The High Cost Of Stress In The ABA Workplace
As a planet full of workers, we are getting increasingly stressed out. According to a recent article in the Huffington Post levels of stress in the workplace are reportedly 18% – 24% higher now than they were 30 years ago. Why? Potential culprits include unreasonable workloads, and an increasingly blurred line between work and personal life.
Are those behavior analysts working in the ABA clinical world immune to this? After all, Behavior Analyst was recently rated as one of the top 10 jobs for do-gooders, with most individuals reporting their job as being highly meaningful.
Yet, clinical behavior analysts may well be positioned for high levels of stress on the job. This point was recently highlighted when my colleague, Jane, quit her job at her ABA company.
Jane started work a few years back at a company, doing exactly what she wanted to be doing – clinical behavior analysis. She had clients she adored, families who loved her, and coworkers she enjoyed. But she quickly found she needed to put in more time than she was allocated to do the job the right way. She spent many late nights writing funding reports, creating stimuli for her clients, or programming iPads.
At first this was OK, because she loved the work she did, and the people she did it for. Plus, she was used to late nights, fresh out of grad school. Yet, this constant assault on her personal time started to take its toll. She rarely took time off because all of her work would simply pile up, creating a nightmare when she got back. When she did take time, Jane always remained connected via e-mail and would sometimes spend hours a day working, while on “vacation”.
Now we may look at this and think we see a dedicated worker, which may well be true. But in fact Jane was stuck between a rock and a hard place.
At an ABA conference, a presenter once made the point that we behavior analysts tend to be very “rule-governed” people. This is something our field and our culture encourages. We seek out the function of behavior using data and analysis, rather than intuition or guess work. We look to research first when trying to solve a problem, and know how critical it is to follow the behavior plan. We create task analyses, job aids, and process maps to make sure the work gets done just as it should. And we strictly adhere to our code of ethics.
And these are, indeed, good behaviors for our culture to support.
Yet, when these cultural norms come against organizational practices that don’t support them, we see situations like Jane’s. Jane had, on one hand, her responsibility to provide effective services in adherence to the culture of the field and the code of ethics. On the other, she had a responsibility to her employer.
After all, an employer has the responsibility of providing effective services, but also the responsibility of generating revenue and minimizing expenses, making the best use of resources, and navigating an often treacherous landscape of regulations and requirements. For some, these constraints are met by increasing caseloads, and billable hour requirements, decreasing the availability of professional development, training, and supervision activities.
All of this came together for Jane and forced her into two choices:
1) Take on the extra case load, and follow the cultural and ethical codes of our field by providing the right services, regardless of the fact that this required her to dip deeply into personal time.
2) Take on the extra case load, but risk breaking the ethics code by lower the quality of services to preserve her personal time.
In other words: to have a reasonable work/life balance she had to violate her code of ethics and personal values.
Six months in, she was still putting in full effort in all aspects of the organization, hoping to get faster at meeting the case requirements and completing reports. 18 months later things had not changed much, but her stress levels were constantly building, pushing her down the path to burnout. All things associated with the company had become aversive, and she was becoming cynical. Nonetheless, she continued to sacrifice the time needed to provide exceptional service for her clients.
Finally, 3 years after starting she threw in the towel and quit. Despite her efforts, things had not changed, and she finally had to prioritize her own mental and physical health.
While from an organization’s perspective, adding to the caseload of BCBAs, and limiting the time spent on non-billable activities are logical steps to keeping the organization afloat. However, this does not come without a cost. Research has shown stress, burnout, and management practices to be directly associated with turnover, which can in turn cost organizations heavily (Arshadi & Damiri, 2013; Mor Barak, Nissly, & Levin, 2001).
In a past bSci21.org article on how organizations can deal with turnover, the costs at the behavior technician level were estimated to be around $5,000 per turnover. For the BCBA level, those costs skyrocket, nearing 30% – 100% of that individual’s yearly salary. Some fields can support turnover at such a high cost; for example, in fields like finance, law, or business consulting where there are people lining up waiting for a position to open.
Yet this is not the case in the ABA clinical world, where profit margins are narrower and the jobs are plentiful.
For example, in California alone, you can find hundreds of job postings per month for BCBA positions on sites like Monster.com, craigslist.com, indeed.com, and the ABAI job board. Yet, according to the BACB, there are just 3,700 BCBAs in the whole state. While this is not the case in every state or location, by and large this is not an employer’s market. Which makes practices and policies that create a stressful work environment, even more toxic to the organization’s success.
While many companies do work to enact policies to prevent stress, burnout, and turnover, as the Huffington Post article pointed out “If policy changes aren’t supported by cultural shifts, employees won’t feel comfortable following the new policies — so for any real change to take place, leaders and managers have to model these new behavioral norms.” This means leaders must not only talk the talk, but must also walk the walk – and reinforce the behavior of others who walk the walk as well. For example organizations may support cultural changes by supporting policies that:
1) Take into account the true time requirements for non-billable tasks
2) Allow employees to engage in preferred, non-billable activities that still add value to the organization, such as research, professional events, or continuing education.
3) Support reasonable supervision limits
4) Recognize the fact that individual stress management strategies do not address the root cause of stress.
Additionally, other articles on bSci21 and other blog sites provide additional insights into creating a more positive and effective work environment.
While this may paint an unattractive image, there are, in fact, many organizations out there dedicated to creating a culture that supports BCBAs and embraces the values of the field of behavior analysis. And as the field moves forward and grows, organizations that create a work environment that supports the culture of our field, while reducing stress in an already stressful job, are likely to be the ones that succeed.
Arshadi, N., & Damiri, H. (2013). The relationship of job stress with turnover intention and job performance: moderating role of OBSE. Procedia – Social and Behavioral Sciences, 84(2003), 706–710. http://doi.org/10.1016/j.sbspro.2013.06.631
Mor Barak, M. E., Nissly, J. A., & Levin, A. (2001). Antecedents to retention and turnover among child welfare, social work, and other human service wmployees: what can we learn from past research? A review and metanalysis. Social Service Review, 75(4), 625–661. http://doi.org/10.1086/323166