Burnout in the behavioral healthcare space for providers who deliver autism and intellectual and developmental disabilities (IDD) services is pervasive. In order for us to tackle burnout, we need to understand its root cause so we can help behavioral health professionals access the support they need to continue to deliver services sustainably.
The field of applied behavior analysis (ABA), which is often used to increase the autonomy and independence of individuals with autism and IDD, is relatively new in comparison to other medical industries like nursing or physical therapy. Licensure for behavior-analytic qualified health care providers started in 2009 and is currently in 35 states. Yet, ABA is one of the most rapidly growing industries in healthcare. The demand for technicians who deliver ABA services is growing at a rate of 8 percent each year, and the demand for qualified healthcare providers, the Board Certified Behavior Analysts (BCBAs) overseeing the technicians, has increased by 5,852% since 2010. Despite the growing demand for ABA providers, ABA organizations are still experiencing staff shortages with turnover ranging between 30-75%. This revolving door of essential personnel not only puts logistical and financial strain on the organization, but it contributes to burnout of retained employees who fill the gap of short staffing and, more importantly, negatively impacts patient progress.
Creating sustainability in ABA clinics
Staff shortages in a rapidly increasing industry are creating unique situations where fewer people have to do more work and staff take on responsibilities outside of their current job description. Because of this, the role of technology is integral for increasing efficiency in ABA organizations and enabling BCBAs more time for direct care. ABA agencies across the country are using technology to offload administrative tasks which, in turn, allows BCBAs to spend more time working with their clients. Given the high demand for these services across the country, scheduling can easily turn into someone’s entire job as they manage tight schedules, cancellations, waitlists, and insurance coverage eligibility. The same can be said for billing. Spreadsheets and manual tracking can leave room for costly human error. When deciding to implement a technology to automate these manual tasks, it is essential to look at the bottlenecks that are reducing the productivity of staff: what tasks take clinicians the longest? What are they saying is the most tedious? Organizations can meliorate the burden of staff shortage and turnover by listening to our clinicians’ pain points and automating administrative work to software. It helps clinicians stay focused on more clinical duties while limiting the number of “hats” staff have to wear in order for them to provide meaningful, medically necessary services.
Supporting the development of BCBAs with continuing education opportunities
For BCBAs, pursuing opportunities for continuing education and professional development is more than just a nice-to-have; they must do so to maintain their credentials and/or license. BCBAs are required to take certain courses every few years to be in good standing with their credentials and/or license so that they are providing the most up-to-date care to their patients. This is due, in part, to the constant evolution of the regulatory landscape in the ABA field. For example, the state of New York now permits BCBAs to extend their licensed scope of work beyond autism and support individuals with other related disorders. If not provided by their employer, BCBAs often have to pay out of pocket to take such courses which may include travel, placing a financial burden on their employee. I am encouraged that more and more ABA organizations are providing professional development opportunities to their BCBAs. When employers offer opportunities for continuous professional development to their employees at no expense to their staff, it can help increase employee satisfaction and reduce turnover. Offering these courses also suggests to their staff that they are supported and cared for, and encourages them to take advantage of new career opportunities within the organization while broadening their clinical skill sets.
Through strategically implementing time-saving technology, ABA organizations are creating opportunities for professional development and allowing the next generation of BCBAs to advance their careers and attain higher salaries. The surge in demand for BCBAs shows no signs of letting up, and neither does the fight to gain and retain quality talent. Leveraging technology to complete tedious and time-consuming tasks to reduce administrative salaries or clinicians being pulled away from services is a necessary solution to staff shortages experienced by the ABA industry, leading to clinician burnout. While it won’t be the only solution, alleviating clinicians from conducting menial tasks which add to their already long days while providing them with support and training will contribute to the care needed to combat burnout at its core.
Dr. Kerri Milyko
Dr. Kerri Milyko, Ph D, BCBA-D, LBA is Director of Clinical Programming at CentralReach.
