The Hidden Challenges of Being a Behavior Analyst

In this episode of Acorns to Oaks, Kristine and Sarah talk honestly about the challenges of being a behavior analyst.

They discuss cancellations, scheduling, telehealth, assessment, insurance barriers, treatment integrity, building new programs, and the emotional reality of caring deeply while learning not to take every stress home.

They also explore the pressure in the ABA field to constantly “do better,” and why improvement and pride in the work can exist at the same time.

This conversation is for behavior analysts, RBTs, parents, caregivers, and anyone who wants a more human look at the work behind ethical, compassionate ABA.

This episode speaks honestly about some of the harder realities inside ABA. Kristine and Sarah discuss insurance barriers, the pressure within the field to constantly “do better,” and the emotional weight of problem-solving work.

The goal is not to dismiss criticism or avoid accountability. It is to hold two truths at once: the field should keep improving, and many behavior analysts are already doing thoughtful, ethical, meaningful work every day.

That balance is central to Nurture & Nature’s approach: compassionate care, clinical humility, and pride in doing the work well.

Acorns to Oaks is presented by Nurture & Nature ABA, providing compassionate ABA therapy and parent support in Valley Village and the San Fernando Valley.

Learn more or schedule a consultation: nurtureandnatureaba.com

Follow Nurture & Nature on Instagram, YouTube, Facebook, and LinkedIn.

This podcast is for educational purposes only and is not a substitute for individualized clinical care.

Transcript

SPEAKER_01 0:07

You're listening to Acorn Stokes. I'm Christine Dixon, Board Certified Behavior Analyst, Board Certified Advocate in Special Education. And along with me is the most phenomenal and perfect Sarah Moreau, Board Certified Behavior Analyst and Nurse Practitioner. That's right. Sarah, today we're talking about uh the top five biggest complaints about being a behavior analyst.

SPEAKER_00 0:30

Yeah, you know, I don't know about you. I've had a I've had a week.

SPEAKER_01 0:34

Have you had a week? We can really get on the complaint train at any time, but it right? It's true. Very easy. Easy thing to do. Well, first off, if you are a behavior analyst, you are in the problem-solving business. That's right. So you have to understand that you're gonna have problems. You've taken on problems to solve.

SPEAKER_00 0:51

That's your role. Yeah. Yes. Seems like a really good idea at first.

SPEAKER_01 0:56

It still is a really good idea.

SPEAKER_00 0:57

It still is a good idea. But yeah, there are definitely days when you look around and think, oh, that's a lot.

SPEAKER_01 1:04

That's a lot. Or wow. I was on planet tempered tantrum for like two straight hours. Right. Yeah. Yeah. There can be, I think um, the logistics of this type of treatment, it happens in the home. Well, at least in our practice. Yeah. And in the applied science, it really was supposed to be done in the client's natural environment. Yeah. I know there's a lot of these clinics out there that are pop-ups, and um, but we do most things naturally in the home. Um so cancellations. Oh yeah. Oh boy. Oh. Last minute, sometimes at the door. Sometimes when you're driving, you're an hour into your drive to see a client, cancellation.

SPEAKER_00 1:47

Yeah. Yeah. And that happens. And there's very good reasons for that happening. Yeah.

SPEAKER_01 1:52

Um but cancellations can really do jobs.

SPEAKER_00 1:56

They can really, yeah, because then it throws off your whole day. And now what do you do with that time? How can you redirect that effort to someone else if possible?

SPEAKER_01 2:06

And scheduling is a challenge. Uh, you have to be extraordinarily flexible. You have to be able to pivot. Oh, this is canceled. Two minutes later, I'm jumping in to see this. Yeah. Yeah. So you've got to learn to pivot on a dime if you're going to be successful.

SPEAKER_00 2:20

Yeah. That was one of the hardest things for me to learn.

SPEAKER_01 2:23

It was, yeah.

SPEAKER_00 2:24

That was really hard.

SPEAKER_01 2:25

And I think new B C BAs, that's one of the hardest things is like, how do you schedule all this? Yeah. Hopefully you have a scheduling team you're working with that, you know, can give you alternatives.

SPEAKER_00 2:35

Yeah. Yeah. And it's gotten better, I would say, with telehealth, because then I don't always have to have hours between clients in terms of driving to get there. Certainly, I prefer to be in person because you can actually see what's going on and really take everything in. Um, but telehealth is a good option from time to time.

SPEAKER_01 2:59

Um I think it's a good option for treatment. I think it's a horrible option for assessment. Yes. Agreed. Maybe the first meet and greet, maybe background information, maybe the insurer's norm reference assessment. Yeah. Yeah.

SPEAKER_00 3:14

That telehealth, but to really do the analysis, you need to be in the environment. You need to see all the variables. Yeah.

SPEAKER_01 3:23

And that's one of the things I ask is like, can I have a tour of your home? I want to see the whole environment. And you know. Yeah. Yeah.

unknown 3:30

Yeah.

SPEAKER_01 3:31

So, yeah. But yeah, telehealth does help in that. You get those options, but scheduling is tough. Scheduling is tough. Yeah.

SPEAKER_00 3:39

And that's kind of true just in life as well.

SPEAKER_01 3:41

Yeah. Yeah. But with ABA, there's a lot of contingencies that the boards have put the responsibility on the behavior analysts, like the RBT hours, right? So sometimes you're in an ethical dilemma where client really needs you really want to see this client. You know, it's a pivotal point in their treatment, but you have to go over here because you have to supervise this RBT under the ethical code for a certain percentage of their time per month. I love that contingency.

SPEAKER_00 4:08

That that could be very difficult as well. But I love how we have a team effort, you know. So if I need to see a client, but we also have a therapist that needs to be supervised. I have someone else I can reach out to to get that supervision covered and then also care for the client.

SPEAKER_01 4:23

I mean, I think for the most part, we share cases, and that helps beat some a lot of these contingencies, I think. And that way you don't feel guilty when you have a bereavement or you're not feeling well, or you need to, you know, have a mental health day. Yeah. Um, then you know that someone else knows that case if there's like an emergency or something one day. But scheduling, it's challenge. It's challenge. Yeah. Yeah. Um, number second challenge, the insurance companies. I have to say it with God. Yeah, they are horrific. I hate to say it.

SPEAKER_00 4:58

I mean, well, their purpose is to not provide funding for services. Yeah.

SPEAKER_01 5:04

And they have these clinicians that have never met the patient. Yeah.

SPEAKER_00 5:07

And they just are dealing with them is and sometimes their peer reviewer isn't a behavior analyst. We we were in a meeting recently. Someone typed in the chat that they had a peer review with a podiatrist. Yeah. I mean about behaviors. How does that work? Yes. Yeah, there's a lot of questions about insurance, and it is definitely a challenge.

SPEAKER_01 5:30

I think challenge number three for me is the do better challenge, which has been trending over the past five years. Every conference we go to, and and Sarah actually lost it at the last conference because we've always been being like, do better. They always saying to us, do better, do better, which is not in itself a bad no. And I and I want to do better. I want to do better, but that's all we're told is do better, do more.

SPEAKER_00 5:57

Um it just comes across as very um self-deprecating.

SPEAKER_01 6:02

Yes, I do. I feel like there's a lot of self-deprecating behavior analysts. I mean, always telling us to do better. And, you know, uh we do phenomenally. I, you know, I'm really happy.

SPEAKER_00 6:15

And we're striving all the time to improve. Yeah. But yeah, I I that's an interesting, interesting emotional component. It is.

SPEAKER_01 6:25

It's like, um, yeah, I remember we saw this great presentation by Dr. Pat Freiman. And he is just, oh, he's a real rock and roller. He really is. He really is. And he's just saying uh he came to nurture nature, and he was saying that he heard at the conference that there were bad behavior analysts, and he was like, no, behavior analysts are good. They are good people. And he went on to say, you know, they're a superhero that, you know, isn't never gonna get a Hollywood movie made of them. And that, you know, we dedicated few. And I think when he said that, I just got, oh, I got chills.

SPEAKER_00 7:00

Yeah, he's a magical speaker, also. Yeah, just really connects with his audience and yeah, but just an excellent person, also.

SPEAKER_01 7:09

You know, the science works, it does, and it's been proven. And a lot of people do the right thing every day. And a lot of behavior analysts dedicate their livelihood and their vitality to helping other people, and that's a good and beautiful thing. It is. And you know, ABA is not just for autism, you know, we've taught recovering stroke victims how to speak again, and we teach a variety of diagnoses and medical fragility and you know, design systems that work for peop for people that might not have these systems that need it to be.

SPEAKER_00 7:49

There's a lot of applications of ABA beyond autism, um, which I hope we will explore more.

SPEAKER_01 7:56

Yeah.

SPEAKER_00 7:57

Yeah.

SPEAKER_01 7:57

But the do better. Yeah. I for a self-deprecating field. It's like maybe we need to start talking positively and use our own science on what we're saying about our science, right?

SPEAKER_00 8:09

I agree. Like I think it's important to have pride in the things that you do well. Yeah. And also know that we're constantly striving to do better. But why can't it be both? I do this really well, and I'd like to improve in this area. Yeah. Instead of I'm terrible. Yeah, be exactly. I've gotta do better. It's like um, maybe not the most productive way of improving our science and improving our work.

SPEAKER_01 8:38

Yeah, I think we need to just say like science is dynamic and we're ever changing and ever involving towards the best good, you know, to the greatest good. Um so yeah. What's another challenge being a behavior analyst? I think sometimes the party question. The party question. It happens the same way every time at a party. Oh, someone's like, Sarah, what do you do?

SPEAKER_00 9:06

Oh, yeah, that's an awfully long. And you say, I'm a behavior analyst and a nerve practitioner and a PhD student. And then they glaze over and walk away. Actually, I heard so I hear they always say, Are you analyzing my behavior right now?

SPEAKER_01 9:21

Oh, yeah. Like at every party, it's like, what do you do? I'm a behavior analyst. Are you analyzing my behavior right now? I always say, Yes, I am.

SPEAKER_00 9:32

I I actually think um, yeah, that's an interesting question. I don't know why we have such an emphasis socially on talking about our jobs, but we really do. I I feel like um maybe I should just make one up. Like I'm a I'm a dog herder. Oh. Yeah. That might be a a more appropriate socially.

SPEAKER_01 9:54

Which the science of ABA has been applied to. In fact, we went to a workshop on dogs and ABA.

SPEAKER_00 10:01

Yes, athletic dogs, uh, competitive dogs and rats and jars. Yes.

SPEAKER_01 10:07

It can be used across a variety of sciences and fields and industries and healthcare and and it works in so many ways. It really does work. It really does. Yeah, but it does have challenges. Yeah, yeah. That's true. I think treatment integrity. This is a term that behavior analysts use when we have the right treatment, we've proved functional control, meaning we've implemented treatment, we've seen maladaptive behaviors go up, you know, autonomy, self-expression, functional communication uh go up. We see maladaptive behaviors go down. Yes. Um, yes, but treatment integrity.

SPEAKER_00 10:46

Yeah. Uh I think one of the things that really affects that is when we have staff changes. And that happens frequently because we have a lot of people that are in school and are advancing and learning and we love that and we want to support them. And sometimes we have to make changes because, hey, it's a new quarter, and now I have a new schedule. Um, and so sometimes getting everyone trained up immediately uh to keep that treatment integrity uh can be a challenge.

SPEAKER_01 11:13

Yeah. And we have uh nanny changes, right? Yep, and mediators, right? Mediators are the people that are gonna implement the treatment. So there might be changes. Grandma comes to town that changes things. Yeah. Don't cry. Here's that new toy you've been wanting, right? Don't cry, you wipe your eyes. It's fine. Grandma's here. Yeah. And that might not be the treatment plan, right? It might be like he's gonna say, you know, what he wants, or you know, yeah. So yeah, treatment integrity can be tough. Another challenge.

SPEAKER_00 11:46

I mean, I think building new things, which is something I really love to do, building new programs, new social skills groups, new outings groups, um, maybe a new adaptive skills group where we're working on life skills. Uh, all of these things are so much fun and they can be really hard because you'll have scheduling issues, you'll have staffing issues, um there's a lot of moving parts when you're building new things. Yes. And that can be really challenging.

SPEAKER_01 12:17

Yeah. I love those challenges though. I know there's hiccups and you know, anytime you're building something new, there's there's some pressure and you know, things come up and there's things to learn. But if you push past it and you, you know, strive and work diligently, I think, you know, you come up, everything's coming up roses. And it's totally worth it. Yeah, yeah. It is totally worth it. But new program designs and going through the process of that, and you know, that can be challenging, new clinical programs. Yeah, yeah. Any other challenges being a behavior analyst?

SPEAKER_00 12:57

You know, uh something I learned from you early on, which I think is really important. Uh not taking home the emotions of the day. Yeah. Learning to rationally detach and go about your life after work. That was really hard for me at the start. Yeah.

SPEAKER_01 13:16

Yeah, that's super important. You know, because as behavior analysts, you want to care and you should be connected to your clients and you should engage and you should be very passionate about what you're doing because that brings about the best outcomes. However, that's a heavy burden. Yeah. And you, you know, at the end of the day, you have to put work aside or it will eat you up. And there will be nothing left. Yeah. You can think about clients all day long. The work will always be there. You have to discipline your mind to be like, I'm gonna go through rational detachment and now I'm gonna be with my family. Or yeah.

SPEAKER_00 13:55

Yeah, I think being able to redirect back to yourself at the end of the day is so important because you have to be well to help others. So true. And it does come to a point if you're allowing these stresses to creep into your mind outside of work hours that um that's all you'll do. You get overwhelmed. Yeah.

SPEAKER_01 14:15

Because we're in the problem-solving business a lot of times, you know. So it's like we're dealing with a lot of problems. We ask people, yeah, what are your greatest challenges? Let me work with you and take those on. And you do take them on. Yeah. You have to be strong.

SPEAKER_00 14:30

Yeah, you really do. And and I think it's also just really important to take care of yourself in that way. Um, to make sure that when the day is over, I'm finding a way to put that aside so that I can focus on myself for the night and then come back refreshed to this problem the next day.

SPEAKER_01 14:46

Absolutely. Self-care. And that's our next topic. It is. So it's been great talking to you on the challenges of being a board certified behavior analyst. Thank you on behalf of all the people you've helped for the wonderful work that you do. Um, at the end of the day, it is worth it, I think. And so too. So thank you for watching Acorns to Oaks and subscribe, comment, like, don't like. Interact with us. Yeah, we're open.

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