By Evelyn Gould, PhD, BCBA-D, LABA
As an Applied Behavior Analysis (ABA) practitioner, what keeps you awake at night? If you are like me, you worry about client progress and whether you can help a particular family. You worry about confrontational parents, grandparents that are sabotaging your plans, and contentious IEP meetings. You worry about staff faced with severe aggression and self-injury and your ability to support them. You imagine the pain parents are going through as they watch their child struggle to learn basic skills, and grieve the loss of the life they thought they would have. And you worry about the reports you need to write, and how you are going to manage everything, and still do a good job… I would assume that almost anyone would agree what we do is difficult.
ABA practitioners are tasked with changing behavior that is generally creating huge problems for an individual and those around them.
ABA offers an understanding of human behavior that suggests positive change is possible for everyone.
Indeed, there’s a great deal of joy and reward to be had in our work, but there’s also a great deal of stress and pain.
Recent data suggests that while ABA can be one of the most rewarding careers, it can also be one of the most stressful (Plantiveau, Dounavi, & Virués-Ortega, 2018; Sundberg, 2016). ABA practitioners work with clients struggling with extreme learning and behavior challenges, in often challenging contexts. It is inevitable that at some point we experience struggle and failure, as do our clients, their families, and the staff we work with.
Embarking on ABA treatment thus involves choosing to expose ourselves and others to situations that evoke aversive private events (such as my nighttime musings). When faced with our own and others distress, how do we respond effectively as ABA practitioners? How do we understand distress from a BA point of view?
Most BCBAs (Board Certified Behavior Analysts) do not have good answers to these questions. In my experience, when problematic verbal behavior shows up, most practitioners do some combination of the following:
- Ignore private events altogether (just plain avoid dealing with it!)
- Abandon functional analysis and focus on topography (get caught up in the content of thoughts or words)
- Argue with, or try to persuade, using logic and science (“But the research!”)
- Attempt to fix or rescue the person from their experiences
- “Walk on eggshells” (avoid direct communication)
- Pull from other disciplines (i.e., use non-behavioral strategies!)
- Otherwise accommodate or reinforce avoidance (e.g., use distraction)
From a behavior analytic (BA) perspective, these strategies (all avoidance driven) are not likely to be particularly effective, and in fact may actually make things worse in the long-run (Hayes, et al., 1996). If you don’t believe me, think of how successful you’ve been at “winning over” parents who repeatedly reject your treatment recommendations or struggle to follow behavior plans when their child is experiencing distress. These strategies are also not examples of using the science of ABA to guide us.
The need for ABA-based strategies for addressing complex verbal behavior is even more apparent when we look at the daily tasks of ABA practitioners. The majority of our time is spent interacting with other highly verbal humans (staff, parents, teachers, etc.), either directly (during meetings, school observations, treatment sessions, phone calls), or indirectly (via email, treatment plans, reports, clinical notes). Take a few moments to imagine doing your job without engaging in complex verbal behavior or responding to private stimuli. Are you able to imagine doing your job without thinking, feeling, remembering, problem-solving, imagining, etc.? Are you able to imagine doing your job without talking to other people? I’m certain the answer is a resounding, “No.” So whether you are aware of it or not, you are constantly intervening using complex verbal behavior (like members of any other profession) and responding to your own and others private events. The question is, how do we keep our BA hats firmly on and respond more skillfully when doing so?
Acceptance and Commitment Therapy (ACT) is a behavioral approach to understanding complex verbal behavior in terms of how it functions for an individual in a particular context (Hayes, Strosahl, & Wilson, 2011). Adopting an ACT approach might help us keep our BA hats on when encountering private events, and facilitate more effective verbal interactions during the course of our everyday work activities.
I was drawn to ACT by my deep love of behavior analysis and the desire to stay true to my science, while dealing with ALL complex human behavior.
See also: The Inner, the Outer and the Soul: An Intro to Metaphor in Behavior Analysis
Note that if you still think private events aren’t your business, go back and read some Skinner (e.g., 1945; 1974). ACT hasn’t stopped me worrying, nor has it stopped me feeling stressed, but it has helped me behave more like the practitioner and human being I want to be every day at work: a compassionate, kind, responsive, and effective clinician, despite the worries and stressors… and that helps me sleep better at night.
References
Hayes, S., C., Strosahl, K., D., & Wilson, K., G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Chicago: Guilford Press
Hayes, S., C., Wilson, K., G., Gifford, E., V., Follette, V., M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–68.
Plantiveau, C., Dounavi, K., & Virués-Ortega, J. (2018). High levels of burnout among early-career board-certified behavior analysts with low collegial support in the work environment. European Journal of Behavior Analysis, 1-13.
Skinner, B. F. (1945). Operational analysis of scientific terms. Psychological Review, 52, 270
Skinner, B. F. (1974). About Behaviorism. New York: Knopf.
Sundberg, D. (2016). The high cost of stress in the ABA workplace. Retrieved July 20th, 2018, from https://bsci21.org/the-high-cost-of-stress-in-the-aba-workplace/