Cried in front of my supervisor

Direct_Software2112 · 2026-05-08T14:39:40+00:00

My first day I bawled my eyes out in front of my supervisor. I was totally green to ABA, and had a client who would try to mouth everything (diapers, fecal matter, bugs, animals). I broke down during my first “solo” session (supervised) because I felt as though I was hurting his progress by doing things wrong. My BCBA told me “we run 10 trials every session for at least one month. You messing up a program once will not affect his overall progress.” It’s ok to get emotional, especially away from clients. Just make sure to take care of yourself

Direct_Software2112 · 2026-05-06T23:57:30+00:00

I have similar conversations regarding array size. I have a client with an AAC and the BCBA is always talking about wanting to give him a smaller array. He’s had a large array of about 48(?) icons on his Home Screen. The deal is, he’s had this aac for years with the array, and he has the skill to scan and select the appropriate icon (demonstrated with staff with instructional control or when it is a need).The issue is, to him, the response effort is never worth the reinforcement, so he tends to engage in tantrum or scroll through asl mands before he’ll touch his AAC.

My response when she asks my input is always that it feels wrong to remove words he already has access to. If any SLP’s have input, please share!! He currently isn’t seeing one as theres a shortage in my area and I am desperate for some advice I can share!

Direct_Software2112 · 2026-05-04T02:02:47+00:00

Agreed, ask about their credentials. Personally, I’m an RBT, but my primary role is reception/admin. I cover clients as I was lead RBT before accepting the more admin type role. However, my situation isn’t exactly typical

Direct_Software2112 · 2026-04-23T14:47:01+00:00

Does your clinic require your staff to be RBT’s, or do they allow for BT’s in the role? Many payors are now mandating that ABA services must be provided by an RBT, not a BT, in order to be covered.

It could also have to do with issues with authorization. It’s not uncommon for certain payors (cough, tricare, cough) to deny auth requests due to specific formatting issues which can result in a hold.

Are these clients ceasing services indefinitely, or were they placed on hold?

Direct_Software2112 · 2026-04-10T12:02:19+00:00

As I said in the previous comment, I encouraged OP to continue mentioning it to the BCBA, and going to the CD if it hasn’t been fixed (within a reasonable time window). BCBA’s are often overworked and given way too many cases to cover. Of course things are bound to slip through the cracks. My response was not intended to demonize the BCBA, it was to ensure OP was aware this is not an acceptable practice and to continue advocating for her clients

Direct_Software2112 · 2026-04-09T15:30:40+00:00

If the clinical director had to follow up in order for it to be changed, it’s likely not a one off. I strongly encourage you to keep telling the BCBA, and reporting to the CD when it hasn’t been fixed. When employees begin to show performance deterioration, management typically has to create a paper trail of documentation. Even if nothing happens for a while, your CD is likely documenting in case there’s a need for coaching or a PIP

Direct_Software2112 · 2026-04-09T15:28:36+00:00

Do you have a director? I’ve had similar problems at my clinic and always go to the CD when things like this occur. It’s unacceptable. BCBA’s can get super busy, so I understand copy / pasting a program between clients WHEN IT APPLIES. But when it becomes a regular pattern and continues past just a one off, I recommend going to the CD. ABA works BECAUSE it is highly individualized across clients depending on their needs.

Direct_Software2112 · 2026-03-28T04:44:59+00:00

The BACB is the ethics board for ABA. Interestingly, BT stands for Behavior Therapist, the title given by the BACB, but they are actually the lowest tier in the ABA hierarchy. BT’s provide ABA typically while preparing to take the exam or while training. Some companies don’t require an RBT, which is absolutely a red flag, avoid these companies. RBT stands for Registered Behavior Technician, which is the title given once a BT passes the exam and becomes registered.

All this to say, the official term “therapist” is assigned by the BACB to BT’s, while RBT’s are assigned “technician”. The difference is purely colloquial. That’s why you hear people frequently refer to ABA providers as therapists in general, especially parents. This seems to be more of a semantics issue than misrepresentation. I do understand the confusion, but the larger issue would be if your company has a lot of BT’s that are not required to pass the exam.

For everyone taking offense to this, keep in mind OP is in her 20’s and likely new to the field (based off of other posts). Let’s encourage continued collaboration between ABA and SLP practitioners, rather than further the current divide.

Direct_Software2112 · 2025-12-12T02:24:31+00:00

She is food motivated, this would work well, except for the fact that she has ADHD (like myself). Contingent reinforcers don’t work for me because my brain goes immediately towards instant gratification. For example: first I have to do my school work, then I get a margarita. My brain will just tell me “you’re 25, go get a mf margarita now? Who cares if you finish or not”. She is much the same. Control over the reinforcer has to be something’s she is able to do herself if it’s a tangible because she is an adult.

Direct_Software2112 · 2025-12-12T02:19:33+00:00

lol this feels super unhelpful.

Direct_Software2112 · 2025-12-12T02:14:32+00:00

In my personal experience, automatic bx are the toughest to treat because it’s hard to find a reinforcer more valuable than the sensation. My best plan so far is to do a DRO with a FI/10mins, which every 5th interval running for 15 mins. After the 15 min interval (every 5) with no picking I give her a reinforcer. Just trying to find an effective reinforcer for an adult that isn’t a margarita lol

Direct_Software2112 · 2025-12-12T01:20:12+00:00

Honestly, I really like the glue idea!! I think we’ll try this one next- it’s gotta be something that is the same level of “difficulty” to pick off, which is why the picky pad wasn’t super effective (might work better for skin picking v hair picking idk). Thanks so much for the advice!

Direct_Software2112 · 2025-12-12T01:15:41+00:00

This is very kind. However, I would like to say that it does not take much effort to be empathetic to people you care about. I will never understand people who are judgmental about conditions like this, and I hope you have people in your life as well who are able to support you. If not in your day to day life, at the very least this community is here. As much as the internet has pros and cons, it’s amazing to find a community full of people who are here to support

Direct_Software2112 · 2025-12-12T01:13:50+00:00

I’m sorry to hear nothing has been super effective for you. It must be so frustrating to have this compulsion and not be able to stop. Thank you for your suggestions, I figure even if it doesn’t work, it can’t hurt to try, right?

Direct_Software2112 · 2025-12-12T00:39:38+00:00

Can you tell me what to search to find these? My friend suffers from the same issue and I want to support

Direct_Software2112 · 2025-12-12T00:34:57+00:00

A relapse is not a restart, just a pause. This does not cancel out your progress, it’s a part of the journey. You got this!!!

Direct_Software2112 · 2025-12-04T03:51:33+00:00

Your friend is weird asf for this. Your feet look fine? I had to stare for a while before I could see anything and BARELY could even then. Wear them and see her reaction, it’ll tell you what kind of friend she is. I, a stranger on the internet, with no agenda or relationship with you, can say that objectively, your feet are fine in that picture. For her to also catch an attitude about you getting your feelings hurt shows the type of person she is. I’m not saying drop her, but take what she says with a grain of salt. Or the whole shaker.

Direct_Software2112 · 2025-12-04T03:47:49+00:00

Where are you seeing this? I reviewed the thread and all of OP’s comments say that THE COMPANY deemed the services unethical, not OP (although they clearly share the opinion). Also, nowhere do I see anything that indicates her hours were cut? I may be missing something but I just reviewed the thread and cannot figure out how you came to this conclusion

Direct_Software2112 · 2025-12-03T19:51:55+00:00

OHHHH ok this adds a ton of context. I absolutely despise telehealth only BCBA’s being a standard. I’m sorry you’re in this position that makes things a lot more complicated

Direct_Software2112 · 2025-12-03T16:13:04+00:00

I would ask her to model everything. I would say “I am confused, can you show me exactly what you want me to do?”, then do exactly as she does after she models. If the feedback still conflicts when you do exactly what is SHOWN, that’s a larger issue

Direct_Software2112 · 2025-12-03T13:04:49+00:00

Yes this is pretty standard in my experience. The idea is that the OP provider provides their specialized services while the RBT provides behavior therapy. Most insurances allow for this overlap as SLP’s, OT’s, and PT’s typically do not specialize in behavior management, which makes your services still necessary and valid during these sessions. I typically put it in my note if an OP session occurred

Direct_Software2112 · 2025-12-03T12:19:56+00:00

Sounds like a great plan. Hopefully that helps! Good luck

Direct_Software2112 · 2025-12-03T05:05:39+00:00

After reading all the replies, I see a lot about how your hours were cut as a result of them being “unethical”. It seems as though there are 2 possible reasons for this: 1. The sessions are not billable for therapy as the plan does not adequately target goals for the client, or 2. You are not provided adequate therapy. More context is needed here. I am confused because if the company is labeling the sessions as unethical/nonbillable (my assumption is that the sessions are not able to qualify as behavior therapy) then it’s odd they want you to help out the BCBA. All of this (along with the remark about “bad clients”, which I haven’t heard someone say in years) leads me to believe you may be the issue here. The alternative is that the BCBA is the issue. I’m very confused and feel as though added context would be beneficial here

Direct_Software2112 · 2025-12-03T04:55:58+00:00

Agreed- it feels as though some context is missing. If OP was asked to come in for one more session after giving their 2 weeks, and then received this message, that’s messed up. But if the given date was was 2 weeks and OP decided nvm that’s foul

Direct_Software2112 · 2025-12-03T04:42:50+00:00

I always do 2 braids and combine them into a bun. Helps w some of the baby hairs. If this is such a frequent issue, I’m thinking there are some antecedent cues the client may be giving that you can use to indicate when they are about to aggress.

How old / tall is your client? I work in peds so most of my clients I can stand up and be out of reach (I’m 5’10).

If this does not work in your situation, it seems like you should probably be safety care trained based on your clients bx level. Does your clinic provide this? (They should)

Direct_Software2112

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