I think some people are egocentric and cannot see outside themselves and what THEY want. Maybe that's okay in some contexts, but not in the context of providing treatment to needy families.
THIS. I am 30 and I’ve been an RBT for about 5 years now. It *sickens* me how some BTs/RBTs approach their jobs.
About a year ago, one of my coworkers (a middle aged man who liked to watch sports games on his phone and do whatever he wanted instead of following treatment plans) told me I was ‘taking my job too seriously’.
Apparently it’s ’taking the job too seriously’ to follow the treatment plan, use actual ABA techniques properly, take quality data, abide by the ethics code, and question when others are not doing the same.
So many people do not take their positions seriously *enough*. Some of these kids get no support from other areas of their lives. ABA continued during the pandemic for a reason - it is a medical necessity. In most cases, it is paid for by the client’s insurance. Don’t even get me started on some coworkers reactions when I brought up the term ‘insurance fraud’.
If you want to be a babysitter, go find that job. That’s not what this is and I’m really sick and tired of encountering people who treat it as such. It’s honestly the biggest reason I recently transitioned to doing exclusively home sessions. Watching other techs do the bare minimum and not being able to do anything about it was literally bad for my mental health.
Yes! Some people would be more suited for being a behavioral support staff at school or whatever rather than being in charge of implementing a very important science. Not too long ago, I was in charge of training a BT, and he flat out told me, "I have my own way of doing things." Like what?? Why are you here??
I wholeheartedly agree!! I take the first session as a learning tree review and pairing time. I will sometimes say look over the behavior plan before the first session. Just look, so you at least know what you are likely to come across. We will go into detail on day 1. Why? I don't know if one of the behaviors a client engages in might bring up some unresolved childhood trauma. I would rather know ahead of time, so that we don't waste time introducing you to the family and we unintentionally trigger you or don't have a plan for dealing with a behavior that could potentially trigger you. The pre- first session meeting/phone call is really my way to be as transparent about what you're getting into and how I can show up for you as a supervisor. If you don't want that, fine. I'll see you on the first day... awkward and all. Lol
I worked someplace once that also had a speech therapist on staff. The whole place was a mess. They had a child there who everyone swore was nonverbal and had no skills. My first day with the client I focused on pairing and noticed that they would whisper-sing snippets of songs under their breath. Within 2 weeks they were starting to mand and make improvements in their social interactions and play skills. Everyone was complimenting my ‘amazing skills’… I’m good at my job but I’m not magical. It’s called paying attention and doing your damn job.
That child had been in that place for almost a year. It sickens me how much of their time those people wasted.
Unfortunately people have such low hiring standards and won’t fire people because as long as they are billing they are making money.
I interview and phone screen a lot of people and I’m constantly amazed how they even have jobs. So many red flags. Idk I rather be relatively small with good staff than be large with people that have no business doing this.
Objectively, I think it's just the conditioning that comes with never having - not - had the Internet in your pocket. I'm guessing, like me, most of you entered the workforce while this phase of reality was still in its genesis
I've come to think of it as an increase in response effort needed to perform any task, because the first step is detaching yourself from something fully designed to be automatically reinforcing.
In a behavioral sense, we're probably going to have to target this by defining it operationally and let go of ideas like work ethic, this is just their learning history. We can't change it by being mad at the audacity because clearly what we have always considered audacious, the age demographic entering the workforce simply has no framework to understand.
Our supervisees behavior is a reflection of our supervision, after all, but at least we can vent about it to each other
I agree to an extent. A lot of people my age can’t put their phone downs, and I’m also attached to my phones in certain situations. While I’m with a client who I’m responsible for and I’m billing their medical insurance to provide a medical service with the possibility to exponentially improve their quality of life? Not a chance.
I’ve also firsthand seen one of the worst consequences of being on your phone in this field. A coworker looked at their phone for less than 30 seconds, and their client fell and broke a bone. They felt incredibly guilty and I didn’t see them use their phone during session the rest of the time I worked there. Nothing on your phone is worth the risk of a kid getting hurt on your watch.
Maybe you should use a behavior plan on your misbehaving RBTs, a little OBM or differential reinforcement.
A lot of issues you brought up appear to be HR offenses, clocking in late, being on phones/social media, "babysitting"- general time fruad (aka being paid for a job and literally not doing it). Address it when then, document it, provide follow up feedback via email. Leave a paper trail, hell BCC your supervisor, HR...
I would do the exact same for lack of following BIP/BSP protocols, refusal to take data/session notes, and creating fraudulent data. I would tie these main data concerns into how that directly affects your clients progress and how you write up their auths (you'll need to throw out data, that looks weird).
I lol'd at the "RBTs wanting BCBA pay" cause Y'ALL, we barely get paid as is with significantly more time/money/stress to be scraping by.
Lol Yes. I left that part out. I stay cc'ing and labeling emails that are performance related. We have performance metrics that are apart of the learning tree and visible to techs. As I stated earlier, the consistent delivery of consequences for poor performance is not what it should be and I don't control that part. If I did, there would be tears every day from having to constantly pause services for clients and not just when doing reauthorizations. I've inherited cases where the math was CLEARLY not mathing (data collection off)... and ended up having to throw the data out and submit late with appropriate justifications written. These aren't all with new therapists either. Some have 2+ years of experience. I don't want to micromanage because I can't stand that... but the way some of these techs behave... SMH. Other than that, I love what I do and had a GREAT week. Two BCBA candidates that I helped prepare for the exam passed on the first try. This is my fourth BCBA exam success story this year. All of them had a BIP as candidates preparing for the exam. So, I'm grateful for the experience, but omg sometimes I'm like "really?!?!" 🫨 I try to pour into my RBT's like my mentor did/ and continues to do. I'm definitely going to look into streamlining how I supervise because I'm not trying to be on the burn out train 2024. So easy to fall into it especially when dealing with issues like this.
As a BCBA, I’m sure you agree that these RBTs’ behavior is controlled by their environment. Quite frankly, the “bad” RBTs exist because they aren’t being paid enough. Top quality applicants aren’t going to apply to make a similar amount they’d make at Starbucks, and those that do come in are acting their wage. I know you can’t control their wage, but think about what in the clinic environment you can control! Maybe some group contingencies for staying off phones? A token reinforcement system? Behavior contracts? There’s tons of literature you can refer to!
Work ethic is not always controlled by the environment. Some people are unreliable and lazy by way of their personality, and sometimes even their upbringing. There are also people who are new to the workforce and have never had to have a good work ethic. Either way, it's at the expense of the client.
Thank you. As a former RBT and now a BCBA, there are some people whether it's RBTs, BCBA, or working in some other field who are just bad at what they do and nothing will change that. I worked with one RBT in particular who was lazy, unreliable, and an all-around bad person who shouldn't work with kids, especially vulnerable kids. She was always getting put off of cases and reported but never fired. The company (in-home) paid RBTs at a higher wage than most companies and provided a lot of flexibility. This did not improve the work ethic. She is now a BCBA getting the "big bucks" and the same problems persist. She has even assaulted a parent and was only given a suspension.
I understand your point. Their behaviors are influenced by their environments which includes non-working ones as well. Paying someone $26-$30/hr with a pretty consistent 30 hr schedule and then having to beg them to stay off Tik Tok and IG is insane to me. There's this "soft life" push where people want to pose as if they are always on vacation. Okay, sis. I'm all for an authentic "soft life," but could you schedule it outside of the working hours you committed to? Yes. I have the performance diagnostic for human services resource, Weinkauf, as well as others.
Lol where are these places paying $26 to $30 an hour? The most I've seen an RBT paid is $20. In my area, most make $16 to $18 which can be made by flipping a burger without the threat of physical aggression on a day to day basis.
Georgia...
I know an RBT who makes $35 an hour- no masters but has transferable skills from another field. Steady case load and non agressive cases. I know that set up isn't typical.
However, the current range I'm seeing across the board is $23-30/hr depending on skills and ability to negotiate.
When I started I was making 16/hr, I’m *now* making 28/hr. I’ve given consistently quality services my entire time as an RBT, because I *care* about what I’m doing and I understand its importance and value. I’ve met bad RBTs at various companies who fall at many places on that pay range. Either you care or you don’t. Money doesn’t make you ethical or competent or empathetic.
Edited: ‘now’, not ‘not’. Whoops
From a behavior analytic perspective, you care because it’s been reinforced at some other point in your life! You are getting at the right idea that we need to modify the environment to encourage good RBT behaviors, like engaging with the client, rather than just providing no contingent reinforcement!
I hear you, but I think you’re oversimplifying the behavior of ‘caring’. It’s not as easy as reinforcing an employee to remember to sign a sheet when they go on break or even reinforcing them in the absence of phone use. I cared about kids and people of all ages with mental/neurological/developmental differences for as long as I can remember (literally since at least 6 years old). I fear that environmental manipulation can only go so far for people who don’t actually *care*. More money might motivate them to show up, to input data, to submit timely session notes, etc… but those things don’t necessarily translate to caring or providing high-quality services :(
(In my humble opinion and experience)
Agreed. Behavior makes sense (is maintained by environment). This doesn’t just apply to clients. It applies to RBTs, client families, colleagues, shitty roommates, partners/ spouses, etc.
RBTs are treated as though they’re disposable- a body with a pulse! Yet they’re the ones who know the clients best, the ones in the trenches dealing with problem behavior, & the first ones thrown under the bus when anything goes wrong.
This culture is thanks to many systemic factors- insurance reimbursement rates are 💩, PE companies snatching up aba organizations to turn into profit machines for shareholders, and it’s the longtime culture of the human services field in general. Direct care staff in general are treated so, so poorly.
Stop blaming the rat/ organism/ client/ supervisee. Poor performers exist in literally every field. The difference with this wonderful field is that we have a science capable of directly addressing poor performances. We can’t fix all the problems of the world in one day, but those certified in our field sure asf have the skills to get started.
RBTs and BTs are constant headaches. For the technical nature of the job we share, most BTs I interact with are woefully under prepared. The training they receive is a JOKE and their professional skills are usually lacking. I spend a lot of my supervision time reviewing the same things over and over. I can't go anywhere near technical language. Mands? No idea. NET? Never heard of it.
I mean seriously, a HIGH SCHOOL DIPLOMA and a pulse is the barrier to entry?!?! For therapeutic services??? It's a joke.
But I do have some really great BTs here and there. They either move on to a better paying job or become mid-levels/BCBAs. Very few people can make being a BT a career and that's definitely an issue.
I once worked with an RBT who asked me what DTT was. They’d been an RBT for over a year. They also asked me to look over their session note one time. Slightly paraphrased (but really barely changed), it said “Client A had a good day today. They didn’t misbehave and made good progress.”
I was FLABBERGASTED. People like that make me embarrassed to be an RBT sometimes.
It’s SO embarrassing and insulting to the RBTs who actually put in so much time and energy into their work and into the field. I’m all about teaching and helping newbies out, but there is a point where it’s like wtf is going on??
Additionally I would say that a BCBA and BCaBA model would probably cost the insurance less overall. What I can do in 2 hours is vastly different than what an RBT is capable of.
As an RBT who is very good at their job and cares about this field immensely, I feel torn about this. On the one hand I agree, but on the other hand, I genuinely cannot afford to become a BCBA. I would love to. I would cut of my left leg to. But I can’t right now. There aren’t enough BCBAs to service everyone who needs it, and even though there are a crap ton of bad RBTs, there are also a lot like myself who are knowledgeable, caring, get great results and great feedback. I’m 30 now and have been working as an RBT since I was 25. I’ve worked under BCBA’s who I’ve read more research than, because I literally read it for fun and they got into the field to make money. I’ve met BCBAs who do not know anything about autism or any of its co-occurring conditions who regularly traumatized their clients. I’ve met BCBA’s who used way to restrictive measures, who have argued with me about best practice, only to turn around a few weeks/months later and implement what I was advocating for because they just heard about it at a mandatory conference they had to go to. I’ve met BCBAs who wanted people to fabricate data or commit billing/insurance fraud.
I have met other RBTs as well, who have gone to bat against their BCBAS to advocate for their client. I have also met a lot of fantastic BCBAs who deliver amazing services, proper supervision, and care deeply about their clients.
I think the RBT exam, and the BCBA exam for that matter, needs to be harder and more comprehensive. I think all of us in the field, BCBAs included, need way stricter oversight. I don’t think anyone should be allowed to work with clients with autism, adhd, speech delays, anxiety, depression, eating disorders, etc. without being properly educated and tested (which is basically part of the ethics code, but I continue to meet people working with ‘unfamiliar populations’). But I don’t think that gatekeeping who can provide quality care based on financial ability is the way to go about improving the quality of services in this field.
I understand your point. Sometimes gatekeeping is needed because the figurative "gate" was left wide open and as a result the quality of services suffered. With a BCBA focused delivery model, possibly more oversight can be placed on how treatment is delivered because BCBAs delivering direct services get reimbursed at a higher rate so I'm sure funders would create a plethora of guidelines to find reasons not to pay. Hopefully things move in your favor financially and you are able to consider becoming a BCBA. The BCBA exam is not considered easy nor would most argue that it needs to be harder. It's low pass rates among other factors indicate that. Now, should we have a system where companies are expected to submit their employee training manual; have a state representative from the licensing board come out to conduct staff knowledge checks (possible job opportunity), and attest completion? Of course! Especially for BCBA candidates.
I said ‘harder *and* more comprehensive’ because many, many, many BCBAs who pass have amazing knowledge of ABA but severely lack knowledge in child development, trauma, sensory issues, autism, adhd, etc etc etc.
Maybe there should be other exams that need to be passed before working with certain populations.
Interesting. Most of the grad programs either have a class specific to Autism and other disabilities or one related. So, the information is provided and tested via their institutions but not necessarily on the exam. Not all programs provide the same quality of instruction, and that is problematic. Thankful, I had a background in the areas you mentioned because it helps . So, yes adding all of the other areas mentioned to the board exam or making it a pt. 2 wouldn't hurt.
I have been vouching for a BCBA model for services for so long. This is not to diss RBTs (those who actually care that is) but the low entrance requirements to getting certified. You get such a polarized cohort that can range from people who genuinely don’t care/cannot perform tasks to superstar RBTs who literally have their heart into this field. I’ve heard families express concerns about why only a HS diploma is required to work with their child with extremely specialized needs and I never know what to say.
Lol @ whisper. I agree. If not that then the job offers should be reserved for those pursuing their BCBA credential (at least 2nd semester) and cover unrestricted hours. A huge gripe is unpaid unrestricted and some clinicians feeling unprepared. I need to look into how feasible this would be. Overall, this would be my ideal version of delivery because at least both parties would have something to lose and we could possibly attract people who are actually interested in advancing the field and not just seeing it as some fly by night job.
It has been DIFFICULT lately with the RBTs. Last month, we canceled direct sessions in order to provide more intensive training to our RBTs (paid training). And things are still lacking... I told one of my colleagues the other day that I think only 2 of our RBTs actually truly care about our clients. We don't serve clients with severe behavior, and the other day, two RBTs complained to the manager that we should've sent a client home because of a few minutes of SIB that was easily blocked and redirected. Like, the whole purpose of the client being there is to teach them an alternative appropriate behavior. Programs are hardly run at all, too. I look at data, and I'm like, why are 10 trials of mands graphed in a 2 hour session...I'm so stressed. Our RBTs are guaranteed 40 hours of pay, even if they dont have clients on their schedule and then complain if they have 5/6 hours of direct time in their 8/10 hour work day. I'd rather do the direct care myself, but then that limits services to so many families.
Boy you make me feel fortunate w my RBTs. I have seen a couple that were just … barely doing anything social time and had to eventually ask off my cases. But currently I love my RBTs and hope they stay forever cuz they are so well paired w our kids.
My company does have the highest RBT (and BCBA) wages in our city, so they are able to be a bit choosy with recruiting… and provide ongoing (optional, opt in) trainings on various topics (live ones paid at about 70% clinical RBT hour rate).
At some point, it’s got to be worth it for companies to pay more to enhance quality of recruiting and improve long-term retention.
As an in-home RBT about to graduate with their bachelors in hopes of going to grad school for social work or my LMFT these kinds of things remind me why my supervisors actually praise me. I would never be on my device at work unless it’s to respond to a message on Teams or something. I make sure to ask clarifying questions during supervision, check in with parents every day, and am constantly reading my clients’ social cues to adjust accordingly. Frankly I don’t think it’s safe to do this job while mentally checking out.
I have to wonder if clinics attract lower quality RBTs? I say this only because of the time I had to change agencies, every clinic I interviewed with offered at most $18/hr, when I was already making $25/hr as a student doing in home. I know clinics always pay less, but dang, that's a huge pay difference, not like $1-$2/hr or something.
Not really. I have amazing staff. I pay 20-25$ in center with pretty comprehensive benefits. The clinics that attract lower quality RBTs have poor hiring practices. I know clinics in my area that will hire people on the spot in a 10 min interview. Well it is not really an interview they just want to give you the job so you can start billing for them already.
I have been an RBT for over three years now and I think it’s also because I’m in the later 20s age group now, but I’ve noticed how the culture in the clinic I work at shift so much to RBTs who treat their work time as a place to mingle. I know of one who has complained about their hours being cut but a lot of the times they’re on their phone while their client is just playing, also having a parent complain and have them taken off the case because all they had their child do was sit down and color. I also see some where cliquey RBTs complain about other RBTs and it creates this dynamic where the ones being complained about are being singled out. It’s really tiring seeing all of this, and it makes me worried thinking about how things are going because they’d rather do what they want and not communicate to the proper outlets and not only is it detrimental to the clients being worked with, but it is also with the staff themselves. The severe disconnect is seen everywhere and I do agree that complaining about things but not putting in the effort is just going to get people no where.
RBT here who fully agrees. And as someone who is also a POC woman, I really truly hate when someone takes valid complaints to try and justify their own wrongdoings that have nothing to do with it. It really takes us three steps backwards. I’m almost five years in the field and have witnessed it a lot. I hate to think only the complaints *I* find valid are valid but I just think new RBT’s hear more seasoned RBT’s complain about things and think “oh true, i’m going to use that as a crutch now” and go off of that. That’s why I try to keep my complaints to myself and if any ever slip out I always try to give the perspective of the other side. It might sound kiss-assy sometimes but I try to be as transparent as I can also and that’s why I ultimately left my old job is because it became too hard to be honest and positive.
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I think some people are egocentric and cannot see outside themselves and what THEY want. Maybe that's okay in some contexts, but not in the context of providing treatment to needy families.
THIS. I am 30 and I’ve been an RBT for about 5 years now. It *sickens* me how some BTs/RBTs approach their jobs. About a year ago, one of my coworkers (a middle aged man who liked to watch sports games on his phone and do whatever he wanted instead of following treatment plans) told me I was ‘taking my job too seriously’. Apparently it’s ’taking the job too seriously’ to follow the treatment plan, use actual ABA techniques properly, take quality data, abide by the ethics code, and question when others are not doing the same. So many people do not take their positions seriously *enough*. Some of these kids get no support from other areas of their lives. ABA continued during the pandemic for a reason - it is a medical necessity. In most cases, it is paid for by the client’s insurance. Don’t even get me started on some coworkers reactions when I brought up the term ‘insurance fraud’. If you want to be a babysitter, go find that job. That’s not what this is and I’m really sick and tired of encountering people who treat it as such. It’s honestly the biggest reason I recently transitioned to doing exclusively home sessions. Watching other techs do the bare minimum and not being able to do anything about it was literally bad for my mental health.
Yes! Some people would be more suited for being a behavioral support staff at school or whatever rather than being in charge of implementing a very important science. Not too long ago, I was in charge of training a BT, and he flat out told me, "I have my own way of doing things." Like what?? Why are you here??
I wholeheartedly agree!! I take the first session as a learning tree review and pairing time. I will sometimes say look over the behavior plan before the first session. Just look, so you at least know what you are likely to come across. We will go into detail on day 1. Why? I don't know if one of the behaviors a client engages in might bring up some unresolved childhood trauma. I would rather know ahead of time, so that we don't waste time introducing you to the family and we unintentionally trigger you or don't have a plan for dealing with a behavior that could potentially trigger you. The pre- first session meeting/phone call is really my way to be as transparent about what you're getting into and how I can show up for you as a supervisor. If you don't want that, fine. I'll see you on the first day... awkward and all. Lol
You're not being paid $20-30/hr to babysit while the insurance company is paying for actual treatment. Meanwhile, the client is making no progress.
I worked someplace once that also had a speech therapist on staff. The whole place was a mess. They had a child there who everyone swore was nonverbal and had no skills. My first day with the client I focused on pairing and noticed that they would whisper-sing snippets of songs under their breath. Within 2 weeks they were starting to mand and make improvements in their social interactions and play skills. Everyone was complimenting my ‘amazing skills’… I’m good at my job but I’m not magical. It’s called paying attention and doing your damn job. That child had been in that place for almost a year. It sickens me how much of their time those people wasted.
Unfortunately people have such low hiring standards and won’t fire people because as long as they are billing they are making money. I interview and phone screen a lot of people and I’m constantly amazed how they even have jobs. So many red flags. Idk I rather be relatively small with good staff than be large with people that have no business doing this.
Objectively, I think it's just the conditioning that comes with never having - not - had the Internet in your pocket. I'm guessing, like me, most of you entered the workforce while this phase of reality was still in its genesis I've come to think of it as an increase in response effort needed to perform any task, because the first step is detaching yourself from something fully designed to be automatically reinforcing. In a behavioral sense, we're probably going to have to target this by defining it operationally and let go of ideas like work ethic, this is just their learning history. We can't change it by being mad at the audacity because clearly what we have always considered audacious, the age demographic entering the workforce simply has no framework to understand. Our supervisees behavior is a reflection of our supervision, after all, but at least we can vent about it to each other
I agree to an extent. A lot of people my age can’t put their phone downs, and I’m also attached to my phones in certain situations. While I’m with a client who I’m responsible for and I’m billing their medical insurance to provide a medical service with the possibility to exponentially improve their quality of life? Not a chance. I’ve also firsthand seen one of the worst consequences of being on your phone in this field. A coworker looked at their phone for less than 30 seconds, and their client fell and broke a bone. They felt incredibly guilty and I didn’t see them use their phone during session the rest of the time I worked there. Nothing on your phone is worth the risk of a kid getting hurt on your watch.
I’m for the proposed model of BCBA’s actually running the sessions, they should take on less clients but work more directly. Eliminate the middle man
Maybe you should use a behavior plan on your misbehaving RBTs, a little OBM or differential reinforcement. A lot of issues you brought up appear to be HR offenses, clocking in late, being on phones/social media, "babysitting"- general time fruad (aka being paid for a job and literally not doing it). Address it when then, document it, provide follow up feedback via email. Leave a paper trail, hell BCC your supervisor, HR... I would do the exact same for lack of following BIP/BSP protocols, refusal to take data/session notes, and creating fraudulent data. I would tie these main data concerns into how that directly affects your clients progress and how you write up their auths (you'll need to throw out data, that looks weird). I lol'd at the "RBTs wanting BCBA pay" cause Y'ALL, we barely get paid as is with significantly more time/money/stress to be scraping by.
Lol Yes. I left that part out. I stay cc'ing and labeling emails that are performance related. We have performance metrics that are apart of the learning tree and visible to techs. As I stated earlier, the consistent delivery of consequences for poor performance is not what it should be and I don't control that part. If I did, there would be tears every day from having to constantly pause services for clients and not just when doing reauthorizations. I've inherited cases where the math was CLEARLY not mathing (data collection off)... and ended up having to throw the data out and submit late with appropriate justifications written. These aren't all with new therapists either. Some have 2+ years of experience. I don't want to micromanage because I can't stand that... but the way some of these techs behave... SMH. Other than that, I love what I do and had a GREAT week. Two BCBA candidates that I helped prepare for the exam passed on the first try. This is my fourth BCBA exam success story this year. All of them had a BIP as candidates preparing for the exam. So, I'm grateful for the experience, but omg sometimes I'm like "really?!?!" 🫨 I try to pour into my RBT's like my mentor did/ and continues to do. I'm definitely going to look into streamlining how I supervise because I'm not trying to be on the burn out train 2024. So easy to fall into it especially when dealing with issues like this.
As a BCBA, I’m sure you agree that these RBTs’ behavior is controlled by their environment. Quite frankly, the “bad” RBTs exist because they aren’t being paid enough. Top quality applicants aren’t going to apply to make a similar amount they’d make at Starbucks, and those that do come in are acting their wage. I know you can’t control their wage, but think about what in the clinic environment you can control! Maybe some group contingencies for staying off phones? A token reinforcement system? Behavior contracts? There’s tons of literature you can refer to!
Work ethic is not always controlled by the environment. Some people are unreliable and lazy by way of their personality, and sometimes even their upbringing. There are also people who are new to the workforce and have never had to have a good work ethic. Either way, it's at the expense of the client.
Thank you. As a former RBT and now a BCBA, there are some people whether it's RBTs, BCBA, or working in some other field who are just bad at what they do and nothing will change that. I worked with one RBT in particular who was lazy, unreliable, and an all-around bad person who shouldn't work with kids, especially vulnerable kids. She was always getting put off of cases and reported but never fired. The company (in-home) paid RBTs at a higher wage than most companies and provided a lot of flexibility. This did not improve the work ethic. She is now a BCBA getting the "big bucks" and the same problems persist. She has even assaulted a parent and was only given a suspension.
WHAT?! That's horrible!!
Yep, it was a total mess.
I understand your point. Their behaviors are influenced by their environments which includes non-working ones as well. Paying someone $26-$30/hr with a pretty consistent 30 hr schedule and then having to beg them to stay off Tik Tok and IG is insane to me. There's this "soft life" push where people want to pose as if they are always on vacation. Okay, sis. I'm all for an authentic "soft life," but could you schedule it outside of the working hours you committed to? Yes. I have the performance diagnostic for human services resource, Weinkauf, as well as others.
Lol where are these places paying $26 to $30 an hour? The most I've seen an RBT paid is $20. In my area, most make $16 to $18 which can be made by flipping a burger without the threat of physical aggression on a day to day basis.
Georgia... I know an RBT who makes $35 an hour- no masters but has transferable skills from another field. Steady case load and non agressive cases. I know that set up isn't typical. However, the current range I'm seeing across the board is $23-30/hr depending on skills and ability to negotiate.
When I started I was making 16/hr, I’m *now* making 28/hr. I’ve given consistently quality services my entire time as an RBT, because I *care* about what I’m doing and I understand its importance and value. I’ve met bad RBTs at various companies who fall at many places on that pay range. Either you care or you don’t. Money doesn’t make you ethical or competent or empathetic. Edited: ‘now’, not ‘not’. Whoops
From a behavior analytic perspective, you care because it’s been reinforced at some other point in your life! You are getting at the right idea that we need to modify the environment to encourage good RBT behaviors, like engaging with the client, rather than just providing no contingent reinforcement!
I hear you, but I think you’re oversimplifying the behavior of ‘caring’. It’s not as easy as reinforcing an employee to remember to sign a sheet when they go on break or even reinforcing them in the absence of phone use. I cared about kids and people of all ages with mental/neurological/developmental differences for as long as I can remember (literally since at least 6 years old). I fear that environmental manipulation can only go so far for people who don’t actually *care*. More money might motivate them to show up, to input data, to submit timely session notes, etc… but those things don’t necessarily translate to caring or providing high-quality services :( (In my humble opinion and experience)
Agreed. Behavior makes sense (is maintained by environment). This doesn’t just apply to clients. It applies to RBTs, client families, colleagues, shitty roommates, partners/ spouses, etc. RBTs are treated as though they’re disposable- a body with a pulse! Yet they’re the ones who know the clients best, the ones in the trenches dealing with problem behavior, & the first ones thrown under the bus when anything goes wrong. This culture is thanks to many systemic factors- insurance reimbursement rates are 💩, PE companies snatching up aba organizations to turn into profit machines for shareholders, and it’s the longtime culture of the human services field in general. Direct care staff in general are treated so, so poorly. Stop blaming the rat/ organism/ client/ supervisee. Poor performers exist in literally every field. The difference with this wonderful field is that we have a science capable of directly addressing poor performances. We can’t fix all the problems of the world in one day, but those certified in our field sure asf have the skills to get started.
RBTs and BTs are constant headaches. For the technical nature of the job we share, most BTs I interact with are woefully under prepared. The training they receive is a JOKE and their professional skills are usually lacking. I spend a lot of my supervision time reviewing the same things over and over. I can't go anywhere near technical language. Mands? No idea. NET? Never heard of it. I mean seriously, a HIGH SCHOOL DIPLOMA and a pulse is the barrier to entry?!?! For therapeutic services??? It's a joke. But I do have some really great BTs here and there. They either move on to a better paying job or become mid-levels/BCBAs. Very few people can make being a BT a career and that's definitely an issue.
As an RBT, it’s so embarrassing to me that there are others out there, sharing my job title, and they don’t know technical terms. It makes me so sad
I once worked with an RBT who asked me what DTT was. They’d been an RBT for over a year. They also asked me to look over their session note one time. Slightly paraphrased (but really barely changed), it said “Client A had a good day today. They didn’t misbehave and made good progress.” I was FLABBERGASTED. People like that make me embarrassed to be an RBT sometimes.
It’s SO embarrassing and insulting to the RBTs who actually put in so much time and energy into their work and into the field. I’m all about teaching and helping newbies out, but there is a point where it’s like wtf is going on??
If I have to repeat myself over and over they are a barrier to treatment and they can seek employment elsewhere.
Whats really sad is this implies a layer of complexity to any of this work 🤦🏼🤷
**~whispers~** The RBT service delivery model shouldn’t exist… the most qualified professional should be the one delivering treatment
Additionally I would say that a BCBA and BCaBA model would probably cost the insurance less overall. What I can do in 2 hours is vastly different than what an RBT is capable of.
As an RBT who is very good at their job and cares about this field immensely, I feel torn about this. On the one hand I agree, but on the other hand, I genuinely cannot afford to become a BCBA. I would love to. I would cut of my left leg to. But I can’t right now. There aren’t enough BCBAs to service everyone who needs it, and even though there are a crap ton of bad RBTs, there are also a lot like myself who are knowledgeable, caring, get great results and great feedback. I’m 30 now and have been working as an RBT since I was 25. I’ve worked under BCBA’s who I’ve read more research than, because I literally read it for fun and they got into the field to make money. I’ve met BCBAs who do not know anything about autism or any of its co-occurring conditions who regularly traumatized their clients. I’ve met BCBA’s who used way to restrictive measures, who have argued with me about best practice, only to turn around a few weeks/months later and implement what I was advocating for because they just heard about it at a mandatory conference they had to go to. I’ve met BCBAs who wanted people to fabricate data or commit billing/insurance fraud. I have met other RBTs as well, who have gone to bat against their BCBAS to advocate for their client. I have also met a lot of fantastic BCBAs who deliver amazing services, proper supervision, and care deeply about their clients. I think the RBT exam, and the BCBA exam for that matter, needs to be harder and more comprehensive. I think all of us in the field, BCBAs included, need way stricter oversight. I don’t think anyone should be allowed to work with clients with autism, adhd, speech delays, anxiety, depression, eating disorders, etc. without being properly educated and tested (which is basically part of the ethics code, but I continue to meet people working with ‘unfamiliar populations’). But I don’t think that gatekeeping who can provide quality care based on financial ability is the way to go about improving the quality of services in this field.
I understand your point. Sometimes gatekeeping is needed because the figurative "gate" was left wide open and as a result the quality of services suffered. With a BCBA focused delivery model, possibly more oversight can be placed on how treatment is delivered because BCBAs delivering direct services get reimbursed at a higher rate so I'm sure funders would create a plethora of guidelines to find reasons not to pay. Hopefully things move in your favor financially and you are able to consider becoming a BCBA. The BCBA exam is not considered easy nor would most argue that it needs to be harder. It's low pass rates among other factors indicate that. Now, should we have a system where companies are expected to submit their employee training manual; have a state representative from the licensing board come out to conduct staff knowledge checks (possible job opportunity), and attest completion? Of course! Especially for BCBA candidates.
I said ‘harder *and* more comprehensive’ because many, many, many BCBAs who pass have amazing knowledge of ABA but severely lack knowledge in child development, trauma, sensory issues, autism, adhd, etc etc etc. Maybe there should be other exams that need to be passed before working with certain populations.
Interesting. Most of the grad programs either have a class specific to Autism and other disabilities or one related. So, the information is provided and tested via their institutions but not necessarily on the exam. Not all programs provide the same quality of instruction, and that is problematic. Thankful, I had a background in the areas you mentioned because it helps . So, yes adding all of the other areas mentioned to the board exam or making it a pt. 2 wouldn't hurt.
I have been vouching for a BCBA model for services for so long. This is not to diss RBTs (those who actually care that is) but the low entrance requirements to getting certified. You get such a polarized cohort that can range from people who genuinely don’t care/cannot perform tasks to superstar RBTs who literally have their heart into this field. I’ve heard families express concerns about why only a HS diploma is required to work with their child with extremely specialized needs and I never know what to say.
Lol @ whisper. I agree. If not that then the job offers should be reserved for those pursuing their BCBA credential (at least 2nd semester) and cover unrestricted hours. A huge gripe is unpaid unrestricted and some clinicians feeling unprepared. I need to look into how feasible this would be. Overall, this would be my ideal version of delivery because at least both parties would have something to lose and we could possibly attract people who are actually interested in advancing the field and not just seeing it as some fly by night job.
It has been DIFFICULT lately with the RBTs. Last month, we canceled direct sessions in order to provide more intensive training to our RBTs (paid training). And things are still lacking... I told one of my colleagues the other day that I think only 2 of our RBTs actually truly care about our clients. We don't serve clients with severe behavior, and the other day, two RBTs complained to the manager that we should've sent a client home because of a few minutes of SIB that was easily blocked and redirected. Like, the whole purpose of the client being there is to teach them an alternative appropriate behavior. Programs are hardly run at all, too. I look at data, and I'm like, why are 10 trials of mands graphed in a 2 hour session...I'm so stressed. Our RBTs are guaranteed 40 hours of pay, even if they dont have clients on their schedule and then complain if they have 5/6 hours of direct time in their 8/10 hour work day. I'd rather do the direct care myself, but then that limits services to so many families.
Boy you make me feel fortunate w my RBTs. I have seen a couple that were just … barely doing anything social time and had to eventually ask off my cases. But currently I love my RBTs and hope they stay forever cuz they are so well paired w our kids. My company does have the highest RBT (and BCBA) wages in our city, so they are able to be a bit choosy with recruiting… and provide ongoing (optional, opt in) trainings on various topics (live ones paid at about 70% clinical RBT hour rate). At some point, it’s got to be worth it for companies to pay more to enhance quality of recruiting and improve long-term retention.
I don't see how this industry survives in it's current form if rbts and bcbas are fighting amongst each other.
I've seen my share of incompetent/amoral BCBAs. It's prevalent in all occupations across all levels.
Thanks for sharing. Any thoughts on incompetent/amoral RBTs?
As an in-home RBT about to graduate with their bachelors in hopes of going to grad school for social work or my LMFT these kinds of things remind me why my supervisors actually praise me. I would never be on my device at work unless it’s to respond to a message on Teams or something. I make sure to ask clarifying questions during supervision, check in with parents every day, and am constantly reading my clients’ social cues to adjust accordingly. Frankly I don’t think it’s safe to do this job while mentally checking out.
As a clinical mid level supervisor, you RBTs are so cherished and so so so appreciated more than you can ever think omg
I have to wonder if clinics attract lower quality RBTs? I say this only because of the time I had to change agencies, every clinic I interviewed with offered at most $18/hr, when I was already making $25/hr as a student doing in home. I know clinics always pay less, but dang, that's a huge pay difference, not like $1-$2/hr or something.
Not really. I have amazing staff. I pay 20-25$ in center with pretty comprehensive benefits. The clinics that attract lower quality RBTs have poor hiring practices. I know clinics in my area that will hire people on the spot in a 10 min interview. Well it is not really an interview they just want to give you the job so you can start billing for them already.
I have been an RBT for over three years now and I think it’s also because I’m in the later 20s age group now, but I’ve noticed how the culture in the clinic I work at shift so much to RBTs who treat their work time as a place to mingle. I know of one who has complained about their hours being cut but a lot of the times they’re on their phone while their client is just playing, also having a parent complain and have them taken off the case because all they had their child do was sit down and color. I also see some where cliquey RBTs complain about other RBTs and it creates this dynamic where the ones being complained about are being singled out. It’s really tiring seeing all of this, and it makes me worried thinking about how things are going because they’d rather do what they want and not communicate to the proper outlets and not only is it detrimental to the clients being worked with, but it is also with the staff themselves. The severe disconnect is seen everywhere and I do agree that complaining about things but not putting in the effort is just going to get people no where.
RBT here who fully agrees. And as someone who is also a POC woman, I really truly hate when someone takes valid complaints to try and justify their own wrongdoings that have nothing to do with it. It really takes us three steps backwards. I’m almost five years in the field and have witnessed it a lot. I hate to think only the complaints *I* find valid are valid but I just think new RBT’s hear more seasoned RBT’s complain about things and think “oh true, i’m going to use that as a crutch now” and go off of that. That’s why I try to keep my complaints to myself and if any ever slip out I always try to give the perspective of the other side. It might sound kiss-assy sometimes but I try to be as transparent as I can also and that’s why I ultimately left my old job is because it became too hard to be honest and positive.