Self-Care for the BCBA
Taking care of business, but first, take care of yourself.
Congratulations on passing the big exam! You are officially a BCBA. Beginning work as a new BCBA can be very exciting and also very overwhelming. New supervisory roles, professional development requirements, and staff training are just a few of many new responsibilities that come with the BCBA title.
With these new responsibilities also comes the pressure to perform. New BCBAs often overextend themselves in the first few years of practice and may experience fatigue and burnout. In 2018, The European Journal of Behavior Analysis published a study looking at burnout rates for behavior analysts. Researchers surveyed 183 working practitioners and the results indicated that 67% of those individuals were experiencing mid-to-high levels of burnout. Additionally, the results of the survey showed that approximately 30% of individuals were experiencing little to no job satisfaction (Plantiveau, Dounavi, & Virues-Ortega, 2018).
The largest factors related to burnout often stem from lower levels of training and reduced schedules of supervision (Bottini, Wiseman, & Gillis (2020). This suggests that a newly-minted BCBA will be more likely to experience some aspects of burnout than those who have been in the field for a while.
Engaging in regular self-care practices is important for well-being and can improve overall job satisfaction. Research also suggests that professionals who engage in self-care and other protective behaviors to avoid burnout are more likely to demonstrate compassionate care with their patients (Taylor, LeBlanc, & Nosik, 2019).
In the medical field, empathy and compassion have been found to be related to positive outcome measures, including patient compliance with treatment recommendations (Schneider, Kaplan, Greenfield, Li, & Wilson, 2004) and overall health of the clinician (McClelland, Gabriel, & DePuccio, 2018; Riess, Kelley, Baily, Dunn, & Phillips, 2012). In other words, managing your own needs may also make you a stronger and more effective clinician, overall.
While engaging in activities such as exercise, taking bubble baths, getting massages, or taking time-off from work might all be very effective ways of reducing stress levels when feeling overwhelmed, there are also many proactive steps that new BCBA’s can take towards “professional self-care” to pave the way for continued job satisfaction.
Here are just a few:
- Participate in a professional community. Facebook, Linkedin, and professional organizations can be great resources for professional development. It can be helpful to have a community of other behavior analysts to lean on for support and guidance. Collaboration with other types professionals may be beneficial, as well. Although your expertise may be behavior, a Speech Therapist or Occupational Therapist might work with similar populations and can offer you additional support and new perspectives.
- Find a positive model. Research conducted by Gibson, Grey, & Hastings (2009) suggests that the level of supervisor support provided to an employee can inversely predict the likelihood of burnout for that employee. Although you may no longer need supervision hours, you should still seek out mentor-mentee relationships with seasoned professionals. It is also valuable to take advantage of opportunities to observe other professionals at work and utilize their advice and resources when offered. For example, advanced career professionals may have helpful scripts for dealing with challenging situations, unique methods for tracking patient care needs across their caseloads, or self-care strategies to reduce overall stress levels.
- Seek opportunities for professional development. Some professional organizations are working to provide continuing education for behavior analysts on self-care, compassion fatigue, and using behavior analytic technology to support our own needs. For example, Women in Behavior Analysis offered a workshop titled “Practicing ACT as Self-Care for Behavior Analysts”, presented by Jonathan Tarbox, PhD, BCBA-D during their 2020 Conference. Furthermore, ABA Inside Track, a popular behavior analytic podcast, offers an episode specifically on managing staff burnout (Episode 98- Staff Supervision III, Pt 2- Staff Burnout).
- Set boundaries. Newly credentialed BCBAs are often eager to land their first supervisory role and may forget to set important boundaries with their employers, coworkers, and clientele. New BCBAs may feel pressure to work additional hours, take phone calls from clients on their days off, or offer additional session times during the weekend. Identifying your own personal and professional boundaries prior to beginning a new role is crucial to ensuring a positive professional experience. Establish what those boundaries are and plan to express them in a clear and professional manner to your employer. Communicating to your supervisor an achievable timeline for documentation to be completed or setting reasonable expectations about your working hours you’re your clients are just two examples of important boundaries to establish. It may not always feel comfortable to communicate these expectations, but you will be glad you did. Setting boundaries can be as simple as creating an outgoing voicemail reminding patients and families to call 9-1-1 in case of emergency and to expect a return call for non-emergency messages within 2 business days. Finally, after you establish and communicate these boundaries, make sure you stick to them!
- Play! Lee, Wang, & Yang (2019) found that play at work can reduce burnout and increase positive attitudes at work. By encountering enjoyable experiences at work and acknowledging the reinforcing parts of the day, you are more likely to continue to engage in those work activities. For BCBAs that work closely with children, engaging in more play during session time will provide more opportunity for reinforcement for both the client and the BCBA, win-win! Outside of session time, employers can boost employee morale by creating more opportunity for play, such as company-wide games or friendly competitions.
- Check in with yourself. Set aside specific time in your week to engage in your own hobbies and preferred activities. Engage in activities that encourage more time reflecting on yourself and your well-being. This will help you learn more quickly how to identify what changes you might need to make, any boundaries you might need to set, and can help you meet your own personal goals. Spend more time checking in with yourself and make yourself a priority. Remember, you are not your job!
References
Bottini, S., Wiseman, K., & Gillis, J. (2020). Burnout in providers serving individuals with ASD: The impact of the workplace. Research in Developmental Disabilities, 100, 103616. https://doi.org/10.1016/j.ridd.2020.103616
Gibson, J.A., Grey, I.M. & Hastings, R.P. Supervisor Support as a Predictor of Burnout and Therapeutic Self-Efficacy in Therapists Working in ABA Schools. J Autism Dev Disord 39, 1024 (2009). https://doi.org/10.1007/s10803-009-0709-4
Lee, A.Y., Wang, Y. & Yang, F. Feeling Exhausted? Let’s Play – How Play in Work Relates to Experienced Burnout and Innovation Behaviors. Applied Research Quality Life (2019). https://doi.org/10.1007/s11482-019-09794-1
McClelland LE, Gabriel AS, DePuccio MJ. Compassion practices, nurse’s well-being, and ambulatory patient experience ratings. Medical Care. 2018;56:4–10. doi: 10.1097/MLR.0000000000000834.
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, 19:2, 195-207. DOI: 10.1080/15021149.2018.1438339
Riess H, Kelley JM, Baily RW, Dunn EJ, Phillips M. Empathy training for resident physicians: a randomized controlled trial of neuroscience-informed curriculum. Journal of General Internal Medicine. 2012;27(10):1280–1286. doi: 10.1007/s11606-012-2063-z.
Schneider J, Kaplan SH, Greenfield S, Li W, Wilson IB. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. Journal of General Internal Medicine. 2004;19:1096–1103. doi: 10.1111/j.1525-1497.2004.30418.x.
Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2018). Compassionate Care in Behavior Analytic Treatment: Can Outcomes be Enhanced by Attending to Relationships with Caregivers?. Behavior analysis in practice, 12(3), 654–666. https://doi.org/10.1007/s40617-018-00289-3
