Association for Behavior Analysis International

Burnout is highly prevalent among behavioral providers and negatively impacts their well-being and service delivery. Past research has examined the prevalence of externalizing behavior (e.g., aggression, self-injury, elopement) among individuals with developmental disabilities. High frequency or intensity behaviors can lead to crisis situations, which may impact provider perceived competency and safety, and therefore, stress. This survey study examined provider experiences with client externalizing behavior, management training, and perceived stress. 634 direct care providers (115 man; 494 women; 25 other) completed our online survey. Respondents primarily worked with autistic individuals. Although a majority of providers indicated they work with individuals with externalizing behavior, only 67% indicated any formal training in physical management and restraint (Table 2). There was variability in the number of providers indicating that physical management and safety concerns related to externalizing behavior caused stress. We will conduct and present additional analyses regarding how aspects of training related to physical management and caseload characteristics impact stress and burnout. These findings will inform possible training practices that may decrease provider stress.

In the applied behavior analysis service delivery industry, behavior technician annual turnover has been reported to be 30%-75% (Molko, 2018). Such a high turnover rate presents several issues, including a detrimental impact on essential service provision and the accrual of substantial organizational training costs (Molko, 2018). A lack of supervisor support and feedback have been identified as factors that contribute to turnover rate (Arrington, 2021; Austin, 2022; Villanueva Jasa, 2022). Given these considerations, the current study investigated the effect of an incentive program that used technology to help supervisors provide more immediate positive feedback on turnover rate. This was done via a pre and post intervention design with a comparison of the test region group and non-test region groups (organization wide). Behavior Technicians received positive feedback for engaging in desired behaviors related to their work performance standards (e.g. filling out session notes on time, pairing well with clients, and high treatment fidelity). This feedback was recorded by supervisors through a QR code system that was then tracked with Microsoft Forms and Excel. Behavior technicians then received cards for each instance of positive feedback that was recorded. These cards were then used to enter a weekly raffle for gift cards. In addition, the total number of cards gained by a Behavior Technician accumulated for use towards company-sponsored outings. Once they turned in enough cards, the outing was announced and paid for. Monthly technician turnover rates were pulled from the company’s internal employment data system. Results showed a reduction in average monthly turnover post-implementation (14.6% vs. 11.5%). In addition, the intervention region average monthly turnover outperformed non-test regions (11.5% vs. 12.83% respectively)). The practical considerations regarding incorporating this type of program and future directions will also be discussed.

The current study sought to extend Issen et al. (2021) by evaluating the effects of brief group-based Acceptance Commitment Training (ACT) activities on Registered Behavior Technician (RBT) job performance in an Applied Behavior Analysis (ABA) center. ACT activities were taken from the Accept Identify Move (AIM) curriculum and presented in four workshops across four weeks. The workshops included 19 RBTs, 4 BCBAs, 1 BCaBA, and an administrative staff. A multiple probe across three participants (RBTs) design was used to evaluate changes in implementing Discrete Trial Training (DTT) steps and Instructional Control (IC) steps following the ACT workshop. The Cognitive Flexibility Inventory (CFI) survey was also conducted to evaluate the effects of the ACT workshop on participants’ psychological flexibility. Finally, an ACT knowledge questionnaire was conducted before and after the workshops to assess participants' understanding of ACT-related concepts. Results showed an increase in correct implementation of DTT and IC steps for participants one and two compared to baseline. Participant Three received an additional, individualized ACT session, which increased DTT and IC steps for this participant. These results provide implications for supporting staff effectiveness in center-based ABA.

Exit interviews are a tool commonly used by organizations to gather important information from separating employees (Flint et al., 2013). However, the usefulness of this information is influenced by the processes and procedures involved (Pace & Kisamore, 2017). In the field of organizational behavior management (OBM), behavioral systems analysis (BSA) allows for the examination of organizational systems with the external environment (Kast & Rosenzweig, 1972); this methodology is appropriate for large scale initiatives such as exit interviews, which often involve multiple procedures and numerous staff to execute. In the current study, we used BSA to evaluate and improve the exit interview process of an inpatient hospital unit. Process mapping revealed that the format of exit interviewing during baseline was a barrier to process efficiency, and it was hypothesized to negatively impact completion rates. To target this shortcoming, the exit interview was converted from a paper-based format to an online electronic version, thereby automating the process. Changes improved efficiency by reducing: (1) the number of process steps by 45.5% and (2) the number of resources by 33.3%. Overall, these changes produced a 48.0% increase in the percentage of exit interviews completed by direct-care staff. Implications and future directions will be discussed.

Unplanned and excessive staff absences can greatly impact ABA service delivery and the fidelity of behavioral interventions. Several studies have successfully utilized performance management strategies to reduce unplanned absences (Luiselli et al., 2009). In a previous study within an inpatient unit, we utilized performance feedback and contingent restriction to overtime (OT) opportunities at a direct-care staff level to reduce excessive absenteeism. This was initially effective, but eventually, call-outs increased. Additionally, despite increased unplanned absenteeism, supervisory data showed that few staff met the OT restriction contingency. Upon further investigation, it was determined that supervisors were inconsistently implementing the attendance policy. A supervisor-level intervention was introduced, which included establishing excusal criteria, training supervising staff to identify excused and non-excused absences, and delivering performance feedback on supervisor decision-making every month. This modification resulted in substantial decreases in direct care staff absenteeism, which were maintained over a six-month period. The implications and future directions of multi-level intervention programs will be discussed.

Within the field of OBM, Performance Management offers practitioners different tools to assess employee performance (Gravina et al., 2022). The goal of these tools is to identify environmental variables contributing to a performance deficit, which ultimately leads to indicated solution(s). While research supports the efficacy of these methodologies, what is less clear is how combining assessment strategies might further illuminate performance deficits. The purpose of this study was to assess variables preventing managers from directly observing employee behaviors using three different assessment measures. To accomplish this, managers’ time allocation on the floor was assessed via: (1) descriptive data collected on potential barriers, (2) a PIC/NIC Analysis was completed, and (3) the PDC-HS (Carr et al., 2013) was completed with 3 managers. Assessment data were then compared to identify similarities and differences, as well as to help inform intervention planning. In general, we found that each assessment offered a unique perspective, and recognized a solution based on solely one methodology (e.g., PDC-HS) would have been incomplete. Specifically, we found that information obtained by the PIC/NIC and descriptive data helped lead us to more refined intervention. Future considerations for practitioners and implications of utilizing multiple performance diagnostic tools will be discussed.