The Anatomy of Burnout Part 3: When Progress Stalls and Everything Else Follows

Let's dig back into our ongoing chat about burnout. A quick recap: Two weeks ago, we talked about how we BCBAs sometimes architect our own demise through burnout. Last week, we touched on the systemic issues. These were issues that had a lot more to do with the structure of the role or the company itself. More specifically, we talked about the impact of caseloads and billable expectations.

But today, let's jump into something that hits home for all of us—the stalling of progress.

Progress is (and should be) the currency that BCBAs pursue. Progress is the heartbeat of what we do. It's the adrenaline shot that courses through our professional veins. Ask anyone, from an RBT to a Clinical Leader, "Why do you love what you do?" and they'll point to progress. Go a little deeper and they recall a heartwarming story. For all of us who’ve worked in ABA for even just a little bit, there’s a Timmy or Sarah that we worked with that went from "couldn't" to "could". We were hooked after that. We still beam with pride and our hearts pound a little harder when we think about those kids.

So, what happens when progress comes to a screeching halt? Well, sometimes it's a little bit of a gut punch that leaves a mark. We should take immense pride in the progress we make with our kiddos. When that pride dwindles, it’s like sipping on a cocktail of frustration and sadness.

Further, if we want to turn that frustration and sadness into full-blown despair, we go to work for companies that don’t value progress (and sometimes kid themselves that they do). Clocking into a company that cares significantly less about progress than you do wears on you. After a year or two, you feel like you’re walking around in someone else’s body when you’re at work. Sunday nights are gloomy. Monday mornings are gloomier. That's not just a recipe for burnout; that’s an guaranteed invitation.

But, after our last two discussions, how do you know when your company doesn’t value progress? These aren’t bulletproof heuristics, but they might help in coming up with that conclusion.

• Treatment Plan Review: If nobody even glances at your data or treatment plans, it can mean a couple of things. It may mean they think you’re awesome and that you have everything under control (not necessarily a bad thing if it’s true…but it has to be true). Or, it could mean that they don’t care too much about clinical progress, outcomes…or your kiddo.

• Stagnant Programming/Learner Regression that goes unnoticed: When your programming has the same energy level as a sloth on sedatives and nobody raises an eyebrow, that's more than a problem—it’s an existential crisis for any BCBA who is trying to right by their clients. However, if no one is monitoring progress they won’t notice. Further, if your RBTs don’t seem to be phased by this lack of progress, it might mean that little/no progress has become a company norm.

• Absence of Supervisor Meetings: Are BCBAs meeting weekly with their clinical supervisor? Are there opportunities for 1:1 interactions and overlaps with them weekly-ish? If you're not routinely calibrating and getting clinical supervision, you're sailing a ship with no compass.

• External ABA Conferences and CEU Events: If your company seems to avoid external ABA conferences like the plague, they're essentially saying your professional growth isn’t on the agenda. Companies might avoid these conferences for a variety of reasons. Some companies would prefer to keep BCBAs in the dark about what’s out there in the wide world of ABA and keep feeding them you-know-what. Or, it’s because they’re afraid (and insecure) that a clinician may get seduced and poached by another competing provider. Other times, it’s about keeping clinicians on the grind for billable hours—if you’re at a conference, you’re not billing. Either way, it’s a bad look. And it’s a bad look because it explicitly communicates to the clinicians where new ideas and clinical progress lie on the priority list.

• Feedback: If the only time you hear from higher-ups is about billable criteria, then let's be clear: You're a cog in a billing machine, not a clinician focused on meaningful change. ‘nough said.

• Clinical Resources: Check the BCBA office: Do you have access to resources? If you needed to conduct a VB-MAPP assessment, do you have the resources to do so? Or are you in line behind three other BCBAs that need to use the materials to make it happen? Do your kiddos have reinforcers or are they waiting in line to play with the five Hot Wheels cars in the clinic? Waiting in line for resources is a norm—and it’s a regular thing. But when it gets out of hand to the point that clinical progress is jeopardized, then it’s time to have a talk with your supervisor.

It Starts With You. We talked about self advocacy last week as a starting point. Know this—burnout can be prevented through self-advocacy. It can become your lifeline. The lack of clinical progress can be like quicksand for a BCBA’s motivation and job satisfaction; it’s what we’re here to do and we all want to do it.

Get yourself a mentor if your company isn’t providing one. No luck? Drop me an email. Let’s talk!

Do you resonate with the above? I'm all ears, as always.