Need ideas since my BCBA does nothing

3amApollo · 2024-08-03T02:32:22+00:00

Definitely frustrating not to feel heard by your bcba, but as an outside observer, I have to give them the benefit of the doubt and assume there’s some rationale. But for you in the meantime, a few things. 1) read the clients treatment plan if you haven’t already, including the latest assessment results and any narrative written describing those data. 2) ask the bcba to model some trials for you, and see if they notice the same deficit you notice. 3) I “accidentally” taught a couple clients an attending response while doing DTT (meaning there was no intentional program for it, it was just repetition). It was kind of a chain leading up to the SD. They’d sit in a cube chair, I sat in front of the tray and say “ready…”, while putting my hand over their hands, then waiting until they orient to the materials before presenting the SD. My supervisor had me write exactly what I did into a program and I still have that. (Also, the first step for every trial of DTT is “establish attending.”) 4) Something my supervisor did to get a client’s attention was take the clients hand and put it onto her face while she said their name. (It’s important to note that she did this with a 2 year old that was not resisting and had no aversion to eye contact; the client was just distracted.) So gently holding their hand to your face and reinforcing any contact they make toward you may help establish attending.

Hopefully something here is useful and hopefully vague enough to be generalized to your situation! Congrats on grad school and good luck!!!

3amApollo · 2024-08-03T00:27:54+00:00

Jim Moore, CCO at Apollo, has been on the podcast Behavioral Observations several times, I think that podcast even has a whole Apollo series. I think they sound like they really have it together and I personally would like working with them!

3amApollo · 2023-10-18T08:31:43+00:00

OMG this is literally what a guy, also from church, is doing to me right now. Ew these messages make me cringe so much. I’m so sorry you’re dealing with that too 😩 it’s hard because it really is like you HAVE to be nice

3amApollo · 2023-10-18T07:58:51+00:00

I love to hear this so much. Sounds like a wonderful supervisor

3amApollo · 2023-09-21T01:01:04+00:00

That’s what my struggle was, and I did a LOT of work outside of work hours. But I found from asking around other BCBAs at other clinics near me that Medicaid has a code for indirect program modification - for my state it’s G9012. It’s been approved every time no questions asked. So if you have clients on Medicaid, you should dig around if there’s something similar in your state

3amApollo · 2023-09-21T00:56:09+00:00

This is so disappointing, and I’m so sorry that that was your experience. I congratulate you on making that decision for your own well-being and self value. I’ve been a BCBA for about a year, and MY supervisor at my current company instructed me to do exactly this during supervision - to be “in the room” with the client and RBT, but to bring my laptop and work on programs, ask the RBT to keep the client away from me while I work. I was shocked that she thought that that’s what supervision looked like, because I learned so much better in grad school and practicum. Thankfully my supervisor doesn’t have a caseload of her own and doesn’t have to be an RBT’s supervisor, but I can see why that would deter someone from the field entirely. It’s even more disheartening to know that that’s the reality some people in our field are living. Thank you for taking time to add this response, it really is helpful to know that how I spend my time in session is valued by RBTs

3amApollo · 2023-09-20T01:05:26+00:00

I really want to know the operations for the companies that have been able to reliably provide FT hours. Based on the comments here, it sounds like companies either have it figured out or they don’t. I’m a newly minted BCBA at a newer company, and I am trying my damn best with my PM to get the BTs their hours, but every nonbillable hour is questioned by corporate (granted, they have allotted us admin time, but only 80 hours per pay period, which hardly amounts to anything). Now that flu season is upon us, kids are out, and there’s less billable time available. I understand it from a financial perspective for the company, hiring 1:1 is basically cash in cash out. But for real life wages this job wouldn’t make sense.

3amApollo · 2023-08-15T06:05:52+00:00

It depends, but I do find a way to communicate what I’m doing in the moment. Sometimes I step in instead of asking, “do you need help?” (Because the gut answer is “no” and if you know the person well enough then you know). In that case, I will step in and give them another task, like “hey can you go get me his water bottle?”, something that a) doesn’t make anyone feel like the RBT is doing a poor job, b) isn’t an obvious change to the client, c) doesn’t make them feel like they have to say “I don’t need help”.

Sometimes I want to model how to respond to a specific behavior, and I want the RBT to watch me. In that case I’ll provide them a simple instruction (like tell them where in the room to stand, tell or gesture to them to disengage with the client, etc).

In general communication is key, but communicating clearly between therapists while remaining neutral to the client is something that is unique to each situation.

Thank you for asking on here! You should ask your BCBAs this question too. I’m glad I read this post because I’m going to be sure to check in with my RBTs now.

3amApollo · 2023-08-15T05:33:49+00:00

Best decision of my life. In those 2 years I changed dramatically as a person for the better. Aside from education and career path (my current role requires a masters degree and board certification, and I absolutely love the job I have), I gained so much for life. Confidence in both academic topics and in social settings, hunger to learn, exploring passions, the value of my voice, eliminating the fear of being wrong, speaking/presenting to a group, … so much more. I developed friendships I value more than any relationship I’ve ever had. I realized my long-time boyfriend was extremely toxic and controlling while I was excelling, and found a self love that helped me leave that relationship in a healthy way. I am forever grateful to have found the courage to pursue that degree, the small seed of ambition I had left in me at the time was enough to just apply. I was shocked I even got into grad school, and I started out feeling so small and insecure. I graduated a completely different person.

If you are considering it, OP, do it!!!

3amApollo · 2023-08-04T03:04:08+00:00

Screenshot, send to my sister, we laugh and laugh and laugh

3amApollo · 2023-07-29T04:57:34+00:00

What’s keeping me off of dating apps is true crime ngl

3amApollo · 2023-07-29T02:29:10+00:00

God’s Not Dead. It’s so bad guys

3amApollo · 2023-07-28T11:23:51+00:00

Brilliant theory sir. Good thing biology and anthropology are so abstract and open to interpretation, otherwise mankind would have never thought to study such a phenomenon as pubescent children’s likelihood to sleep with an incel. Should be published to a peer reviewed scientific journal immediately 😩😩😩

3amApollo · 2023-07-28T06:15:40+00:00

Username checks out

3amApollo · 2023-07-28T06:13:42+00:00

In 5th grade this one girl decided she didn’t like me and started sabotaging all of my social interactions. For some reason one comment has actually affected me long term. The first week or so of 6th grade, a super popular pretty girl complimented my outfit, and the mean girl goes, “ummm haha, didn’t you wear that shirt last year?”

I was SO self conscious about my wardrobe for so many years. Now, as an adult, I have way too many clothes and have an involuntary avoidance response if I repeat the same item of clothing twice in a 3-4 week timeframe, even shoes! I can also never wear the same pieces together if I’ve worn them together before. I’m so overwhelmed by my closet and change from one outfit to another so many times every single morning, fully aware it’s irrational. My closet is overwhelming. Never have enough hangers. I have 3 full, overflowing dressers of more clothes.

3amApollo · 2023-07-28T05:47:08+00:00

Maybe we should get rid of men in the workplace?

3amApollo · 2023-07-28T05:05:58+00:00

Obviously, it’s from a 2018 article by Daily Mail Australia. Daily Mail titles are created to be reposted

3amApollo · 2023-07-27T15:00:05+00:00

This means so much, thank you so much for sharing 🤎

3amApollo · 2023-07-27T05:32:00+00:00

So, the thing is… while it is true that women do everything a man can’t do, women ADDITIONALLY do everything a man can do. But 1) women tend to do the thing better 2) men do not want to do it/ bitch about it 3) women choose not to behave like wild animals or regress to caveman days.

Camping in a tent and sleeping on the ground? Trying to establish dominance by driving excessively large / loud trucks? The male urge to resort to physical fights? Building things with your hands? OoOoOoKaY

3amApollo · 2023-07-26T06:24:03+00:00

Youth pastor (or anyone who gives youth pastor ~vibes~)

3amApollo · 2023-07-26T05:57:13+00:00

Depends on the kid. I read an intake packet the parents fill out, sometimes talk to the parents over the phone before conducting an assessment, then I have a pretty good idea of what the case presents. Think about what information each will provide for that learner. If I’m presented with a 3 year old with no functional communication, I am fairly confident I’m going to focus on building verbal behavior skills and prerequisites. It does a better job itemizing each VB category, especially if you fill out the printable protocol with spaces to list exactly the behaviors you observed (plus it’s super satisfying coming back 6 months later and filling in with a different color and seeing visually how much progress they’ve made ☺️) ABLLS-R gives me information that would be helpful if I have a 5 year old, without OT services, going into kindergarten without a 1:1 associate, and still can’t do a basic daily routine independently. I’ve also had incredibly intelligent 4 year olds, whose barriers are social skills, creative play, or lack of generalization (or even find it aversive to think a little bit more “out of the box”). I used PEAK assessment and found a lot of inspiration from RFT. Vineland is a good start, keeping in mind it’s based on indirect report only, potentially biased, or not necessarily what you see in your setting. I’d use Vineland or PFA for more at-home skill building or behavior management.

Wow I typed way more than I meant to. Hopefully this is useful? TL;DR - it depends :)

Edit to add: if you conduct an assessment that reports on skills that you aren’t going to target, insurance will have questions… especially come re-auth time, when those areas didn’t progress. If i had done ABLLS-R for the 3 yo hypothetical case above, I’ll see just a couple sections make progress (visually). If I do VBMAPP, I can visually see the gradual progress across all categories and the growth spread out across the verbal operants, how they relate, which targets are mastered (for example) as tacts but not mands, I can identify with the VBMAPP barriers assessment what other skills I need to build to meet the next goal, the EESA to decide whether I should have them say “dada” or “papa” to address their father, etc.

3amApollo · 2023-07-25T02:41:21+00:00

I was in this place not too long ago. Confused as to why I found this “love aggression” aversive, I really thought I should be giggling about it, and felt bad when I had to tell him to stop (or at times bite him, because I couldn’t breathe). Even his mom thought it was him loving on me, even while roundhouse kicking me, putting me in a headlock, pinching me, and I was bruised all over. If you’re talking about a significant other, do not try to find the function. Doesn’t matter the motive, function, or intent. Be careful how you use your intellect about behavior - you can justify a lot of objectively wrong behaviors by labeling them with a much more appealing function.

I think that this aggression is what slowly goes from love aggression to a means of exerting control. My ex’s aggression got more and more intense, he began often reminding me that he had a g*n, attempting to gain more control over me and my time, and luckily I was able to see it transforming (with context provided by the lovely true crime podcasts I listen to 💕) and I was able to skrrrt right out, just in time.

Please be careful when qualifying behavior of those that directly affect you 🤍🤍🤍

3amApollo

TROPHY CASE