BCBA and RBT Burnout: Signs, Factors, and Solutions for ABA Professionals
BCBAs watch over their patients but may overlook their own well-being. Our guide is the definitive source for combating burnout, backed by research and expert advice. Learn to identify signs and prevent burnout by fostering a supportive ABA environment.
Inside this article:
- Factors contributing to BCBA and RBT burnout
- Ways for BCBAs and RBTs to reduce burnout
- Ways for ABA practices to alleviate burnout
- Checklist for ABA practices to prevent burnout
What is BCBA Burnout?
BCBA burnout refers to the emotional and physical exhaustion that BCBAs can experience. This burnout comes from the high stress and demands of their work. Burnout can lead to feelings of cynicism and detachment from the work.
Burnout results from prolonged, chronic, unresolvable job-related stress. The term "burnout" comes from the metaphor of exhausting or smothering a fire. With burnout, a long-term imbalance of demands and resources eventually makes a person unable to adapt.
BCBA burnout specifically refers to the state of burnout experienced by ABA (Applied Behavior Analysis) professionals, including BCBAs (Board Certified Behavior Analysts) and RBTs (Registered Behavior Technicians).
BCBA burnout is a critical concern for ABA clinic owners and anyone aspiring to open an ABA clinic. It is essential to have a comprehensive understanding of burnout, including its definition, identification, and prevention strategies, to create a supportive clinic where patients and staff thrive.
Key Takeaways
- Burnout causes emotional exhaustion in overworked employees who have an unhealthy work-life balance.
- Experts believe that at least half of all BCBAs and RBTs have experienced burnout in ABA.
- The major symptom of burnout is emotional exhaustion; others include job dissatisfaction and poor performance.
- At its most extreme, burnout can cause BCBAs to quit, increasing turnover for ABA clinics.
- To prevent burnout, clinics must prioritize BCBA and RBT self-care, reduce workloads, and streamline operations.
There are several definitions of burnout, but most draw from Christina Maslach, Ph.D., and Susan Jackson, Ph.D. These two noted researchers defined burnout as a three-dimensional syndrome comprising emotional exhaustion, depersonalization, and reduced personal accomplishment. Their most cited paper, "The Measurement of Experienced Burnout," published in 1981 by the Journal of Occupational Behavior, introduced the Maslach Burnout Inventory to measure burnout.
Today, the World Health Organization (WHO) uses a very similar definition, characterizing burnout with three dimensions: "(1) feelings of energy depletion or exhaustion, (2) increased mental distance from one's job or feelings of negativism or cynicism related to one's job and (3) reduced professional efficacy." Critically, this definition specifies that burnout refers specifically to occupational, or work, exhaustion, and is not a general mental condition that appears in other parts of life.
Experts disagree on the specific definition of burnout. However, they all agree that burnout can persist unnoticed for years and create a self-perpetuating cycle that negatively affects ABA staff, patients, and the clinic.
What are the Costs of BCBA Burnout?
BCBA burnout hurts the BCBA's physical and emotional well-being. It can also cause BCBAs to quit, leading to high turnover that is expensive for the clinic to manage. Also, long-term stress hinders the BCBA's work and patient care.
A 2022 BMC public health paper titled "Shortening of the Burnout Assessment" addresses the negative toll that burnout can play on an individual's health. The authors write that burnout is "associated with poor physical and mental health of employees such as cardiovascular disease, anxiety and depression, musculoskeletal disorders, insomnia, and psychosomatic complaints."
Burnout's cost goes beyond the toll on individuals. It also affects clinic operations, leading to employee turnover. That's especially true if BCBA professionals perceive no signs of improvement or change. This leads clinics to face the costly process of recruiting, hiring, and training new employees.
Researchers put a dollar amount on the cost of burnout in a 2022 paper titled "Self-Care Strategies and Job-Crafting Practices Among Behavior Analysts: Do They Predict Perceptions of Work-Life Balance, Work Engagement, and Burnout?" The paper, published in Behavior Analysis in Practice, states that "costs associated with recruiting, hiring, and training new employees can vary widely, but can amount to as much as 200% of 1 year's salary. The paper cited salaries for ABA service providers range from approximately $34,050 to $39,100 for direct reports and roughly $67,200 to $83,100 for supervisors. The authors continue, estimating that "the average turnover costs per individual ABA service provider could be as high as $166,200."
What are the Symptoms of Burnout in ABA?
Exhaustion is the main symptom of burnout in ABA. This includes all forms of exhaustion: emotional, mental, and physical. Other symptoms include reduced job satisfaction, decreased job performance, and high turnover rates.
The available literature on ABA burnout is limited, but we can draw insights from the extensive research discussing burnout in the broader workplace context. Surprisingly, despite its widespread recognition across numerous fields, there is no universally agreed-upon list of symptoms specific to burnout in ABA. Unlike an independent diagnostic category in the Internal Classification of Diseases, burnout is classified as an occupational phenomenon. Some define it as a syndrome that arises from chronic, unmanaged workplace stress. Consequently, clinicians don't have a standardized set of symptoms to diagnose burnout professionally.
Still, when assessing burnout, experts focus first on mental, emotional, and physical exhaustion. Then, they focus on the second of the three dimensions used by WHO: (2) cynicism related to one's job and (3) reduced professional efficacy. These are the three symptoms that the Maslach Burnout Index (MBI) uses to assess whether an individual is suffering from burnout.
Burnout touches all parts of the clinician's social network, from their colleagues to their patients to their friends. Consequently, many experts argue that burnout symptoms don't just exist at an individual level.
Noted researcher Wilmar Schaufeli, Ph.D., makes this case in the 1999 book Stress in Health Professionals: Psychological and Organizational Causes and Interventions. He writes, "Burnout is not restricted to symptoms at the individual level. In addition, interpersonal symptoms in relation to recipients are also observed (irritability, dehumanization, indifference) as well as symptoms at the organizational level ( job dissatisfaction, job turnover, low morale)."
Twenty-one years later, Schaufeli developed his Burnout Assessment Tool. It's a questionnaire with four dimensions: exhaustion, mental distance, cognitive impairment, and emotional impairment.
Researchers also developed a new approach to diagnose and screen individuals for burnout, specifically focusing on the link between burnout and depression. They call this system the Occupational Depression Inventory (ODI).
Signs of BCBA and RBT Burnout
Burnout is a serious problem for clinic professionals. The earlier you treat BCBA and RBT burnout, the better. Watch out for these signs:
- Emotional exhaustion
- Reduced productivity
- Withdrawal from work and social activities
- Physical symptoms
Bardsley, BCBA, describes her experience with burnout as an "emotional spiral."
"When I'm experiencing burnout," she says, "I know that I can't deliver the level of excellence I strive for, which only heightens my emotions that are already around me from the staff, kids, and parents. And it's not just the emotional toll; it affects my physical well-being too. I find myself overstimulated throughout the day, and it can be difficult to find peaceful sleep at night. Additionally, it sneaks into my social life and decision-making, often without my awareness. It's a delicate balancing act, trying to prioritize myself without letting others down, even though it's not my intention."
What is the ABA Burnout Rate?
In two recent studies, about two-thirds of ABA professionals were experiencing medium to high burnout. The rate depends on job status, degree of burnout, outside support, age, and other demographic factors.
In a 2021 study, 72% of BCBAs and RBTs reported medium to high levels of burnout. The researchers surveyed 826 ABA practitioners with various experience levels for their paper titled "Self-Care Strategies and Job-Crafting Practices Among Behavior Analysts: Do They Predict Perceptions of Work-Life Balance, Work Engagement, and Burnout?" It appeared in the journal Behavioral Analysis in Practice.
In a 2018 survey, two-thirds of early-career BCBAs (about 67%) experienced moderate to high burnout. For this study, 183 early-career BCBAs took the Maslach Burnout Inventory test to measure burnout. The authors published their findings in the European Journal of Behavior Analysis.
Given those studies, it seems clear that burnout is prevalent in ABA, although the burnout rates likely vary within the diverse population of BCBAs and RBTs. You have tools at your disposal to gauge your team's situation.
Use the Maslach Burnout Inventory, Occupational Depression Inventory, or Burnout Assessment Tool to evaluate your staff’s burnout levels. These assessments provide valuable insights into your emotional exhaustion, depersonalization, and reduced personal accomplishment. By understanding your staff’s burnout risk, you can take proactive steps to prevent and manage burnout effectively.
What are the Contributing Factors That Cause Burnout in ABA?
Burnout in ABA happens when multiple factors interfere with work-life balance. The demanding nature of ABA work, with its long hours and intense emotional demands, can result in exhaustion and decreased personal time.
The specific causes of burnout vary but can include prolonged work demands, long hours, low salaries, persistent conflict, and more. Socio-demographic factors play a role, too. The 2018 study on “High levels of burnout among early-career board-certified behavior analysts with low collegial support in the work environment,” published in the European Journal of Behavior Analysis, found that young individuals who may define work as their primary source of satisfaction report higher rates of burnout.
Bardsley says she's more likely to experience burnout when her caseload becomes unmanageable. "There was a time at my previous center where I had eight cases, all with similar-aged clients. However, the amount of work required for each case was overwhelming. When the current center I work for first opened, I was the only BCBA. I had to write all the programs, handle all the challenging behaviors — it felt like they were all intense problem behaviors. It was just adding fuel to the fire. And that was even before the onset of COVID."
She adds: "However, I also noticed that it's the emotionally intense cases that truly contribute to a quick spiral into burnout. When you have a substantial number of emotionally intense clients or cases, it's not just about managing your own burnout anymore. You also have to grapple with the burnout experienced by your staff members as they struggle to stay motivated."
Mental health professionals are particularly susceptible to burnout because several factors intersect. Here's a summary of the contributing factors for burnout:
- Emotionally intense work
The nature of work in ABA means that BCBAs and RBTs must deal with challenging behavior regularly. Some BCBAs report unrealistic demands and low salaries.
Also, the individuals receiving ABA services may have complex needs, challenging behaviors, or co-occurring conditions. Designing and implementing effective behavior intervention plans can be demanding and time-consuming, adding to ABA professionals' workload and stress levels. - Heavy workload with long hours
According to the Behavior Analyst Certification Board (BACB), demands for BCBAs have increased by 23% from 2021 to 2022. The growing demand can't keep up with certification, putting pressure on current staff to manage more cases.
"There’s definitely pressure to accept any case,” says Bardsley. “It’s like being caught between a rock and a hard place, especially when it’s not your own center. You’re being pushed to take whatever case they assign to you, even if you feel uncomfortable because you know deep down that this case requires more than what you can provide. It triggers anxiety and fear, which can easily lead to burnout. You feel like you have no sense of control over your own workload.” - Career culture: help others first
BCBA culture prioritizes the needs of others -- and encourages going to great lengths to assist clients. BCBAs may inadvertently neglect their own needs, experience chronic exhaustion from excessive work, and face internal and external pressures.
“You’re expected to be a superhuman,” Bardsley says. “People assume that the emotional berth of a BCBA is huge and that we will never crack under the pressure.” - Lack of resources and support
Inadequate resources, limited staffing, and insufficient support systems can significantly contribute to burnout. ABA professionals may face challenges with materials, supervision, or collaboration with colleagues, which can intensify work-related stress. In addition, many feel underpaid. - Challenging environments
ABA professionals often work in various settings, including homes, schools, and clinics, where they may encounter challenging or disruptive environments. Dealing with environmental factors such as noise, distractions, or lack of suitable workspaces can add to the overall stress and burnout risk. - Losing touch with the purpose of their work
As burnout progresses in BCBAs, they may feel disconnected from their purpose.
What are the Ways to Reduce ABA Burnout?
Individuals and employers have tools to reduce ABA burnout. Ideally, individuals and their clinics will work together. Take these steps:
- Reduce the workload
- Provide self-care resources
- Reduce tedious tasks
- Foster a positive work environment
- Give BCBAs more control over their hours
Addressing burnout should not be a last resort. Instead, be proactive. You might find it’s like implementing antecedents in ABA behavior intervention plans (BIPs). These interventions aim to mitigate burnout and enhance overall well-being by cultivating a healthier work environment.
A survey of 92 ABA professionals highlighted the importance of high-quality training and ongoing supervision in preventing burnout. The authors published their research in a 2019 paper titled “Supervision for Certification in the Field of Applied Behaviour Analysis: Characteristics and Relationship with Job Satisfaction, Burnout, Work Demands, and Support.” It appeared in the International Journal of Environmental Research and Public Health.
Ways for Individuals to Reduce BCBA and RBT Burnout
To avoid burnout, BCBA and RBT professionals can prioritize self-care, set boundaries, seek support, and practice stress management. They can also work with staff to manage workloads and implement system-wide changes that promote a healthy work-life balance.
Here are a few ways that individuals can reduce burnout:
- Self-care and self-awareness
“The simple things everyone tells you to do really do work,” Bardsley says. “Be mindful of fitting in the things you need to help you emotionally regulate – sleep, exercise, eating well, being with friends and family.” - Leave work at home
“I tend to be a workaholic,” Bardsley says. “There have been times when I get caught up in these cycles of working long hours without realizing the impact until it’s too late. But now, I’ve become more self-aware, and I’ve made a conscious effort to leave my work computer at the office. This simple intervention has made a tremendous difference.” - Cultivate a positive culture among your staff and colleagues
“I implemented systems to cultivate a strong team dynamic, both within my staff and throughout the company,” Bardsley notes. “It made a significant difference for all of us. We were still facing challenges, but we knew we were in it together.” - Speak up about caseload
“I do feel more at ease voicing my concerns when I sense that my workload is reaching a level that could lead to burnout,” Bardsley continues. “However, this aspect can be challenging because nobody wants to turn away a child in need. It’s somewhat easier to be heard when dealing with clients who pose a safety risk and require special attention. Yet, there’s always this lingering feeling that we’re not doing enough, and rewriting that narrative is quite difficult.”
Ways for ABA practices to reduce BCBA and RBT Burnout Turnover
To reduce burnout and turnover, ABA practices can foster a positive work environment, provide regular support, and promote work-life balance among staff. They can also enable a community within their clinic.
Since the COVID-19 pandemic, more ABA clinic owners have become aware that their teams suffer from burnout. Since then, many clinics have taken more measures to prevent burnout and alleviate its effects when it does arise.
“I’ve definitely noticed, especially since COVID, that more clinics are mindful about making sure that BCBAs are not overloaded with work,” says Bardsley.
Here’s a summary of how ABA practices can reduce BCBA and RBT burnout and subsequent turnover.
- Workload management
ABA practices can reduce burnout and turnover by implementing effective workload management strategies. ABA supervisors can help ensure that BCBA and RBT caseloads are reasonable and manageable. Supervisors can regularly reassess and adjust caseloads as necessary rather than assuming the BCBA will speak up about it. - Foster a supportive working environment and recognize good work
ABA clinics can create a supportive work environment where BCBA and RBT teams feel valued, appreciated, and supported. Encourage open communication, provide feedback and professional development opportunities, and promote work-life balance.
Bardsley describes her last team’s dynamic as a prime example: “It was such a delightful experience. It brings me joy just thinking about it. We all recognized the unique contributions of each individual staff member, celebrated their strengths, and ensured they felt seen and valued for their specific gifts. We brought that same mentality to the entire center. We implemented awards and praised our peers, creating a positive ripple effect. People genuinely enjoyed it and wanted to extend that same appreciation to others. It was a wonderful domino effect.” - Offer resources for training and professional development
ABA clinic supervisors can invest in staff development to enhance job satisfaction and reduce burnout. For example, ABA clinics could provide comprehensive training and ongoing professional development opportunities for BCBA and RBT staff. - Regular supervision and support
Effective supervision helps build confidence, reduces stress, and enhances job satisfaction. ABA supervisors can offer case consultations, peer support, and supervision sessions to address challenges, provide guidance, and ensure ongoing professional development. Also, supervisors should make sure that the BCBAs have a voice in creating their own work schedules. - Streamline organizational processes
Investing in the ABA clinic will create a positive work environment. ABA supervisors can assess organizational factors contributing to burnout and turnover, such as tedious administrative processes.
Also, ABA clinic owners may consider implementing ABA management software to help eliminate tedious tasks for the BCBA, streamline their work, and improve overall job satisfaction. - Implement workplace policies to promote self-care
For instance, clinics can set a policy that discourages any non-emergency communication after work hours. This simple intervention can help create a healthier work-life balance for staff. By respecting their personal time and allowing for proper rest, employees can recharge. - If possible, hire more staff to meet the demand
The only way to meet the demand and prevent burnout is “hiring more and more people,” says Bardsley.
If possible, hire more staff to ensure you don’t overload your current BCBAs. However, supervisors must be proactive about ensuring their staff are not overworked and select cases according to employee capacity rather than demand if that isn't possible. - Encourage supervisors to model self-care
By exemplifying self-care practices, supervisors can create a virtuous circle where trainees observe and learn how to prioritize their own well-being. This sets a positive example and helps foster a culture of self-care within the organization, reducing the risk of burnout for future supervisors.
How ABA Practice Management Software Can Help Improve BCBA Retention
Applied Behavior Analysis practice management software offers a wide range of advantages that can help ABA practices to enhance the bottom line. They can create a more productive and contented workforce by engaging employees and investing in their growth.
These advantages include:
- Early detection of potential problems
ABA practice management software can produce reports that help identify which employees might leave. For example, the software can help show workers who are stressed or regularly absent. Managers can then use this information to address the problem, whether it be through additional training, monetary rewards, or stress management programs. - Improve communication and build community
ABA software can also enhance internal communication and foster a sense of community. This results in improved employee engagement and productivity levels by providing a place for employees to voice their issues and suggestions. - Overall management
Additionally, organizations can monitor staff growth and pinpoint learning management requirements using ABA practice management software. Companies can build a more engaged workforce that can better handle the difficulties of the modern workplace.
“Implementing software in our ABA practice has been a game-changer in mitigating burnout,” notes Bardsley. “It has given us a significant amount of time back, allowing us to focus on what truly matters.”
How Artemis ABA Practice Management Software Can Help Reduce Turnover and Increase Retention
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With Artemis, clinics can cultivate a culture of growth, success, and self-care, ensuring a thriving and dedicated team of clinicians committed to providing the highest quality care to their clients. With AI-powered technology for billing and revenue management, Artemis improves financial performance, creating a stable and secure work environment for staff and the organization.
If you’re hoping to create a thriving ABA clinic, try Artemis ABA. Artemis understands how quickly clinic management and organization can get in the way of patient — and staff — care. Trust Artemis to put your staff and patients first and unlock the full potential of your ABA clinic.