As promised, we're wrapping up our series on burnout. We've talked about how we, as BCBAs, sometimes dig our own burnout holes. Then, we discussed the two heavy hitters: outrageous billable expectations and a work culture that doesn't give two cents about clinical progress. This week, I'm bringing you the grand finale of our burnout saga, and it's a nasty cocktail mixed from the elements we've already touched on.
The Final Culprit: Rapid Onboarding
That's right, we're talking RAPID onboarding. And not just rapid onboarding of kiddos; I mean new RBTs and BCBAs, too. It's like a merry-go-round on steroids.
Rapid onboarding happens when there’s an emphasis on bringing kids and staff on at a breakneck speed. This often means cutting serious corners. Sometimes the effects are immediate…other times they aren’t.
So why does it fry us?
Let’s start with rapid staff onboarding. And, let's start with the human aspect of it all. Rapid onboarding means the company is pretty much swiping right on everyone. They adopt what I like to call the "warm body approach," sometimes filling positions with any living, breathing human. Needless to say, turnover rates shoot up faster than a rocket. Why? Because "everyone" is not cut out for ABA. The RBTs need intensive coaching, and guess who that falls on? Yep, you got it: the BCBA. And when RBTs bail, BCBAs follow suit, often because they're the ones left filling the gaps.
Rapid onboarding doesn’t simply pertain to staff…it pertains to the clients as well. Naturally our clients deserve quality services. But when you're starting them at the speed of light, there's no time to ensure the brand of ABA you offer fits their needs. So you get minimal clinical progress, and that's a recipe for mass burnout (see the last post for more on that). Obviously we want to help as many clients as we can. However, when we get to the point where we haven’t developed a rhythm and cadence to the process, you’re not necessarily helping clients. In fact, you may be exposing them.
So, without further introduction, here are a few key indicators that your company might be moving too fast.
Giant New Hire Classes. If you see a new hire class that's like 25% of your current staffing, raise an eyebrow—or both. This is often a sign the company is in a mad dash to cover caseloads, prioritizing quantity over quality. The odds of getting a cohesive, well-trained team diminish the larger these classes get.
Inadequate Training. Newbies with minimal ABA experience maybe get a week of training at most? Training is where the rubber meets the road. If the onboarding process is too quick it can get messy. Shortcomings are overlooked and important issues end up excused. BCBAs should expect to train their RBTs…but in situations like this, BCBAs may end up dealing with more training. If turnover is high enough, training seems to become the focal point of the consultation—to the point improvements and adjustments aren’t being made to learners’ programs. Instead, the focus turns away from the learner to the under-skilled RBT.
Sky-high or mass turnover. Staff come in and go out like it’s a revolving door. This doesn't just affect morale; it makes for a chaotic work environment. You'll find yourself constantly playing catch-up rather than focusing on the quality of the services you provide. Giant new hire classes leads to under-skilled and inadequate staff (see above). Throw that together with engorged caseloads and your under-supported people head for greener pastures where support staff are more abundant and they can make an honest impact. This applies not only to RBTs….but BCBA staff as well.
Last-minute Client Assignments. Certainly we want to allow as much access to care as we can. We want to get learners through the door to make that clinical progress that they so terribly need. And, we should be ready to do so with some expedience. However, when you show up for work on Monday morning and you’re surprised with a brand new client (and so is the RBT), this becomes a little too close for comfort. Yep, that means you haven’t read through the learner’s documentation detailing their clinical background. Yep, that means you’ll have to cancel that other consultation or parent training so you can take the time to support the RBT (since they’re just as clueless as you are about this new client). Nope, you weren’t asked to take this client—you were told. No consideration for what this might mean for you or your existing caseload. No consideration for you existing schedule. Assigning clients at the last minute can have a ripple effect, impacting not just the BCBA but the entire team and even the clients themselves. Do this a few more times to a clinician and it starts to wear. We’re not flipping burgers here; we’re shaping lives.
Direct Therapy. I personally love to be 1:1 with kiddos—and, as BCBAs, we should have the willingness to hop in and do a little direct therapy when needed. However, when it gets to the point where you’re spending two or three unplanned, full days in therapy every week, it starts to wreak massive havoc on your schedule with your other clients and what you can do for them. When BCBAs are constantly being pulled into therapy, there are a couple of possible explanations that tie back to the pace of onboarding. First, this occurs when the organization over-hires inadequate and undependable staff and then doesn’t weed them out in the training process. Overzealous to bring these staff on, they overlook shortcomings initially only to leave their existing, quality staff (the BCBAs) holding the bag down the road. Second, this can happen when organizations—overzealous to get kiddos in the door—refuse to look directly into their staffing numbers knowing that a BCBA will pick up therapy if they need to. At the end of the day, it pulls the BCBA away from their specialized role. Tasks and responsibilities become neglected. Progress is sacrificed. And people start to get unhappy.
Musical Chairs with RBTs. How many times has this happened: You sit down for consultation and—voila!—your sitting in front of an RBT you’ve never worked with before. You find out that your experienced RBT is permanently switched to another client due to demands on the schedule. This constant reshuffling disrupts the flow of services and makes it challenging to maintain consistency, which is gold in our line of work.
As I mentioned in all of my offerings on this subject, self-advocacy isn’t just a buzzword; it’s our lifeline in this high-stress gig. We can’t blame our company, our RBTs, or anyone else for issues they don’t know exist. If you see red flags waving, don’t just quietly simmer in frustration—step up to the plate and make your concerns known—and do so professionally and respectfully. On the flip side, a reality check is in order. You’re going to encounter some of the above—and you’ll likely have to have flexibility. Yes, sometimes we HAVE to start a kiddo last minute…don’t expect some of the things I’ve highlighted above to never happen. Further, set yourself up for reality—not every new hire will be the next ABA prodigy.
That said, rapid onboarding can burn you out. Flexibility is crucial; adaptability is your friend. But, a constant state of ‘emergency onboarding’ will corrode your clinic’s culture quickly—and it’s worth tastefully addressing in your meetings with your supervisor.
What do you think? What are some of the other casualties of rapid onboarding?