result from the exhaustion you experience as a part of your individual burnout.
The Compassion Fatigue Awareness Project offers an overview of the issue as well as steps to help counteract it. A diagnostic self-test can get you some objective answers about your own condition, even if you don’t feel like you are experiencing it.