Tip #108 A Call for Human-Centered Training: Revisiting BCBA Interventions in Residential Care

 Supporting the Adult Population as a Board-Certified Behavior Analyst (BCBA)

Tip #108 A Call for Human-Centered Training: Revisiting BCBA Interventions in Residential Care

This scenario presents a common and critical challenge for Board Certified Behavior Analysts (BCBAs) in residential settings.

As the consulting BCBA, you observe an individual supported by the residential provider consistently displaying vulnerable distress behaviors, these behaviors are identified as high-intensity property destruction and ongoing physical and verbal aggression. Your functional assessment pinpoints the function as escape/avoidance. The specific antecedent is staff's ongoing prompting and advising the individual to adhere to their physician-prescribed meal plan. The moment the individual deviates from the plan and staff prompt compliance, the distress behaviors are immediately evoked.

Residential staff, feeling constrained by their duty to follow doctor's orders, express frustration, believing the individual is simply "acting out" and "knows what they are doing." This is where our primary responsibilities as BCBAs—and our humanistic approach—must intersect.

The Problem with Protocol-Only Training

As BCBAs, our first instinct is often to focus on training staff, typically through Behavior Skills Training (BST), to ensure proficiency in proactive and reactive strategies.

However, a more parsimonious and ultimately more effective approach is to first encourage staff to consider the client's perspective, thoughts, and feelings. Imagine being constantly scrutinized and criticized—by multiple shifts of staff—for a momentary lapse in a restrictive health regimen. Imagine the emotional toll of knowing your favorite meal choice will be met with immediate, structured criticism, potentially followed by staff discussing your "vulnerable episodes" among themselves. This environment erodes dignity and makes the escape-maintained behavior entirely understandable.

"Based on the BACB Task List (5th ed.), under Selecting and Implementing Interventions, we are professionally responsible for collaborating with others who support and provide services to clients (Behavior Analyst Certification Board, 2017). This collaboration must extend beyond mere procedural compliance."

Leading with Empathy: Modifying the Training Focus

Instead of focusing our training solely on reiterating the behavior support plan strategies, we must lead with the mantra: "We are humans supporting other humans; let's provide grace."

While this might seem to "ruffle a few feathers" because it's not strictly the traditional operational approach we are taught as BCBAs. We must understand that generalizing our training to focus on a human-first approach overrides rather than rigid structures and procedures.

Research supports modifying the approach. As noted in the study by Setiawan et al. (2021), training significantly influences an employee's work ethic and performance quality. The study suggests that job training boosts not just skills, but also the high-quality standards and dedication necessary for superior work. This implies that if treatment integrity is low, it may be due to a training approach that has failed to instill a high-quality, person-centered ethic.

If a BCBA identifies constant Interobserver Agreement (IOA) or treatment integrity concerns, they must modify their approach to training. Below are three recommendations to help staff not only understand the concepts but also apply them in the field with a focus on quality and empathy.

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Recommendations for a Human-Centered Training Infrastructure

1. Training Infrastructure: Active, Brief, and Relatable

Instead of conducting passive, lengthy PowerPoint trainings that staff are expected to absorb and immediately apply, restructure your training to be:

• Active and Brief: Limit training to 15–30 minutes and focus on only one specific strategy that needs immediate correction.

• Behavioral Skills Training (BST) with a Twist: Use games, real-life examples, and non-examples.

• Use Pop Culture for Context: Utilize relatable media, such as segments from popular television shows (like the workshop on Dunder Mifflin's Guide to Onboarding & Training facilitated by Melanie Page, M.Ed., BCBA on Verbal Beginnings: Behavior Live), to demonstrate effective and ineffective behavioral responses in a low-stakes, memorable way.

2. Simplified Context: Prioritizing Clarity over Jargon

Many BCBAs mistakenly use training to teach staff ABA terminology. When a crisis is occurring, staff don't need to recall whether they are using a DRA or implementing negative reinforcement; they need to know the simplest, most effective way to support the person.

• Condense Language: Convert the behavior support plan strategies into simple, high-school-level language. A useful tool is using an AI platform like ChatGPT or Gemini to quickly convert complex, technical descriptions into plain language before pasting them into presentations.

• Focus on Action: The focus must be on actionable steps that are easy to remember under pressure, not on memorizing ABA terminology.

3. Emphasize a "Call-In" Culture, Not a "Call-Out" Culture

The staff's job is already demanding; they need support, not constant criticism or reprimands. During training, adopt a supportive and collaborative posture:

• Listen and Collaborate: Listen to staff's input and allow them to vent. Then, collaboratively provide solutions based on the behavior support plan's strategies.

• Supportive Follow-Through: The follow-up solution can be in-the-moment hands-on support, providing simple visual resources, or outlining an immediate action plan to resolve a persistent problem the staff member highlighted. This transforms the BCBA from an auditor into a genuine, supportive consultant.

Here’s a new resource I created titled “Human-Centered Training Checklist for BCBAs Supporting Adults in Residential Settings.”

This checklist is designed to guide BCBAs when creating or conducting staff trainings—both formal (e.g., Behavior Support Plan trainings) and informal (in-the-moment or group coaching). Each component emphasizes a human-centered, ethical, and skill-building approach aligned with BACB standards.

📄 Access the checklist here:
https://drive.google.com/file/d/1iLaIUuXcyQoCPPAgUuIF6yhiHPEMc8Mh/view?usp=sharing

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BCBAs must train support staff to "filter their views to alter their emotions," shifting their perspective from judgment of a client's "acting out" to recognizing the person's vulnerability and humanity. This approach emphasizes that people make mistakes and need support, ultimately fostering a "call-in culture" where staff feel empowered to seek guidance instead of relying on rigid, ineffective protocols.

(Picture Credit: Found on "We Quote for You" Facebook Page) 

If you read this, the seed has been planted... the question is how are you going to apply it...

From the one and only... Shanda J Your BCBA

Author Credit: Modified and enhanced with support from my AI tool, Gemini.

References: 

Behavior Analyst Certification Board. (2017). BCBA/BCaBA task list (5th ed.). Littleton, CO: Author.

Setiawan, Y., Junaedi, A. T., & Chandra, T. (2021). The effect of employee work ethics and training on employee performance and service quality at PT XL Axiata Riau. Journal of Applied Business and Technology, 2(3), 194–205. https://doi.org/10.35145/jabt.v2i3.76