Transforming Applied Behavior Analysis Through AI-Powered Tools with Adam Ventura (Part I)

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Welcome to ABA on Tap, where our goal is to find the best recipe to brew the smoothest, coldest, and best tasting ABA around.
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I'm Dan Lowry with Mike Rubio, and join us on our journey as we look back into the ingredients to form the best concoction of ABA on tap.
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In this podcast, we will talk about the history of the ABA brew, how much to consume to achieve the optimum buzz while not getting too drunk, and the recommended pairings to bring to the table.
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So without further ado, sit back, relax, and always analyze responsibly.
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all right and welcome yet again to another installment of aba on tap i am your ever grateful co-host mike rubio along with mr daniel lowry mr dan how you doing today sir
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great great doing great excited to have another guest on today
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yeah it's been a couple weeks since our last guest it was a great conversation with dr scott o'donnell and i i think that uh today's conversation will will be uh just as promising and interesting we're going to be talking about Something that, quite frankly, I've been a little fearful of, and I think I've admitted it on the podcast, and I think that our guest is going to help me work through that fear today.
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So I'm excited to welcome Adam Ventura.
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Let me talk a little bit about Adam.
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He is a leader in the integration of artificial intelligence and behavior science.
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He's the founder and CEO of Intraverbal AI, a company that's dedicated to transforming applied behavior analysis through AI-powered tools that support ethical decision-making supervision and clinical efficiency.
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So without further ado.
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Mr.
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Adam Ventura
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Thank you guys so much for the invite and for that great entrance music as well.
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I remember that you guys just told me a few minutes ago before we went live that you're looking for names for your virtual band.
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So I am going to take some time after this podcast to come up with a couple of names and I'm going to use AI to do it and then send it over to you guys.
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That is
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perfect.
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That is perfect.
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For whatever it's worth, I believe it would be Gemini that helped me with your introduction.
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So I hope it got it right.
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AI-powered Gemini I got it right there on Google.
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That's, again, me overcoming my fears slowly and gradually.
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Obviously, you punch it into the search, it does it for you.
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I hope it's that easy looking forward to the tools that you'll be talking about.
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Before we get to that, we love the origin story here on ABA on Tap.
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We like to talk about the brew, basic ingredients, how everybody brings them together to present something palatable, something that's functional, that works for individuals.
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Please, kick us off.
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Tell us a little bit about your background.
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I think you've done everything that Dan and I have, and now you're pushing the field forward in some new directions.
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So tell us all about what got Mr.
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Adam Ventura started and what keeps you going.
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Sure, absolutely.
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It's interesting that you asked about my origin story here because I've been in the field now for 20 years.
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And I was having a discussion with somebody the other day and they're like, how long have you been in the field?
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I've been in the field for two decades.
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And then I had one of those take a pause moments and I'm like, wow, I've been in behavior analysis for 20 years.
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But I feel like so many people in the field specialize in one thing and that's kind of their claim to fame.
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Where with me, I never really specialized in anything in particular, I feel like my thing that makes me unique is I've worked in just about every setting doing everything.
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So when I started in the field, I started working with adults.
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I was working in group homes.
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I was working in adult day training facilities.
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Then I moved over to doing foster care.
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I did that for a few years.
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And then I started working with kids.
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And somewhere around 2010, 2011, I ended up starting my own company, my own ABA therapy company in Miami.
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And I ran that for almost 10 years before I sold to private equity.
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And during that time, our company grew and flourished.
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By the time I sold the company, we were in three states.
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We had just under 300 employees.
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Good Lord.
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Yeah, yeah.
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It was way more than I ever expected.
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I was very fortunate to work with a lot of great people.
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And we worked in a variety of different settings.
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So like I was saying, we worked in schools, homes.
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I continued doing group homes for a little while after I started my company.
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Then after I sold the company, I did a lot of different things.
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I wasn't sure what I wanted to do next.
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So I did some OBM consulting for a while.
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I started an OBM practice management software system and I wrote a few books during that time as well.
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So I had a lot of different things going on and I feel like I've been very fortunate in that my experience in ADA has been very diverse.
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I've worked in the private sector a lot.
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I worked in academia.
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I taught at Florida International University in the behavior analysis department for 12 years.
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RIP Jose Martinez.
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Actually, he was FIT.
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Oh,
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good
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guess.
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Yeah, so Florida Institute of Technology.
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Oh, sorry, sorry.
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No, no, yeah, no problem, no problem.
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We actually worked with him a great deal and...
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mad respect to him i mean he's he contributed so much to our field but yeah fit is in like the center of florida like the melbourne area fiu is in like the miami area
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gotcha
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but um yeah so uh i i think that's uh uh my elevator speech for my origin story here is that i've worked in a variety of different settings i've been really fortunate in in that area and I know a lot of people in a lot of different domains of behavior analysis.
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And that's something that's really professionally reinforcing for me is I have the opportunity whenever somebody comes to me and says, you know, I really need somebody that works in schools that can help BCBAs get started.
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No problem.
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I know like five people.
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I need somebody that does OBM consulting and manufacturing plants.
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No problem.
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I know somebody.
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So I'm really fortunate in that I know a lot of different people in a lot of areas.
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guys.
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Yeah, I would say that's my origin story here, and happy to dive into any of those details.
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Awesome.
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That's so exciting.
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I feel like, not the mission of the podcast, but it's almost changed over the last little bit.
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We started talking about ABA and the partition of that with individuals with autism, but over the last, especially with the guests that we've had, we've talked about the diversity, and I think that's really special, because ABA so often gets, like we talk about, pigeonholed into autism, right?
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but kids with autism specifically.
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So it's so cool to have somebody like yourself, Adam.
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We've had a few, Dr.
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Scott O'Connell, the last guest, not just with kids with autism, in fact, working with adults.
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So also the organizational behavioral management piece.
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So it's just so cool to have the diversity from ABA.
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Yeah,
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yeah.
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Tell us a little bit.
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So you said foster care and group homes.
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Those can be very diverse, very interesting, very challenging settings.
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Tell us a little bit about your experience there.
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And again, that's certainly now dealing with behavioral challenges outside of spectrum disorders, maybe within.
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Tell us a little bit about your experience in those settings.
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Yeah, I worked in, I only did foster care, I would say for about a year and a half, but I did, I worked with adults in group homes and ADTs for really the first like seven years of my career, six, seven years, something
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like that.
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And it's really hard work in the sense that if you don't work at the right place, and I worked in a lot of different places, you end up becoming a paper pusher.
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instead of somebody that is actively making the lives of the individuals that you work with better.
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And I worked in really tough group homes.
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Like I'm thinking about a couple of group homes that I worked in where we got clients out of jail.
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So they came out of prison and we dealt with the hardest behaviors Um, you can imagine, um, really difficult behaviors, not just physically aggressive behaviors, but property destruction, uh, sexual aggression behaviors, um, severe, severe self injurious behavior.
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So it was, I, I was.
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uh good at navigating the system but i never really felt like i was making the difference that i think our science can and i was moments away from leaving the field and going and doing something else and then i ended up transitioning over to work with kids and you know when you're working with kids you have you're working with a shorter history of conditioning you know so if you're like if you go start a client that's 50 years old and it's been in the system in a group home for 30 years they've been doing the same things the same way um changing behavior is really difficult but you know if you're working with a four-year-old or a five-year-old you know their history of conditioning is much shorter so it's easier to make uh changes and um so yeah it's Working in group homes was challenging.
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It was tough.
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It was physically demanding.
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I've had everything happen to me.
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I've gotten poached, kicked, bitten, burned, hit with chairs, you name it.
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We've had everything happen to us.
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It's challenging work and I wish the system was set up because they're usually run through state or federal money.
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And I wish private insurance were more involved with this to shake things up a little bit.
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And I wish the system worked a little bit differently because you just don't see a lot of movement, a lot of improvement with the clients that are there.
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breaks your heart in a sense you know and it kind of makes your job aversive and i got to that point when i hit like year six i was like i don't want to do this anymore i'm not making a difference you know i'm just pushing paperwork i was involved in audits three four times a year because i was contracting out to different companies they're constantly auditing those places it's really stressful um so it just It wasn't the best time in my professional career.
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I worked with great people.
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I think there's a lot of people there that want to make a difference, but it's not really why I got into the field.
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That makes a lot of sense.
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Yeah.
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Have you heard of a PROACT, PROACT Crisis Management at all?
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What's it called?
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PROACT.
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No, the one that we used was, um, PCM professional crisis
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management.
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Yeah.
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There's also CPI.
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Um, but yeah, the company I work for is product.
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So we work with a lot of people that do group homes and residential facilities and, uh, definitely a different, um, demographic than the, you know, in home ABA.
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Um, and it's interesting too, because we get a lot of people that are coming and starting their own, um, group home and, um, I don't think they realize, kind of like you were saying, Adam, what they are signing up for.
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Because it is a lot.
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The people are a lot.
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And sometimes the support that you get isn't a lot, but the expectations are.
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Here in California, a lot of them are funded by the regional centers and the Department of Developmental Services here in California.
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And yeah, it's a lot.
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It's just thinking about that as you were talking that...
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Yeah, that history of reinforcement.
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Even when we deal with 18 year olds, 15 year olds, it's so much harder than it is a three or four or five year old.
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I can't imagine a 50 year old expecting any sort of behavior change.
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And then like you're saying, it's paper pushing and then probably just going to work and trying not to get hit because you're not really making a whole lot of meaningful changes probably at that age without a lot of intensive support.
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So,
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yeah.
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Yeah, and the other thing I would say too about working with adults is especially within those state-run facilities, is that the behavioral contingencies that the state oftentimes, and I'm not an expert on other states, I did most of that work in Florida, the way they set up those behavioral contingencies, it doesn't reinforce client improvement.
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It reinforces audits and paperwork and you know and behavior goes where reinforcement flows so i ended up doing uh the tasks that the state wanted which is and they it may not be what they state that they want but it's the contingencies contingencies that they set up which were make sure that your paperwork is in order make sure that you're checking off all of these boxes and you know there wasn't you know they weren't doing like in-depth analysis of how how much the clients were improving and they didn't reward the providers um that got these improvements with the clients either so i i think and again there's a lot of great people working at the state and a lot of great providers out there it's just I feel like some
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structural changes would do that system a lot of good.
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these funders want, whether it's private insurance, state, whatever.
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And it's like, do the people even know the procedures?
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That doesn't matter.
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Can we just make sure that the notes look right so we don't fail an audit?
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So I even see that in the private sector of not failing an audit being the motive and the reinforcement for success.
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Yeah, it takes focus away from the real work, right?
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Yeah, it takes the focus away from what you're trying to do.
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So was there any level of, you know, was there any level of measurable success rate for that work?
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I would imagine that they're looking at the paperwork, but at some point they have to look at some rate of success and say, well, this isn't working.
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What are we going to change?
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Or it's just kind of a system that rolls on.
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That's what it sounds like.
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It was my experience that it was a system that just rolls on.
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And I found myself jumping from job to job a lot, trying to find more meaning in my work.
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And we were just talking.
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about, I think Dan, you brought up crisis management.
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And I became a PCM instructor.
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I was like, let me try something new.
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Let me see if I can get some more success here.
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And I started moving into the realm of staff training a little bit more.
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And that included becoming a PCM instructor.
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And I found a little bit more meaning with that.
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And I started moving into supervision and working with younger behavior analysts.
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So that was a little bit more reinforcing And then in 2010, 2011, maybe it was 2009, I forget the year, but the insurance mandate came out.
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And when the insurance mandate came out as, you know, for anybody that's been in the field this long, that was the game changer.
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And I'll identify something in specific.
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When I was working, I worked Medicaid waiver.
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I know you all have an equivalent out in California, but in Florida, it's Medicaid waiver.
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I would get...
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two hours a week to work with the client with no what we called back then behavior assistant help so obviously this is in like i would say 2005 six seven there was no such thing as an rbt there was no such thing as a behavior technician if you wanted what we called back then a behavior assistant um you would have to submit a lengthy behavior program.
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And when I say lengthy, I'm talking 25, 30 pages, not a reauthorization report, like a lengthy behavior program to the local review committee.
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They would have to approve it, and then you would have to get the state to approve it as well.
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And those were few and far between.
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So if you were a behavior analyst back then, you had two hours a week to work with the client.
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And with a client that has, let's say, a 30-year history of conditioning living in or existing within the system, two hours a week you're just not going to make progress you know no matter how hard you try so i i try different creative things i'm like instead of working with the client directly we focus on staff training then i was like well let me start working with the group home managers a little bit and i just kept throwing jello at the wall trying to make it work and it wasn't and it was demoralized
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Yeah, that's a lot.
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Or did you see a lot of people have one incident and then have to go right back in?
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You know, one of the experiences that I had that was very lightning positive, I would say, is I did a lot of IDT meetings, so interdisciplinary team meetings, and I learned a lot from that because we had I feel like we should do so much more of that now.
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I feel like that happens sometimes with IEP meetings in schools, but for the most part, we don't do that.
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But we did a lot of that back then.
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And we would have a psychiatrist there, a speech person there, OT, PT, the group home managers there.
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We would have like an hour and a half long meeting with like 10 people in the room about one client.
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And it was really cool, actually.
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I remember learning so much about medication, how these facilities were run, how we could make environmental changes that would impact the behavior of the client.
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But to answer your question, a lot of what was done was med changes um to these clients again one of the saddest parts is when these clients exist in the system for so long they end up getting prescribed a lot of psychotropic medication and we were doing our best to be good behavior analysts in changing one thing at a time putting in the phase change on the graph phase change line on the graph and then observing what happened with those clients afterwards, and then jumping back into the IDT meeting, having an interaction with the psychiatrist and said, here's the data.
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This is what that med change did.
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So we did a lot of that.
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We worked with, I testified in court a few different times, which was an experience.
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which was kind of an exciting, I'm going to be honest with you, it was kind of an exciting thing to do.
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And when you get in there, you take it very seriously.
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So I remember dressing up in a suit.
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Nobody else was in a suit, but I took it very seriously.
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I dressed up in a suit.
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I came in, I had notes.
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I said, this is what's going on.
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And so to answer your question, I would say it was a combination of, it was really an interdisciplinary discussion.
00:20:54.963 --> 00:22:39.628
And we talked a lot about um their behavior versus the outcome of maybe sending them back to prison or making a recommendation because that wasn't our job to make that decision but we would make a recommendation and we would we would oftentimes sit down and say okay yes he had a really bad behavior this client he attacked another client that's not good but in the broader picture here we think that this was just an isolated incident and that we can make some changes with him with just some tweaks or he's been making so much progress this was just like one bad day and nobody wants to get judged on their worst day you know so uh we took a lot of that stuff into consideration before we made recommendations sometimes it happened you know we had to um have to make some hard choices sometimes you know some of them would you know attack other clients i worked at a place um i'm sure you all have an equivalent out there was called an intermediate care facility in icf and it was basically like a six-story apartment building and in this six-story apartment building we had about 60 adults that worked uh that lived in there and you know, if you had one that maybe had an incident, a serious incident once every few months or something like that, and the injuries weren't that bad, it was more just kind of a scuffle, you know, that's one thing versus, you know, we had serious incidents where, you know, a client pretty badly attacked another client.
00:22:39.709 --> 00:22:44.394
And I won't go into details unless you guys really want it, but some of them are pretty horrifying.
00:22:44.865 --> 00:22:54.858
So long story short, we would try our best to make interdisciplinary decisions and recommendations based on all of the factors involved.
00:22:54.979 --> 00:23:03.570
So I would say that that was one positive part of my experience working with adults is you get to work with other professionals and see different perspectives.
00:23:04.171 --> 00:23:06.314
And I thought that those were pretty positive.
00:23:06.654 --> 00:23:10.804
So from that angle, these individuals were getting a second chance.
00:23:10.884 --> 00:23:14.689
It wasn't like one mishap, one assault within the facility, and then they were going back.
00:23:15.130 --> 00:23:18.555
You all had the opportunity to say, no, wait a minute, they're doing better.
00:23:18.575 --> 00:23:21.239
This is an isolated incident, as you were saying.
00:23:21.278 --> 00:23:29.810
And now, I mean, I guess that's different from now being out in the community where if they're doing that out there and they get picked back up, it's almost a sure thing.
00:23:29.851 --> 00:23:32.173
I'm guessing that they're getting back, you know, thrown back in.
00:23:32.193 --> 00:23:45.521
So that's really neat that at least it seems like the system was working in that way, that within that isolated facility, home or that facility, you all had the jurisdiction to say, no, this is an assault and it would be illegal anywhere else.
00:23:45.642 --> 00:23:50.267
And it would probably put their parole at risk.
00:23:51.028 --> 00:23:53.730
However, we're working to change that behavior.
00:23:53.750 --> 00:24:03.981
I mean, that just sounds, despite all the challenges you're talking about, that seems somewhat positive that people are getting more than a second or third chance to try and change those behaviors.
00:24:05.153 --> 00:24:05.875
Yeah, absolutely.
00:24:05.894 --> 00:24:10.558
And I will say one more thing, not to bring it to a negative thing.
00:24:10.638 --> 00:24:27.875
But again, if we're looking at the behavioral contingencies, if we recommend based on a client's behavior for them to be placed back into a prison type facility, the facility that we're working in loses money for the client that are there.
00:24:28.277 --> 00:24:35.323
So I hate to say it, but if we're just being honest here, that was always a factor.
00:24:35.462 --> 00:24:36.242
It shouldn't have been.
00:24:36.282 --> 00:24:39.306
We did our best to focus just on the behavior.
00:24:39.425 --> 00:24:52.798
But if you're working in an organization and the folks that are in charge of the organization make it clear that if we lose too many clients, that impacts the revenue here and then that impacts jobs.
00:24:52.919 --> 00:24:57.383
So unfortunately, those decisions weren't made in a vacuum.
00:24:57.784 --> 00:25:04.128
We tried our best, like I said, when we get to those IDT meetings to make decisions based on what's best for the consumer.
00:25:05.026 --> 00:25:07.974
but we had to work within reality.
00:25:08.596 --> 00:25:16.702
And if we made, that happened to me a lot when I was a young behavior analyst, I was just like, you know, this is what's in the best interest of the client.
00:25:16.803 --> 00:25:19.726
And then I'd get pushed back from some of the organizations that I worked at.
00:25:19.766 --> 00:25:25.851
And they said, well, you know, and you know, they would make excuses and say, well, if they just go somewhere else, they're going to have the same problem.
00:25:25.891 --> 00:25:27.152
So it's just best to keep them here.
00:25:28.532 --> 00:25:30.375
So you deal with a little bit of that.
00:25:30.414 --> 00:25:36.400
And just like ABA companies now, there was good facilities and there was not so great facilities and you just do your best.
00:25:36.400 --> 00:25:36.974
Yes.
00:25:38.018 --> 00:25:41.942
do your best within those organizations.
00:25:41.982 --> 00:25:43.464
What a fascinating experience.
00:25:43.525 --> 00:25:50.354
And again, I think for our listeners, cool to hear the presence of behavior analysis within that circumstance.
00:25:50.414 --> 00:25:58.325
I don't know how that plays out here in California, but I'm certainly going to look into it because that seems like an important forum where we would be able to make a change.
00:25:58.404 --> 00:26:15.210
And despite some of the systemic challenges that you faced in Florida, which I'm sure are prevalent in any given state with that particular population, Just another angle for us as behavior analysts to consider where our work could be of good contribution and where it's clearly still needed.
00:26:15.569 --> 00:26:18.772
I mean, that sounds like a very challenging experience you went through.
00:26:19.013 --> 00:26:19.794
Thanks for sharing that.
00:26:20.454 --> 00:26:22.037
Okay.
00:26:22.076 --> 00:26:28.282
You were talking, you kind of made a segue there to ABA companies, and you mentioned earlier that you started your own ABA company.
00:26:28.383 --> 00:26:30.224
So can you tell us a little bit about that?
00:26:30.265 --> 00:26:34.390
Maybe what made you want to start your ABA company and how that came about?
00:26:35.521 --> 00:26:36.303
Yeah, absolutely.
00:26:36.563 --> 00:26:40.647
I actually had no interest in starting an ABA company.
00:26:40.769 --> 00:26:43.291
I was an independent contractor.
00:26:43.511 --> 00:26:50.140
It's interesting because I know that most states don't have a culture of independent contractors like Florida does.
00:26:51.040 --> 00:26:56.769
In Florida, we had a big independent contractor culture for a long time, and I was one.
00:26:58.306 --> 00:27:03.474
contracted out to, I remember before I started my company, I was contracted out to four different agencies.
00:27:03.955 --> 00:27:06.339
So I was doing work for four different agencies.
00:27:06.359 --> 00:27:08.163
I was working six days a week.
00:27:08.282 --> 00:27:11.848
I was driving around to different group homes and agencies.
00:27:11.888 --> 00:27:42.717
And I occasionally took or did some work with um card so um there's two different cards though and i always have to explain this there's the private enterprise card and then there's the not private enterprise card i work with the not private enterprise card and they're fantastic they're still in existence and thriving here in florida they really act as I would say support coordinators or service facilitators.
00:27:43.298 --> 00:27:45.558
And I have a good relationship with them.
00:27:45.680 --> 00:28:02.554
And the director at the time, I developed a reputation over the years for dealing with severe cases of like aggression, self-injury, property destruction, just kind of became my professional specialty for a few years.
00:28:03.275 --> 00:28:08.859
So I remember the director of CARD sent me one client and he said, hey, listen, you know, this is...
00:28:09.200 --> 00:28:10.383
It was a younger kid.
00:28:10.423 --> 00:28:13.048
At the time, I believe he was like eight or nine.
00:28:13.169 --> 00:28:15.513
And he said, hey, do you think you could take on this client?
00:28:15.554 --> 00:28:16.415
I said, sure.
00:28:16.455 --> 00:28:27.162
And it was right when TRICARE, interestingly enough, started the I don't know if it was the echo program or the autism demonstration.
00:28:27.201 --> 00:28:28.923
It was one or the other.
00:28:29.183 --> 00:28:29.805
It was one or the other.
00:28:29.825 --> 00:28:30.846
It was like 2009, 2010.
00:28:31.326 --> 00:28:32.988
Sounds about right.
00:28:33.468 --> 00:28:33.868
Okay.
00:28:33.888 --> 00:28:34.068
Yeah.
00:28:34.229 --> 00:28:37.551
And I took the client on and I said, okay, you know, no problem.
00:28:38.212 --> 00:28:41.675
And I started working with the client and then this person contacted me again.
00:28:41.715 --> 00:28:43.198
He said, I might have another client for you.
00:28:44.057 --> 00:28:48.782
And I already had a full slate of clients across the different places that I was working.
00:28:48.803 --> 00:28:50.444
And I'm like, okay, I'll take it.
00:28:50.684 --> 00:28:51.625
But then it was maxed out.
00:28:52.162 --> 00:28:55.807
And then he came to me again and he said, you know, Adam, I've got some more clients for you.
00:28:55.848 --> 00:28:57.592
I'm like, listen, I can't take out any more clients.
00:28:57.932 --> 00:29:00.416
And then he looked at me, he's like, just hire somebody.
00:29:01.357 --> 00:29:06.207
And it was just this kind of direct moment and like crystallizing moment.
00:29:06.247 --> 00:29:07.910
I'm like, I can hire people?
00:29:10.273 --> 00:29:10.994
How does that work?
00:29:11.476 --> 00:29:13.840
So I was like, okay, so I can hire somebody.
00:29:13.941 --> 00:29:16.585
So I had just started teaching at FIU.
00:29:17.057 --> 00:29:21.007
And there was a student that got through my first couple of courses really well.
00:29:21.067 --> 00:29:25.417
So I just went to her and I was like, hey, are you interested in doing this sort of work?
00:29:25.759 --> 00:29:27.102
And she said yes.
00:29:27.403 --> 00:29:33.155
And we didn't have the formalized RBT training back then that we do now.
00:29:34.145 --> 00:29:36.609
you just kind of made up your own training and you did your best.
00:29:37.432 --> 00:29:41.019
So I created a training, trained her for months.
00:29:41.398 --> 00:29:44.203
She started working with some of the clients.
00:29:44.605 --> 00:29:46.127
Things started going really well.
00:29:46.828 --> 00:30:18.480
By the way, that first client that I'm mentioning, um i heard a few years ago graduated college wow and when i first started working with that client yeah it was it's just so rewarding because when i first started working with that client um he was maybe eight or nine years old um he was um it was a military family obviously through tricare he had zero communication skills at eight years old um engaging in severe tantrums severe um property destruction And then he graduated college.
00:30:18.701 --> 00:30:20.003
And it was just such a great moment.
00:30:21.686 --> 00:30:23.650
So yeah, so I brought on this one person.
00:30:23.690 --> 00:30:24.872
She started working with me.
00:30:24.892 --> 00:30:28.719
And then I got another phone call from somebody else at Card.
00:30:29.039 --> 00:30:32.605
And I'm like, listen, the person that I hired is already maxed out.
00:30:33.027 --> 00:30:34.891
And they're like, well, we have more clients.
00:30:34.971 --> 00:30:36.834
And I said, I don't have any more hands.
00:30:37.075 --> 00:30:38.176
There's only so many of us.
00:30:38.196 --> 00:30:40.259
There's only so many hours in the day.
00:30:40.299 --> 00:30:45.261
And then the same person got on the phone with me again and said, Adam, just hire more people.
00:30:46.442 --> 00:30:53.611
And then I got the message after the second instruction, and I just started hiring more people.
00:30:53.912 --> 00:31:04.702
And in 2011, I went from two clients through insurance, two, three, something like that, to about 60.
00:31:05.703 --> 00:31:05.763
Wow.
00:31:05.964 --> 00:31:10.549
Because, yeah, yeah, the insurance mandate just came rushing in.
00:31:11.074 --> 00:31:13.897
and all of these kids that needed services.
00:31:13.938 --> 00:31:23.892
And I was really fortunate because when I taught at FIU, there were so many students in my courses that were interested in doing this sort of work.
00:31:24.311 --> 00:31:31.721
So it kind of became a feeder system for us and we set up training programs and we just grew really quick.
00:31:33.084 --> 00:31:34.787
Did you find it hard to meet the demand?
00:31:34.926 --> 00:31:36.608
Because that's a really quick growth.
00:31:38.111 --> 00:31:38.791
Oh yeah, 100%.
00:31:39.053 --> 00:31:39.753
I think...
00:31:40.417 --> 00:31:47.971
If I knew then what I knew now about growing an ABA agency, we would have grown to 200 clients in that first year.
00:31:47.990 --> 00:31:50.013
There was just so much I didn't know.
00:31:50.095 --> 00:31:56.766
I had no understanding about how employment law works or how to start and run a company.
00:31:57.346 --> 00:31:59.190
And you have to do payroll.
00:31:59.349 --> 00:32:05.752
And the biggest thing that I didn't understand, I'll say this really quick, is I didn't understand how medical billing worked.
00:32:07.635 --> 00:32:09.878
Neither did the insurance companies with ADA.
00:32:11.741 --> 00:32:15.928
When we got started, I didn't get paid for the first six months.
00:32:15.949 --> 00:32:16.650
Yikes.
00:32:16.670 --> 00:32:19.032
Not because we didn't know how to do it.
00:32:19.073 --> 00:32:21.297
We were actually doing things correctly.
00:32:23.233 --> 00:32:35.191
I had to send someone that I hired to do billing to sit with people at the insurance company for about two months to explain to them how we should fill out the CMS 1500 form.
00:32:35.211 --> 00:32:35.250
Oh,
00:32:36.071 --> 00:32:36.392
man.
00:32:36.932 --> 00:32:42.240
Yeah, we just started our own ABA company, so I feel you on the billing side of things for sure.
00:32:43.481 --> 00:32:43.942
Oh, my gosh.
00:32:43.962 --> 00:32:57.211
And I'll never forget, I had to have a really comfortable meeting with my staff at the time, and I said, I'm sorry, but you're all going to have to be independent contractors and I'm going to have to pay you 30 days in arrears.
00:32:57.671 --> 00:33:02.916
So they would work, let's say from January 1st to January 31st and get paid March 1st.
00:33:03.958 --> 00:33:08.403
And having that discussion with folks, I'll never forget that day.
00:33:08.442 --> 00:33:09.944
That was a hard talk.
00:33:10.945 --> 00:33:20.837
You know, telling people that they're not going to get paid for a month or two because as I'm sure you guys are going through right now, the insurance companies don't, when people work, they don't
00:33:21.199 --> 00:33:21.980
pay the next day.
00:33:22.279 --> 00:33:22.500
Yep.
00:33:22.980 --> 00:33:24.963
Did you lose a lot of people during that conversation?
00:33:25.965 --> 00:33:26.605
No, you know what?
00:33:26.686 --> 00:33:27.708
I didn't lose anybody.
00:33:27.807 --> 00:33:29.430
And I remember having that talk.
00:33:29.691 --> 00:33:39.027
It was with about 25 of my staff and I'll never forget, we were having this discussion in my very first office.
00:33:39.147 --> 00:33:42.797
I just brought them all in there and I just laid it out straight.
00:33:43.057 --> 00:33:50.634
And I said, listen, you know, if some of you want to leave, I'll understand, but you know, this is our mission here and we're trying to help out these kids.
00:33:51.016 --> 00:33:52.921
I promise I'm doing everything that I can.
00:33:53.698 --> 00:34:21.990
was one of those believe in us believe in me i promise i won't let you down um and it just it took years for everybody on both sides the insurance side and the provider side to figure out how to build aba nobody really understood it you know the the the laws just came down and they said well you have to cover this service and the insurance companies were like okay how do you do that So we there was a lot of providers working with insurance companies.
00:34:22.170 --> 00:34:35.045
It was a completely different time than it is now We met with them regularly and said folks, you know, this is how you need to build these services This is why you need to do this and you need to pay us Yeah,
00:34:36.748 --> 00:34:50.213
it's the wild wild west now I can't imagine what it was like in its infancy I remember and I probably talked about this in the podcast, but the company we worked for originally, that was the one I worked for at that time, there were like no regulations or anything.
00:34:50.253 --> 00:34:52.498
So originally it had to be a licensed staff.
00:34:52.577 --> 00:35:15.666
So it either had to be like a nurse practitioner or an OT supervised because there was in California, there was, certification but no licensing we still don't have licensure yeah insurance said you had to be licensed so we were being supervised in our aba programs by occupational therapists because that's what insurance said that we had to do yeah those were the days those were the days i mean
00:35:15.746 --> 00:35:29.179
it's changed a little bit i think it's gotten a little bit easier from what you're describing um and and one of the things that's very interesting you sound very clinically oriented i think You know, I identify with that right away, meaning you put me to do administrative tasks.
00:35:29.239 --> 00:35:29.920
You're going to lose me.
00:35:30.081 --> 00:35:32.063
You're going to lose my content expertise.
00:35:32.405 --> 00:35:33.405
It's not my cup of tea.
00:35:33.445 --> 00:35:35.208
I need to be out in the field.
00:35:35.369 --> 00:35:36.791
I need to be with clients.
00:35:37.492 --> 00:35:40.719
And it sounds like at the beginning you had to face that transition.
00:35:40.798 --> 00:35:41.940
Tell us a little bit about that.
00:35:42.041 --> 00:35:44.304
You know, it sounds like you're very passionate about the direct work.
00:35:44.865 --> 00:35:46.409
All of a sudden, you're having to hire people.
00:35:46.449 --> 00:35:47.751
You're having to learn employment law.
00:35:48.231 --> 00:35:51.518
You're having to deal with billing and deal with insurance companies.
00:35:52.059 --> 00:35:55.146
Clearly, that takes you away from the hands-on work.
00:35:55.445 --> 00:35:56.307
How did you deal with that?
00:35:56.427 --> 00:35:58.652
What was that experience like for you?
00:35:59.954 --> 00:36:00.896
Yeah, that's a great question.
00:36:00.956 --> 00:36:01.677
Thank you for asking.
00:36:01.938 --> 00:36:04.844
I would say I did like the clinical work.
00:36:05.164 --> 00:36:06.407
I like behavior analysis.
00:36:06.467 --> 00:36:07.568
I think a lot of people...
00:36:08.161 --> 00:36:10.704
get into the field because they want to work with kids.
00:36:11.485 --> 00:36:16.911
I like working with people, but my first love, my first passion was the science.
00:36:17.090 --> 00:36:19.793
I connected with the science.
00:36:20.074 --> 00:36:20.394
I relate to that.
00:36:20.855 --> 00:36:21.295
Oh, can you?
00:36:21.456 --> 00:36:21.735
Yeah.
00:36:21.856 --> 00:36:25.440
And I feel like that doesn't happen as often.
00:36:25.480 --> 00:36:28.983
And that's sad to me.
00:36:29.523 --> 00:36:30.646
I love the science.
00:36:30.706 --> 00:36:34.389
I like learning more about the science, expanding the boundaries of the science.
00:36:34.882 --> 00:36:36.465
Um, so that was kind of my first love.
00:36:36.905 --> 00:36:39.028
Um, I, I did do a lot of the clinical work.
00:36:39.510 --> 00:36:41.813
I enjoy the business aspect of things.
00:36:42.094 --> 00:36:43.518
I really enjoy businesses.
00:36:44.318 --> 00:36:55.077
Um, I've opened since then I've opened a ton of businesses in different aspects of, um, in different, uh, business industries, a lot in, uh, behavior analysis.
00:36:55.137 --> 00:36:56.681
So I like the business part.
00:36:57.402 --> 00:37:08.673
I absolutely hate ABA admin, scheduling, medical billing, reauthorization reports, HR stuff related to that.
00:37:08.994 --> 00:37:09.996
I hate that stuff.
00:37:10.336 --> 00:37:12.702
I went to school for behavior analysis and psychology.
00:37:12.722 --> 00:37:19.293
I did not go to school to learn how billing codes work and audits and the rest of that.
00:37:20.193 --> 00:37:26.264
The business side of things, leadership, management, coaching, that sort of thing, making deals.
00:37:26.465 --> 00:37:27.606
I love making deals.
00:37:27.686 --> 00:37:31.512
I love connecting people, setting up business partnerships.
00:37:31.673 --> 00:37:32.815
I really enjoy that.
00:37:32.856 --> 00:37:49.873
That's really reinforcing for me, but I need to survive and flourish in a business endeavor, I need folks that I can work with, that I can lean on, that can take care of that day-to-day scheduling or billing or keeping the books organized.
00:37:50.273 --> 00:37:53.936
Those are not my strengths, and I lean on people to do those things.
00:37:54.898 --> 00:37:58.420
That's good advice for us, for sure.
00:37:58.440 --> 00:38:05.487
I'm very grateful for this guy who does a lot of the admin stuff for us and will sit on the phone with insurance companies.
00:38:05.586 --> 00:38:13.295
And like I say, I'd rather be kicked, scratched, and spit on than sit on the phone for two hours waiting to discuss some denied claims.
00:38:14.155 --> 00:38:15.677
Anyway, we'll see if that changes.
00:38:15.717 --> 00:38:17.079
I think as I learn more, I agree with you.
00:38:17.119 --> 00:39:14.721
As I learn more in terms of the leadership aspects and I guess how to explain to younger professionals the nature of the business so that they can value their clinical work but also understand its monetary value, it's something that we're really trying to delve into so that we're out to save the RBT I don't know that anybody Yeah, logistically, yeah.
00:39:36.623 --> 00:39:39.726
there's a lot that we can employ from our constant expertise.
00:39:40.527 --> 00:39:41.688
For example, working with kids.
00:39:41.708 --> 00:39:44.972
There's a lot to negotiate in working with kids that can transfer over.
00:39:45.693 --> 00:39:49.277
Do you have any thoughts on that, actually, as a multiple business owner yourself?
00:39:49.358 --> 00:40:09.585
Any thoughts on that, trying to incentivize RBTs to looking at the reimbursement rate that we get from insurances that are going to be compensated somewhere around that in California, that fast food rate, but then they're going to have a much more fluid schedule and presumably a much more challenging job description.
00:40:09.646 --> 00:40:10.695
Any thoughts on that?
00:40:12.161 --> 00:40:15.987
I have a lot of thoughts on that, but I'll try to focus my thoughts.
00:40:16.007 --> 00:40:16.748
Take your time, sir.
00:40:17.688 --> 00:40:18.690
Take your time.
00:40:18.851 --> 00:40:21.974
So it's interesting, Dan, you mentioned FIT over here.
00:40:22.215 --> 00:40:30.326
And with my aviation therapy company years ago, we set up the first hybrid program with FIT.
00:40:30.847 --> 00:40:40.739
And what that meant was we got a fantastic FIT professor to work on our campus at our clinic.
00:40:42.369 --> 00:41:14.606
we set up the fit masters program there so our rbts at the time they were behavior technicians actually did their master's degree at our clinic with the professor there so the reason i'm bringing this up is because the way that we worked around this was i had two feeder systems i taught at fiu i recruited students there and then once they were in doing that kind of rbt back then role Then we convinced them to do the FIT program to get their master's degree.
00:41:14.925 --> 00:41:23.980
And the idea was, I live my professional life with a simple credo, keep moving forward, keep moving forward.
00:41:24.000 --> 00:41:26.384
And I would stress that to my staff all the time.
00:41:26.403 --> 00:41:33.974
And if they were moving forward with their career, then we found that there was a lot less burnout.
00:41:33.994 --> 00:41:38.278
There was a lot less turnover if they were focused on that.
00:41:38.579 --> 00:41:42.965
And those two setups with those two universities made such a difference.
00:41:43.085 --> 00:41:53.458
And I remember with the first cohort of the master's program through FIT, I covered the cost of it for them.
00:41:53.954 --> 00:41:57.681
just to get people excited about it because I knew that it would work well.
00:41:57.702 --> 00:42:06.780
And so many of the people that graduated through especially those first cohorts are fantastic behavior analysts now and run their own companies.
00:42:06.900 --> 00:42:42.376
So I really look back on that as something that I feel positive that I contributed to the field is encouraging people to get excited about our field not just working with kids but also about the science and fit does such a great job of sticking to the science not kind of venturing off and they along with our work experience i think we created a lot of great behavior analysts and that would be my advice to folks out there you can do Everybody tries to get clever.
00:42:42.536 --> 00:42:44.257
Oh, let's do performance scorecards.
00:42:44.297 --> 00:42:45.639
Let's pay them more money.
00:42:45.659 --> 00:42:47.501
Let's give them more time off.
00:42:48.041 --> 00:42:52.387
The way that I like solving that turnover problem is give them purpose.
00:42:53.007 --> 00:42:54.128
Give them direction.
00:42:54.650 --> 00:42:55.530
Say, you know what?
00:42:56.012 --> 00:42:57.132
Here is this goal.
00:42:57.793 --> 00:42:59.094
It's out in the distance.
00:42:59.356 --> 00:43:04.021
It's three years out, but you can become a BCBA one day.
00:43:04.041 --> 00:43:05.181
You can do this.
00:43:05.222 --> 00:43:06.003
You can do that.
00:43:06.344 --> 00:43:10.951
And then here's a whole bunch of short-term objectives along the way.
00:43:11.351 --> 00:43:12.994
Let's hit one at a time.
00:43:13.474 --> 00:43:18.965
You know, and something I used to always say to my staff is, I'm not sure, do you guys know how to eat an elephant?
00:43:20.929 --> 00:43:22.050
One bite at a time.
00:43:23.112 --> 00:43:24.576
There you go.
00:43:24.596 --> 00:43:24.815
One bite at
00:43:24.835 --> 00:43:24.956
a time.
00:43:24.976 --> 00:43:27.521
I find that eating an elephant is one bite at a time.
00:43:27.541 --> 00:43:32.170
And I said, the elephant is getting your BCBA and being a supervisor.
00:43:32.481 --> 00:43:34.123
Because back then, everybody wanted to move.
00:43:34.704 --> 00:43:45.141
You get worn out from doing direct one-to-one care because you can only get spit on and kicked and punched and scratched and the rest of that so many times.
00:43:45.702 --> 00:43:50.829
So I would give them this goal and say, listen, get through three months and then six months and then a year.
00:43:50.869 --> 00:43:54.153
And you just keep stacking accomplishments, one on top of the other.
00:43:54.554 --> 00:43:55.775
And then you hit supervision.
00:43:56.376 --> 00:44:54.190
And what I tried to do at my organization was create keep creating those benchmarks so even if they hit became dcbas something that we set up back then that didn't always work out well but we set up special projects and say hey what are you interested in in behavior analysis um besides therapy and some people would be interested in technology or research or something like that so we tried to create avenues for people so that they can keep moving forward and if they're moving forward if you're busy you're not thinking about some of the hardships in your life because you're busy i remember that was something that i learned from my grandmother when i was a kid um you know that people i think are most content with their life when they're purposeful when they're working towards something so i tried to take that credo and pass it on to the people that I worked with.
00:44:54.451 --> 00:44:55.311
Not sure if that makes sense.
00:44:55.331 --> 00:44:56.492
No, it absolutely does.
00:44:56.532 --> 00:44:57.253
And that's amazing.
00:44:57.293 --> 00:45:01.838
I've been a trainer at my various companies for probably the last 15 years.
00:45:01.878 --> 00:45:06.322
And I've put, I don't know how many people through the ASU program for ABA.
00:45:07.543 --> 00:45:12.809
And I've definitely noticed that the turnover rate is much less for people that are moving forward in their career.
00:45:12.849 --> 00:45:25.516
So kind of to what you're saying then and to what Mike said earlier, if you are trying to set your staff goals as you bring on more staff, then you're becoming kind of more of a staff manager than the direct client.
00:45:26.416 --> 00:45:28.719
Working with direct clients, is that kind of what it became?
00:45:28.739 --> 00:45:35.547
You were using your ABA more for your staff than the clients and then outsourcing the client work directly to the staff that you were training?
00:45:36.748 --> 00:45:38.271
Yeah, you nailed it, absolutely.
00:45:38.351 --> 00:45:47.974
So when you start a business, I mean, you guys know you're going through it now, but when you start a business, especially if you do it by yourself, That was, by the way, one of the mistakes that I made in the beginning was I started by myself.
00:45:48.695 --> 00:45:51.938
But when you start by yourself, you wear all the hats.
00:45:52.237 --> 00:45:57.123
And then as you hire people, the idea is you take hats off and you give the hats to somebody else.
00:45:58.605 --> 00:46:03.168
And as the company grew, I wore less and less hats.
00:46:03.289 --> 00:46:14.862
And then you start wearing different hats and you start having to learn how to, I got so used to in the beginning, leading and motivating people directly.
00:46:14.882 --> 00:46:20.871
Like I told you when I had to have that tough conversation with my staff in the very beginning, hey, you're not going to get paid for 45 days.
00:46:21.552 --> 00:46:22.954
I had it directly.
00:46:23.313 --> 00:46:29.463
And even after the meeting, I talked to key people in that group individually.
00:46:29.583 --> 00:46:34.992
And I talked to them about the importance of what we're trying to do.
00:46:35.032 --> 00:46:36.994
And I had a direct impact.
00:46:37.476 --> 00:46:45.213
But as your company grows and you get people underneath you, There's a great book, if you guys are ever interested.
00:46:45.273 --> 00:46:50.240
It's called The Leadership Pipeline, one of the most fantastic books I've ever read about leadership.
00:46:50.922 --> 00:46:59.976
And as you grow as a professional and as you climb, let's say, the corporate ladder, you have to pick up new skill sets.
00:47:00.496 --> 00:47:35.402
Because if you keep doing the other skill set, you what they call in the book you clog up the leadership pipeline you have to teach other people how to do what you were doing and then back off and lead them and as your organization grows you lead fewer and fewer people but the leadership you engage in has bigger and bigger impact and it took me nobody really ever masters that i mean the Greatest CEOs in the world are still learning every day how to do that better.
00:47:35.922 --> 00:48:07.068
But that was one of the big aha moments that I had is as that pyramid, let's say, grows and you take off hats, the things that you do every day, the interactions that you have with your direct reports, who for me in the end were clinical directors, executive team members, those sorts of people, every word that you say matters because it gets amplified throughout the course of the company.
00:48:07.148 --> 00:48:10.737
And that, that was something I think all CEOs struggle with.
00:48:11.079 --> 00:48:12.041
And I certainly did.
00:48:12.385 --> 00:48:18.893
That's so hard to like, even just with like admin, you know, a lot of times people just don't do it the way you want it to be done.
00:48:18.932 --> 00:48:22.536
And, you know, that gets magnified as you get higher and higher.
00:48:22.617 --> 00:48:31.106
And when you're talking about a company vision, like to make sure that your vision is still manifested as you're adding layers to that direct line employee.
00:48:31.806 --> 00:48:37.954
And the vision is something you spend years and years and we spent countless hours creating with the company and you did as well.
00:48:38.306 --> 00:48:41.594
Um, that's a lot of faith and a lot of trust.
00:48:41.653 --> 00:48:44.599
And I'm sure that's, I mean, that's even challenging now just in one layer.
00:48:45.101 --> 00:48:51.876
Sometimes it's like, you know, I'll do the Excel spreadsheet because I just, I don't, I, it'll be quicker and it'll get done the way you, I want it to be done.
00:48:52.449 --> 00:48:53.871
And learning to allow that too.
00:48:54.672 --> 00:49:02.117
For my end, for example, you take on that and I don't care what it looks like as long as it makes sense and it gives us the information we need.
00:49:02.137 --> 00:49:07.443
I really appreciate you talked, you've used this phrasing about sort of preserving the science.
00:49:07.503 --> 00:49:16.271
I don't know if that's the exact verb you used, but the partnership that you had set up with academia to then be able to train your staff or to do things concurrently, that's ideal.
00:49:16.851 --> 00:49:18.773
I know that's something that we're looking for.
00:49:18.813 --> 00:49:38.838
One thing I like to say is you can provide training say to a prospect of rbt to pass that rbt competency exam and by passing that exam you can then throw them into a session and and you may not have taught them how to do that in other words they don't know how to apply those things that allowed them to pass that exam
00:49:38.958 --> 00:49:42.202
they know the differential reinforcement definition but not what it looks like
00:49:42.242 --> 00:50:00.067
right or what are the the different things that can be done and i know that you know long uh long storied career that i've had in this seen a lot of changes remember creating treatment plans and program books that looked like unabridged dictionaries back in the day when we were using paper.
00:50:00.166 --> 00:50:07.458
And we somehow had this vision that you were going to plan out the entire session from beginning to end, and this is the way it was going to look.
00:50:07.498 --> 00:50:12.425
And then you would get younger professionals out there, and the first five minutes, that plan would go out the window.
00:50:12.927 --> 00:50:17.112
And now they had their RBT competency, but they don't know what to do next.
00:50:17.614 --> 00:50:18.996
What's been your experience in...
00:50:20.418 --> 00:50:24.985
kind of reconciling those two sides of putting out a super well-trained professional.
00:50:25.005 --> 00:50:33.259
And again, starting with the idea that you want to preserve the science, you want them to know what these terms mean on paper from an academic perspective.
00:50:33.298 --> 00:50:44.097
You want them to be able to translate those into action that now looks good in somebody's living room with their four-year-old who's been having a tantrum for the past 45 minutes.
00:50:44.518 --> 00:50:45.940
That's a big translation.
00:50:46.079 --> 00:50:46.900
What's been your...
00:50:47.425 --> 00:50:53.313
know your go-to what's been your success uh in that realm and making that translation for younger pros
00:50:55.117 --> 00:51:17.442
yeah that's that's always a big challenge um you know it's interesting you talked about um creating a behavior plan and i'll use a couple of old sayings here um so i'll use two um because i think they're both relevant so i don't think a uh business plan or behavior plan survive first contact with a consumer
00:51:17.643 --> 00:51:17.922
nice
00:51:18.304 --> 00:51:37.219
so and the other saying that i'll say here i'll quote mike tyson because i think mike once once said that everybody's got a plan until they get punched in the face there you go i'm sure you heard it oh i love it love it And I think both of them apply here, because literally sometimes you will get punched in the face.
00:51:37.621 --> 00:51:45.188
And it's certainly a challenge, I think, I mean, there's so many specific things you can do.
00:51:45.208 --> 00:51:47.893
I think shadowing is absolutely mandatory.
00:51:48.153 --> 00:51:52.039
And every ABA therapy company faces the same challenge.
00:51:52.380 --> 00:51:55.545
You know, it's getting people in to do this work.
00:51:56.286 --> 00:51:58.889
And a lot of people cut corners.
00:51:59.030 --> 00:52:00.192
And I'm going to be honest with you guys.
00:52:00.512 --> 00:52:04.237
There were some times when I had my ABA therapy company before that I cut corners.
00:52:04.697 --> 00:52:06.701
And then I paid for it later.
00:52:06.740 --> 00:52:14.083
And one of the lessons that I learned is you never ever get away with anything, ever.
00:52:14.884 --> 00:52:22.231
And people may think you do if you're running a company or just in life in general, no one ever gets away with anything.
00:52:22.652 --> 00:52:37.849
Because if you do something that you're not supposed to, even if you don't get caught in that moment, you're still impacting your own behavioral repertoire and you think you can do that again, you do it again and then something really bad happens.
00:52:38.561 --> 00:52:45.590
Unfortunately, the contingencies are not ideal in our industry right now, and they haven't been for a long time.
00:52:45.610 --> 00:52:51.998
And if you don't have proper training, and we can have a whole discussion about what proper training means.
00:52:52.438 --> 00:52:55.902
Are you using behavior analysis to teach behavior analysis?
00:52:56.324 --> 00:52:57.023
Are you using PSI?
00:52:57.625 --> 00:52:59.327
Are you using precision instruction?
00:52:59.347 --> 00:53:01.068
Are you training to fluency?
00:53:01.730 --> 00:53:03.172
Are you even training to competency?
00:53:03.231 --> 00:53:04.052
Forget fluency.
00:53:04.233 --> 00:53:07.838
Are you even training to competency, or are you just training to the exam?
00:53:08.353 --> 00:53:11.219
And not everyone is doing that.
00:53:11.481 --> 00:53:24.648
And we're all vulnerable, I would say, to some of the contingencies that are out there, some of the financial contingencies, some of the status contingencies.
00:53:24.989 --> 00:53:26.893
We don't talk about status enough.
00:53:27.715 --> 00:53:56.409
And that, you know, a behavioral perspective money is a generalized condition reinforcer but status and social praise falls under that generalized social reinforcer um category as well and you know i think that's something that we don't talk about enough as well and i think we're all vulnerable to those different contingencies and end up doing things that we shouldn't and i think it's a I think it's a day-to-day grind.
00:53:56.768 --> 00:54:00.476
I think we have to do a good job to make sure that we...
00:54:01.878 --> 00:54:05.744
And we were talking about the ripple effect earlier of the CEO throughout the company.
00:54:05.784 --> 00:54:19.248
As a CEO, I think probably the most important skillset, probably in life as well, but for a CEO is self-control, self-discipline.
00:54:19.809 --> 00:54:28.260
If you make impulsive choices as a CEO, and I've made so many of them myself, that has a ripple effect in your company.
00:54:28.701 --> 00:54:31.043
And if you choose in that moment, you know what?
00:54:31.543 --> 00:54:41.056
Somebody comes to you and says, well, this new RBT hasn't had a proper training or hasn't had enough time to shadow.
00:54:41.496 --> 00:54:45.641
And then you make that one decision in that one moment and say, it'll be okay.
00:54:46.161 --> 00:54:46.822
I've met with them.
00:54:46.862 --> 00:54:47.623
I've seen them.
00:54:47.664 --> 00:54:49.286
They'll be fine.
00:54:50.753 --> 00:54:59.911
I don't know, I didn't do a lot, but those times when I made those really bad decisions, it always ended in problems.
00:55:00.693 --> 00:55:09.782
And so I would say, do your best to have a good training program that's built on a foundation of behavior analysis.
00:55:10.304 --> 00:55:13.648
Train at the very least to competency, at least.
00:55:13.809 --> 00:55:19.836
And if you have the opportunity, train to fluency and then use behavioral skills training for the love of God.
00:55:20.336 --> 00:55:30.490
Make sure that people are getting regular feedback and make sure that your company is set up so that you set up a culture of feedback.
00:55:30.530 --> 00:55:31.291
So many people...
00:55:32.833 --> 00:55:36.438
Talk about, oh, well, I had a meeting, and I gave them feedback.
00:55:36.577 --> 00:55:36.858
No.
00:55:37.177 --> 00:55:48.530
Create a culture of feedback where people are regularly giving people feedback in the moment or right after performance occurs, those sorts of things.
00:55:48.610 --> 00:56:03.581
So I would say, from a CEO perspective, make those self-control, self-discipline decisions as many of the moments of your workday as you can.
00:56:03.621 --> 00:56:06.726
And you'll see that over time it builds.
00:56:08.068 --> 00:56:12.434
You know who does a great job describing this is James Clear and his book, Atomic Habits.
00:56:12.894 --> 00:56:20.646
And he talks about every self-control decision you make is an investment in your individual future.
00:56:20.706 --> 00:56:23.590
And I think that that happens at your organization as well.
00:56:24.070 --> 00:56:38.849
If you decide to live a professionally self-disciplined life, After six months, nine months, 12 months, you're going to see that ripple across your business and you'll provide better care for the clients that you're with.
00:56:39.269 --> 00:56:46.418
You're going to raise better behavior analysts and make no mistake, if you're a CEO, you are raising professionals.
00:56:46.798 --> 00:56:57.951
They're listening and they're watching every single thing that you do and I think As CEOs, you need to realize that and make decisions accordingly.
00:56:57.971 --> 00:56:59.492
I love what you just explained there.
00:56:59.532 --> 00:57:07.545
In the short term, people might take it as a loss to invest that extra time to cultivating that younger professional.
00:57:07.606 --> 00:57:10.411
They see it as a monetary loss.
00:57:10.710 --> 00:57:12.934
You're saying, no, that's your investment.
00:57:13.315 --> 00:57:14.217
That's going to pay off.
00:57:14.257 --> 00:57:17.282
And in fact, if you don't do it, you might end up with a real loss.
00:57:17.666 --> 00:57:20.610
Yes.
00:57:41.985 --> 00:57:48.657
And I talked to the higher management and like, look, we're having turnover, like probably 50% of the staff is leaving within six months.
00:57:48.717 --> 00:57:51.722
This has got to be costing you a ton of money because you're investing time.
00:57:51.762 --> 00:57:54.806
And they're like, yeah, the RBT is just a revolving door.
00:57:54.887 --> 00:57:57.331
Like it's not a long term position anyway.
00:57:57.371 --> 00:57:58.472
And I was like, is this really what?
00:57:59.293 --> 00:58:01.436
And this is kind of what we're talking about with saving the RBT.
00:58:01.496 --> 00:58:01.737
Is this?
00:58:02.018 --> 00:58:03.478
Is this really how we're going to look at it?
00:58:03.539 --> 00:58:09.344
Because at the end of the day, yeah, the RBT suffers, but the client suffers as well because they're not getting competent, consistent care.
00:58:09.384 --> 00:58:10.985
So then we left.
00:58:11.065 --> 00:58:17.291
But I think that, again, really talks to what you're talking about, about having competent staff that is hopefully fluent, but at least competent.
00:58:17.490 --> 00:58:29.402
And I feel like a lot of times because of maybe the level of whether it's reimbursement or credentials that a lot of companies now are not looking at the RBT as needing that level of competency.
00:58:29.422 --> 00:58:36.987
It's just like get them in and get them out and start billing and then we'll higher and just create this cycle, which seems defeating in the long run.
00:58:38.188 --> 00:58:46.976
Oh, and Dan leaves us with a couple of good questions there for Adam, so you'll have to make sure and tune in for part two of our interview with Adam Ventura.
00:58:47.516 --> 00:58:48.318
In the meantime,
00:58:48.338 --> 00:58:50.880
always analyze responsibly.
00:58:52.001 --> 00:58:56.144
ABA on Tap is recorded live and unfiltered.
00:58:56.164 --> 00:58:57.065
We're done for today.
00:58:57.405 --> 00:58:59.807
You don't have to go home, but you can't stay here.
00:59:00.969 --> 00:59:01.949
See you next time.