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Burnout and Systematic Change in ABA · ABA Business Leaders

• speaker-0: because even owners struggle with this, are recognizing the massive contextual shift that has occurred within our profession, which I believe strongly is a huge contributor to this like epidemic of burnout. It's not individual failings, nor is it individual company failings. It is a huge context shift and we are still trying to shove our same systems through this new lens and it's not working. speaker-1: Welcome to ABA Business Leaders brought to you by 3PiSq, where we discuss topics on how to create and grow an ethical and sustainable ABA practice. speaker-2: Whether you're starting, scaling, or thinking about selling your business, we're here to share insights, stories, and strategies to help you on the journey. speaker-1: We owned a successful ABA practice for over 10 years. speaker-2: And now we help other ABA business owners do the same without all the chaos. speaker-1: Stick around, you're in the right place. speaker-2: Hello everyone, welcome to ABA Business Leaders brought to you by 35 Squared. I'm April. And today with us we have a special guest, Dr. Becca Tagg. Welcome, Becca. speaker-1: and I'm Stephen. speaker-0: Thank you. It's good to see you both. speaker-2: Yes, good to see you too. Okay, so full circle moment back in the day, right? When you first started 3piSquared and Becca had a podcast at the time. You were actually a guest on her podcast. That was like speaker-1: again speaker-0: I think 2017, 2018. speaker-1: long time ago. speaker-2: ⁓ yeah. That's yeah. Crazy. Fun times. That's so cool. So yeah, so today we're just, you know, we invited Dr. Becca over to have a chat about a lot of things, but really focusing in on self care in as, you know, in the sense of a clinician, right? Since all of you guys are, most of you guys are clinicians or you're, you know, in some capacity an ABA business leader. ⁓ an owner, clinical director, you know, sometimes we have behind all of those titles, we have ⁓ a lot of things to do. And we feel that we have little time for ourselves. And back in February, I believe it was it's something I think you do yearly, but you put out like self self care. speaker-0: calendar? Every February, every July, which we picked those based on data as, you know, We have no relationship with anyone else like we do with ourselves. And February with Valentine's Day, I also admit Camp Lejeune. So a lot of our team members are military spouses and their partner may be gone. And that can make Valentine's Day a bummer. So between that and that relationship with self. do them in February and then again in July because we serve pediatrics, probably 70 % of our population. And that's the one month between the shit storm of June and the shit storm of September. So let's fill it up with some extra self-care through the Community Care Initiative, which is us making it freely available to everybody else also. So, yep, we do it twice a year for the last six years. speaker-2: Yeah, that's exciting. And I love how, and we can talk more about this, about like what self-care can look like. But over the years, I've downloaded your self-care calendar and have loved to get like new ideas, fresh ideas of, I didn't think of it that way, or, this is a good idea. But I don't know, let's talk a minute about like what self-care is. And I think at this point, I could be wrong. But I think at this point, a lot of us have in the field have heard and talked about, it's not just about bubble baths and chocolate, right? That it's really looking. Take. So that is, think that's whether you're a parent or caregiver or I don't think it matters. If you're a human, I think it can be a challenge to show up for yourself and know what that even looks like. speaker-1: I like cake. speaker-0: Yeah glad to hear you say that you are feeling like a lot of people have gotten that message that self care is not just that consumer self care. ⁓ I'm not sure. I think a lot of times it still comes up, whether it's in talks I'm doing or even in sessions as a psychologist, right, as I'm working with other adults or teens or what have you. I think ⁓ The idea that self-care sometimes is uncomfortable is something that hasn't fully landed. And I think it's less about it being related to self-care and more about as humans, a lot of folks are motivated by avoidance, right? Avoiding things that are uncomfortable. ⁓ And sometimes self-care is uncomfortable, right? Scheduling your ⁓ mammogram is, you know. probably not the most comfortable thing. And at 44, it's a hell of a lot more comfortable than cancer. Do it, you know? And I mean, I'm punchy, but sometimes when ⁓ my phone rings and I see who's on the other end, self-care is hitting the red button. Frequently, it's a hard conversation, right? If I think about at work as an owner, it's having hard conversations. That is self-care. It's also community care. I think that's important too. Self-care, since I started talking about it more around 2016, I think I have a complicated relationship with it maybe now. And I think it's that ⁓ I feel like it's framed as an individual failing. And I hate that actually. And I think that's wrong because burnout is not an individual failing as much as it is a system. And that's why I came up with community care, because I like alliteration and it hits on a context that I think is missing when we're looking at equity. When there's a power differential, and many times there are, you can't, if you're a member of that minority group, the group with less power and control, let's use ethnicity for an example, there's no amount of brownies and bubble baths that's going to ameliorate the impact of racism. So when you have more power or control and you're a member of a majority group, it is your responsibility, I believe, it is my responsibility to create systems of care that protect and support those who have less power and control. That is community care, intentional action done to provide care for a group, which is not the opposite of self-care, but it's rather complimentary to self-care, which is that individual action. aimed at providing care for cells. speaker-2: It's very much a system failing. ⁓ And we have a lot of conversations. We have a support group that we just started in the beginning of the year. And ⁓ there are already a lot of people participating. And this is also where we got the CEO Moms panel from, right? Because we had such great conversation in the support group that I was like, let's bring this out. you guys would join me for a conversation where people can hear. ⁓ But that's that is the our worth is tied so closely like individual worth is tied so closely to these things, right? Like if we're if we are feeling, you know, if we're not able to be as productive yesterday as we were today, or if we're finding that we need to take a break today, but we couldn't we didn't have to take a break tomorrow or anything like that, then then it's the more failing or it's tied to our speaker-1: A lot of these people that we work with are, you know, they are the change makers in their company, right? And so how I assume that there has to be some level of self-awareness to identify that my systems are broken, causing burnout or maybe mistrust, toxic behavior, right? Do you have ⁓ a good way or a helpful way that people can step outside of that? because again, you're going back to, ⁓ I'm the failure because my system, right? So it's kind of this loop, you know what I speaker-0: I want to make sure that we're all on the same page. I, cause I think not being on the same page is where that like being a shit to yourself comes from. Like, this be a my issue. So ⁓ let's look at our profession specifically. And as I've said a million times now, I super appreciate Dr. Carr's use and separation of the profession from the field or the science because they are not the same. am talking about the profession as in BCBAs who are generally working in insurance funded or educationally funded programs for kids with autism. And that is a profession separate from our field. ⁓ So I think there is a, in many ways, a lack of overtly naming and acknowledging the state of the profession. And that is a system and context. matters. So I think that is a useful thing because for leaders specifically within our profession, I believe one of the major contributors is folks are still operating like we're in a system of 2019 when it's 2026. So I just want to kind of review that a bit. the field has changed and that has nothing to do with Dr. Becca Tagg. It has a significant impact on Dr. Becca, just like I'm sure it has. for both of you and everybody listening, but I don't know that folks are aware of that. And the reason I'm taking the time to label this is because I see it as the parallel process of what I see in our ABA graduate students when we're teaching the science, which is missing the understanding of like a case conceptualization, which includes taking context or setting events into the picture. And that's where I think our breakdown is. So, ⁓ There's workforce instability. 2020 changed a ton of things. Full stop. think it's period, right? So there's workforce instability since then. There's certainly tighter margins, financial, like business-wise, due to some change, variety of things, changing payer policies, legislation, increased payer and administrative burdens also connected to those policies, higher expectations from multiple stakeholders. Because we've had a big, I don't know what's the right word, like a consolidation is the word I'm looking for. We've had a rapid consolidation within our profession of private equity backed companies making a lot of acquisitions. And whatever your feeling is about PE is what it is and is as separate from that. That's a huge context shift. Consolidation is a major context shift. And this has led to some of the higher expectations and different operating systems within individual organizations, which is a context and system. But we also have our bigger system context, which is the way our profession has changed. And I do think that there are a lot of leaders who are still operating like it's the system of 2019. ⁓ we just have to get back to that. No. And I did it too for years until realizing, okay, so it's been years now it's time to just, this is the new normal, right? And I don't know that clinicians who are not owners, because even owners struggle with this, are recognizing the massive contextual shifts that has occurred within our profession, which I believe strongly is a huge contributor to this like epidemic of burnout. It's not individual failings, nor is it individual company failings. It is a huge context shift and we are still trying to shove our same systems through this new lens and it's not working. And there is, as Stephen said, self-awareness is part of that. But I also think that stuff jumps off the page at me. Like I think I tend to be more of a systems thinker. So I do think there are ways that you can train to kind of look at those systems and that BCBAs are uniquely poised to do so because It's part of contextual factors of what we know, what is part of our science. And I think it's illustrating that it's missing in our training severely, which leads to treatment outcome impact, but also this individual impact that we're naming. So if one of the big changes that I've experienced as a clinician is less paid time off, and now I'm experiencing burnout, when I can look at that as a contextual factor that has changed, that helps move me towards the idea, ⁓ maybe I need some more time off, or I need to change my schedule. Or if I used to have, unless I was working in a different setting, I was doing more in-home and now I'm doing more clinic, that's a contextual change. Maybe I wanna evaluate that impact. Or maybe I had more little kids or big kids or more students. I think when we are better able to identify the contexts, the multiple contexts, right? That have the potential to impact, then we are better equipped to come up with those functionally equivalent alternatives, which is all self care is. Self care, our replacement behaviors, we know how to this. But I think it gets messy because we're not training our folks in behavior analysis. We're training them in ABA for kids with autism. So that's my hopeful pitch, right? That we are uniquely trained to do this. are able to understand this when we know how to do it. And it's the same process we already know how to do with our identified patients. speaker-2: Yeah, mean, and not to go off on a tangent, but I think that that's that little barrier there is what we see with leaders within the company, right? Because they really have a hard time applying the science to their staff even and what that looks like amongst the organization organizationally outside of just like providing programming for for learners, because we do look at like systems like we help we help business owners look at their systems and, you know, and we look at You know, one of the indicators is like, how many, how often are you putting out fires in a day? Right. Because if you're constantly, if your job is I'm putting out fires, then we need to pause. We need to take a step back and we need to look at this. Right. Because that's not okay. That's not, that's not typical. Like that shouldn't be your job. Your job shouldn't be putting out fires all day long. let's take a step back. speaker-0: The fire twice, you don't have a fire problem, we have a system problem. If somebody comes to me with the same question twice or the same breakdown twice, that's not a them issue, that's a me issue. That means there is something that is not working and it doesn't matter if it used to work. It may not work anymore. And so instead of putting out the fire, what's antecedent interventions? I don't want to keep doing consequential interventions. How do we get ahead of this? Spot on. I agree for that. speaker-2: Yeah. And, you know, I was even, you know, even like as basic as, you know, communicating and they're going right. They can absolutely change. They could work for a while and then we have to we have to adjust them. But but being able to clearly communicate the most basic of like expectations, you know, like even even being able to break something down through a task analysis. Right. And I often like remind people of like, hey, let's go back to the whole peanut butter and jelly sandwich. task analysis, right? You may think that your directions and your steps and your TA are like very clear. And here, take this and make the sandwich. And then this person comes with some odd combination with a knife sticking out of the sandwich or whatever, right? And then we're like, ⁓ well, that's not what I meant, right? And so really being able to apply that in the way of being able to clearly, but clearly define the steps. But to do that, I think you have to also understand what you're wanting your outcome to be. And I think sometimes that could be a little challenging when you're finding yourself in a new skill set as working on the business side of things versus the clinical side of things. speaker-0: I agree, but I also, think it's a slightly different, it's that multiple exemplar, the true mastery. But it's also that I think a lot of leaders, and I've experienced this, as well as other folks I do consulting with where, and actually I don't know that I would have seen it if I hadn't noticed it in others. As a leader and an owner, I often forget that the system is supposed to benefit me too. There are many owners that exist in systems that depend on them but do not benefit them. And that is a damn trap. And I think that is related to our context change in our profession because it is a very different world as a, you know, I own a practice and ⁓ I certainly cannot compete nor do I want to compete with, you know, companies that are backed by billions. I'm also acutely aware that a lot of providers want to work for those companies because they can offer more than I can. The system does not benefit small business owners right now, period. So that also reflects in our specific profession. And that's another context, think, as owners and leaders, we want to be aware of not in a maudlin way, like, ⁓ the sky's falling, but in a, hey, this shit's happening. Because of that, I need to be extra aware that this system needs to benefit me as well, or I need to exit the system. But I find that a lot of leaders And that includes clinical, like BCBAs who are supervising, not just manager leaders. think when you're in a supervisory position, a lot of times we are creating systems that depend on us, ⁓ but are not designed for us or don't really benefit us. speaker-1: I saw the same thing in engineering, right? Like I had this old mentor and I would say, why didn't you write this down? And he said, well, then they wouldn't need me. And it's like, you know, like that, that's a double-edged sword there, right? Like we're depending on you, right? So like, so yeah, I totally get that, right? There is that like mentality of they need me and there is like, ⁓ Sometimes it's fun putting out fires, right? You get ⁓ a certain amount of, I don't know, happiness from having that job. I'm a hero, right? speaker-2: Sometimes you see like something happen quick, right? you can. ⁓ I did that thing. speaker-1: Yeah, you get that. Yeah. And then, you know, like you said, like the system itself and, I've often said this, but the system that we're in, it seems to be a race to the bottom at this point, right? Everything seems to be incentivized to have, I make more profit if I have a less trained staff. if I get them out with the clients quicker, you know, and ⁓ it's, if you don't have a good understanding of those incentives, it's easy to kind of, you know, just follow the river, right, to its end. And ⁓ so it's really important to know what you're getting into so that you can course correct. Because it's just like I said like it we work with a lot of coming I'm sure that you have right where I've heard this way too many times ⁓ I left the company because I felt uncomfortable doing what they were asking or felt unethical and Two years into my own company the only difference between me and and the place I left is it's my name on the door speaker-2: So is the person like then, okay, so they're in the place where they're like, ⁓ gosh, like I'm in my company, things are happening that I didn't want to happen. That's why I left my past place. Yet, how did I get here? like understanding that middle part. And what that what that looks like and what that means and how to how to do it differently. What are the replacement behaviors? What are your intentions there? And what what are you wanting it to happen that kind of goes back to building your vision? Yes, but also like speaker-0: There's more knowledge. the context and... Yes. speaker-1: That we're in, yes. And maybe not, again, maybe not having the awareness, right? Well, like somebody else did it, so I mean, I guess I can do it. And so not having a full understanding of what is out there causing maybe things that we don't want to happen happen. And the levers are kind of out of our control, right? To a certain extent. speaker-0: one of my other beefs with self care is that if I hear about one more pizza party or it's offensive, ⁓ it's missing the point. It's hitting a rhinoceros with a dart, like if you slow down, the issues are way before that and not acknowledging that it's a system problem, it's an ongoing issue. And I think some of that comes from it's a... ⁓ we're not identifying all of the contributors. So in my mind, there are community care initiatives that have to be established. When we're talking about employment, it must be a psychologically safe workplace. It must be a physically safe workplace. I will be honest that some of these next ones are probably just my own and they're not for anybody else. But I believe that health insurance is a requirement that if you have full-time employees, you must offer health insurance and you must offer PTO. People are going to get sick, they're going to be out. Financial stress, if I'm not acknowledging that as a contextual variable that will impact my employees' lives, I am kicking the can down the road to stress myself out because they're gonna get sick, they're gonna get stressed about money and that's gonna become an issue, right? Same thing with healthcare. ⁓ Not having some sort of discipline system that you actually use, right? So some of this... Community care is self-care for the owner and it's things that are uncomfortable for leaders to do though. we're avoiding them because we're avoiding discomfort, but it's always going to catch up with you. It's always like you You can kick the can down the road The road will always come to an end at some point and so the challenge becomes when we're not acknowledging the context that we're in The profession has changed. And so if I want to try to compete with a big box company, I have to remove benefits to increase salary to offer a commensurate salary. Then the person comes aboard, then they have no PTO and they're on one. They have no health insurance. They're on one. Because I did something. I was not realistically looking at my system. I was trying to make it fit something else. Does that make sense? I feel like lot of the self-care and the community care takes care of the owner. It does. Because when your folks are healthy and well and able to do their, you know, they've got technology that works, HIPAA compliant platforms, ⁓ know, time off, they've got... way to access their job aids, they're getting adequate supervision, they're getting adequate training. A lot of those owner leader hassles, I shouldn't say hassles, ⁓ challenges don't happen in the same way. And so when I think of self-care, I know people say you can't pour from an empty cup, which I also hate that because we should not be pouring out of our own cup. Think about a wedding or anytime there's like a tower of... ⁓ Champagne glasses you pour in the top and it overflows. That's what self-care is. It's not dumping out of me into you. I can only serve from my overflow. So to create overflow is a system that's creating an environment where people's needs are met. And then that creates the overflow. So I think our understanding of self-care is still fundamentally flawed. It's not taking from me to pour into you. Otherwise then. then I'm just waiting for someone to pour into me. I've taken away my own autonomy. It's about I need to be so full that I can feed others from my overflow. speaker-2: You know, one of the things that we had a conversation within the support group of BCBA, like, ABA business leaders, right? And not just women either, all people within this group who were contributing to this conversation. Owners saying that they feel guilty going out for a coffee if it's not work related. They feel guilty not being part of the nine to five. speaker-0: In our profession, think a lot of owners are women. And the reason I label that is there are different, ⁓ we're socialized differently. And what I'm gonna describe next is a trap that has happened to me on more than one occasion, it will again, and may come up in your group, which, because you mentioned the moms, I am not their mom. My job is not to take care of them. Full stop. I want to provide systems. that they can access, that provide care should they choose to opt in. I am not there to take care of them and that's different. And I, that may sound like semantics, but for me, there's a big difference because what you described when you were talking about that martyred owner is what I hear from my maternal mental health, my clients that I see for therapy ⁓ who are oftentimes moms where... You know, we've got revenge bedtime procrastination. We're staying up because we don't have any minutes to ourselves. I'm barely eating. I'm I feel unseen and I'm resentful about that family. It's why I it is a huge red flag to me when I hear folks talk about their work family. That's not the same because a family by definition is ⁓ non-contingent. There is nothing you do. I always show up for you. We are together till the end. It's blood thicker than water. Work ain't like that. By definition, it is a contingent relationship. You have to do certain things and I have to do things. That's not a family, but language matters. And so when we keep using this language of family, I become mom, you're the dysfunctional cousin, this is my abusive dad, and no wonder we're all friggin' burned out. speaker-1: Yeah, I mean that totally makes sense to me and so I guess that's my main question is if you're stuck in that loop we we can share hey we've been there ⁓ but it's really hard for people to see when they're stuck in a loop right it's it's hard to be able to step back and say ⁓ wow yeah I see my responsibility in this situation right I am I think I'm providing one thing but I'm actually providing something completely different It's not helpful to anyone. It's not helpful to my staff. They don't have the independence that they should have that would be beneficial to my clients. I don't have the resources available to mentor these people or put out those fires or micromanage them to death. is there like a book that they could read, a video they could watch or a talk they could try and kind of step back and see that? speaker-0: framework would be starting with listing out all of the things they're doing. What are all of your jobs? And that means from picking up supplies to the hiring, firing sessions, billing, whatever, every single task and look at it. Cuz that's the other thing, there's creep happening, right? Where all of a sudden I did this once and now- It's mine. Six years later, I'm still the doing it. And put that on paper. speaker-1: Yes. speaker-0: And then I think there's ⁓ an important ⁓ categorization. What are the things that only you can do as the owner? And that's important because there are some things that only the owner can do. Highlight those, right? So those aren't going anywhere unless you hate them. And in which case then maybe it's a, if most of your list is highlighted and you hate all of that, maybe an owner has run its course for you. And that's okay too. You get to decide. ⁓ Then it's looking at I think this is related to what ⁓ April had said about where people feel like they can't step away. Part of that problem is they've created a system where they don't see themselves as different. And I'm the one working at 11 o'clock at night and on Sundays. So I don't have to be there eight to five necessarily. Like my schedule is different because I have to do different. And that can't mean that if I'm working at 11 on Sunday, that I'm still expecting myself to do eight to five Monday through Friday. So it's rigidity, right? And that often comes from a lack of understanding because when you don't know, you tighten up on everything because you don't know what you can let go, because you don't know what the actual levers are. So get everything that you're doing on paper, highlight the ones that have to stay with you. I'm a big fan of, and I do this at least quarterly, but more often if I notice, it's weird, is a time study. And it's intensive and effortful and invaluable. So you're only going to do it for a week. And I am happy to share a template that I use, but it's every 15 minutes. It's just in an Excel sheet. Every 15 minutes, you write down everything you did in that 15 minutes. And I mean, whether you went P, whether you scrolled for 30 seconds on social media, because what you've got to find, what we'll find is the patterns, because we're analysts, so we can do that. And so you can start to see, where am I leaking time that I didn't even realize it? And then does it need to stay that way? How can I change it? Do I want to change it? Do I not? But it gives you data because without the data we're talking about what I call cardiac assessments. I feel like I'm working too much. Okay. Are you working too much or did you have a bad morning and so now everything feels like the pits? Because that's normal, but that's not what we're making data decision. That's not making decisions on for our little learners. And so we shouldn't do it for us either. So get a good solid time study. And what patterns are jumping out at you? And based on that, what do we want to do differently? Some common things that either I've done or that I've seen other folks get stuck doing is those little tasks. I think of tasks as like in values, like a penny task, a quarter task, a dollar task. And I have been suffocated under penny tasks because they're easy to do. So I'm just like, ⁓ I'll quickly do it. Yes. But a hundred pennies is still a dollar. It's just a lot heavier. So if you're finding a lot of these penny tasks or quarter tasks, where else can they live? Is it hiring somebody? Are you doing more work that is supposed to be somebody else's, which PS, then that creates anxiety around this is somebody else's, but do I actually have to do it because what we say doesn't match what we do and that type of thing, which is a whole other system. I think it's critical for leaders to have uninterrupted time, period. And to get that, you have to really train your folks on what is an emergency, a true emergency, and what is urgent, and what is uncomfortable. But you can do hard things. I believe in you. I will get back to you. You know what I mean? Because we jump in to save or fix. And just like with our little learners, that creates prompt dependency. So we are creating the exact same errors that we do when we are poor clinicians with our little learners. We just, call them our big learners, my employees, call my big learners because I am teaching them and they are vulnerable, like they have less power than me. And so that language helps that stay in the front of my mind. It's always a parallel process. What I do with my big learners should be exactly what I want them doing with our little learners and what I'm doing with our little learners. And so it's it's inconsistency is what leads to this burnout and stress. And that's why there's more anxiety, because the opposite of anxiety is not calm. It's safety and security and certainty. So if we have more of that, that is, think, the biggest community care hack for our world, maybe. speaker-2: This is a big part of my day of what I coach business leaders through, right? And I do it myself too. So it's really super exciting to hear someone else bring these points together. I'm just like... speaker-0: Yes, yes! We have not left behavior analysis! speaker-2: And so even in my own personal life, know, I was feeling we had, you know, we had death in the family. We were all sick. We So it's like the six weeks of time were just like survival mode. Right. And so then the transitioning back to real life after survival mode can be rocky sometimes. Right. And so that first week back, I found myself like back into some old rhythms and routine, like some old behavior. was like, what is wrong with me? Why can't I blink? Blah, blah, blah. You know, and then I was like, hold on a minute. So I did a time audit for myself. I just did a three day time audit for it, because for that, in that moment, that's what I needed. And then also in all of that, some life changes had shifted. I needed to start focusing my afternoons more directly on my child and not multitask work and child, like there were some things that had moved around. So then I recognized just very simply, the first pattern was, ⁓ I've got about 20 and sandwich generation going to in-laws, doctor's appointments, which can sometimes take a full day off. I was like, I have about 20 dedicated work hours a week. And I'm thinking I have like a 40 hour nine to five. was like, okay, all right. Okay. I can do something with this. I can go back and figure out, reacquaint myself with. speaker-0: Hmm? speaker-2: where I want and need to spend my time and what that looks like. speaker-1: So like here's my theory and you can tell me I'm crazy. Okay, so like a lot of what ⁓ BCBAs are doing is they're reducing the bad behaviors, right? And I'm not a ABA therapist or a BCBA so I can say the bad words, ⁓ right? And They're I I've said it a couple times, but they're almost like beating the no out of kids, right? Like the compliance thing they have to be compliant. They can't say no. And I'm wondering if spending 25 years doing that ⁓ does the same thing for your staff. Right. ⁓ they they're doing this. They're saying bad things. They're saying I have to stop this immediately. Is that is that like part of it? Does that that make sense? What I'm saying? speaker-2: I think where you're going is because of people saying that I'm telling my staff what to do, but they're just not doing their job. They're not supporting me. speaker-1: Yeah. Having that, yeah, that, negative feeling in my body. I can't have that. I have to fix this right now. Do know what I mean? The fixing. Yes. I have to, I have to stop this. This can't, this isn't allowed. And I'm just wondering if that is helping this. Does that make sense? speaker-0: Absolutely. And I do think that that is one of the issues. that happens. And that's, again, a parallel issue because our big learners do that in session with kids. They're giving in to the kids because a good session is one where no one's upset because that's comfortable. And that's hugely problematic, right? And again, look, what's good for the goose is good for the gander. We are doing the same thing. So as an adult, if one of my employees is upset, and I'm worried about retaining talent because I'm a small fish in a pond or I don't have the bandwidth to think about hiring somebody else or maybe I am not that far in my own healing journey because I am a huge believer in how the way you do anything is how you do everything. You don't know what you don't know. So you don't realize that your own shit's getting in the way. That is limiting and negatively impacting yourself, but certainly your big learners and your little learners, because we're modeling. So then if I'm trying to save them, because I can't tolerate the discomfort for whatever reason, then I'm modeling for them what to do, which is discomfort is not okay. If somebody is uncomfortable around you, you better fix it and make them happy. So then our learners aren't getting better. whatever that means, but we're seeing more interfering behaviors. So then the kids have harder sessions, so the staff come to me more and I just have more. In that way, and I have struggled with this because I am a good emotional regulator. So the staff were coming to me, it was less about answers because I kept saying, I know y'all know this, what's happening? It was that I was co-regulating them, that we had not moved from co-regulation to regulation. And part of that is one of my own personal challenges. as a, I'm a psychologist, so certainly I learned it. But as a person who's neurodivergent, I have struggled with this my whole life because I am very direct. I can say the same thing to you in person and in email and in email people have said, gosh, Dr. Gregg, you're so aggressive. First off, if I was aggressive, I now know, okay, that, all right, we are different and that's fine. But I'm just being direct and it's because I care about you and I want you to understand. as Dr. Brene Brown says, clear as kind, unclear as unkind. I communicate very directly and clearly, which people don't always like, especially from a woman and I'm a hundred pounds on a good day. So they definitely don't like it from a small woman. And in person though, I'm constantly co-regulating the other person. It's why Interaction with people. I love it. Obviously, it's my special interest. I went to grade friggin 27 for it But it's also something that's really confusing for me. And what I've learned is I have to co-regulate us in this conversation to keep myself safe Because my direct communication style people don't always like so I have to be constantly co-regulating us And so I didn't realize I was doing it because I've always done it And it served me well in some settings, but not others. So ⁓ yes to all of that and it can change. speaker-2: Yeah, I know with, don't know, do you want to speak to the part of what we do is kind of help screen people who come to us and say, you know, I want to start my own business, right? We've done it. We've spoken, we've done some public speaking and we've had many podcasts on, you know, even just looking at red flags and looking at what you need to know before you start. And, and that is probably the biggest concern that we have with owners and that we try our best to like help to talk to people about that. And we've had people who came and then they started working through some of our courses where they've had conversations with us and then they back up and they realize, oh, I did not realize. I had no idea. what the job description of this owner is and how, you know, when we talk to people about, know, do you enjoy being a BCBA? Do you enjoy working like, especially in this model, right? Do you enjoy, you know, the early intervention, the sitting, down the floor in, with the kids and, you know, whatever. Do you enjoy the behavior analytic work of working with these little learners as you? And, and, and, you know, speaker-1: what you went to school for, right? speaker-2: you're going to see less and less of that. And there are going to be a lot of new skills that you have to learn. We had a conversation, I don't know, it's been a little while now. We've had multiple conversations about self-awareness and just understanding what your strengths and weaknesses are and your ability, like looking at co-regulation and even being able to feel into your body, even be able to label your own internal state and understand I mean, I don't even know what to call it. speaker-0: called interception. There actually is a name for it. the system and that's part of, again, it's the parallel process. We have clinicians who do not know that they don't know everything. That's really the And that's why I don't think it's about self-awareness. mean, yes, in some ways, but it's more of a community issue where I'm not seeing healthy, philosophic doubt. I'm not seeing this. Like I went to grade 27 because the only thing I learned each year was the more I learned, the more I don't know. And we don't have that. And so that I shouldn't say for everyone, but there is less of that significantly now. And that means that we have less people who are curious. And if I'm less curious about why, then I'm not collecting my time sampling data. I'm not, you know, it's the offensive part to me is speaker-2: ⁓ no! speaker-0: on what planet do you think this is easy? Because if you think just you're going to open a business, that means that you're thinking that I'm not doing a whole lot. Like if you work with me and you're like, oh, I'm going to quit Dr. Reckes and I'm going to go open my own place. Look, I love that for you if you want to do it, but to do it because you think it looks easy or you think it's good that I'm just not very good at it and that's why it's hard or something like that. We're really missing, I call it the noble intention, which comes from family therapy, functional family therapy. And it's this idea that everybody's doing the best they can with what they've got, even the behavior you don't want to see more of. And that acknowledges that there are, again, contextual factors at play that we don't see in other people's behavior, that it doesn't make it okay, but it may make it understandable. And missing all of these contexts, it's like there's all of these things that are invisible. speaker-2: Yeah, I think it's not just about awareness, it's when you complete, when you get that, when you get the four letters behind your name, ⁓ BCBA or, know, it doesn't mean that then you, you know, everything there is to know about being a BCBA. It doesn't know that you have know everything about providing early intervention for kind of autism. doesn't know that you automatically have all the skillsets to open a business. It's a starting point. It's a starting point. speaker-0: Yes, and I have a talk that's called the end is just the beginning but let's play this system out. So you you pass the exam you have the four letters Their next because this is not bcb's fault either like this all goes together The next experience for them is being inundated by recruiters offering them 100k plus salaries without formal mentorship and without being good at their Job that we know of yet, right because they've not done a competency-based interview. We do they're brand new So even if you're the best brand new BCBA, you're still brand new. So they're getting feedback from the world that gives them this message that we're saying we don't like, right? Which is that you don't have more to learn. You have arrived and you deserve to work as few hours as possible and to make maximal money and you don't even have to be on site. So this is how systems are shaped, right? This is how this system of insurance funded. that were educationally funded, ABA for kids with autism has shaped the view of our workforce, right? Because we impact the system, the environment, and the environment impacts us. And so then we've got folks coming into roles with these beliefs. And let's say instead of going to a big box company, they come to Del Mar, because this happens. They're mad. They are, I am not a great fit for a lot of our current folks because we have performance standards in place. everything is competency based to earn additional money. You do have a cap on your salary because I can't let, not the salary, it's hours. I don't want you working 100 hours a week. And community care is me making sure you don't work 100 hours a week. But because I also only pay you what you're truly generating, then that's, then I'm limiting that. Or our BCBAs do direct work, especially. early BCBAs because one hour of 97153 is an hour of 97153. There's no outside work. When you're new, an hour of 97155 or 5-6 is easily an hour to an hour and half of unbillable or like not acknowledged work. So if I'm having you only supervise and you're hitting your 25 hours per week, but it's all super, you know, 5-5 or 5-6, you are likely working 100 hours a week. I set you up to burn out and because I didn't label the impact of the system or that process policy, you don't understand why. And because of the system of our field or of our profession, what happens in interviews a lot is when now it's the first question, the first thing I bring up, which is RBCBAs do direct. How does that feel for you? Nine and a half out of 10, they say, I don't do RBT work. And I say, let's, I want to pause. It's not our BT work. It's direct work. I've been a BCBA since 2009. I've always done direct. I do direct now. It's an important part of patient care. I like the kids. It's also reinforcing PS. ⁓ so I think if we're not aligned on this piece, we probably are going to be misaligned on other things because I'm also going to want you to help clean and I'm going to want you to fill in and I'm going to want you to change the toilet paper if it needs change. these beliefs have come from the environment, like our system. And I think that this all contributes, right? So then they're in this situation where the clinician believes that from day one, I should be able to make ⁓ 100K plus from home, only doing X, Y, and Z. And you better not tell me any corrections on how I'm doing what I'm doing. We've created the monster. We're seeing folks who are saying, You know, I've been in a couple different places and I keep burning out. What's the pattern in these different places? Or hopefully people are doing that. I'm also seeing folks leaving the field, which is sad, but I burnt out in a previous job and like career. And that's how I sort of arrived here. So I understand how that happens. I think it's when, when you can look at what you're doing in that. What's contributing right? What are contributing to these to my stress? Or be really like we can really work to tease out. What are the functional relationships? How is this happening? And then that helps us to make choices The problem is and will be competing contingencies So folks love when I describe what we do at Del Mar they're like I'm in and then I say here's what our pay is and like ⁓ That's a lot less than what? such and such as offering me. I'm seeing more BCBA direct companies. mean, we've moved to that in a lot of ways. ⁓ So BCBA is identifying that one of the things burning them out is this constant churn of new RBT's and that's not an RBT issue, right? I mean, there's the same system that went through a positive. Like people are starting to identify this and are starting to say, you know what? I'll take less. ⁓ income in my salary in order to have this, which tells me people are starting to notice the contributors. speaker-2: We're seeing it more not in the beginning of the process, but ⁓ no, like here we are, there's a problem. How do we fix this, right? speaker-1: Yeah, I mean, I don't know a couple months ago. I had an owner come to me and say how do I fix this? I had a BCBA. They got a job offer $150 an hour. That's true. I was like, what? There's no way you can fix that. Right. Like that's on fix. speaker-0: yours to fix. That's the important part when we care so much about our profession and what we do at the session as an owner, right? You've given your blood, sweat, tears and time. It feels like it's yours to fix, but it's not. I think of employees ⁓ as I'm leasing them. No one's gonna stay with me forever. They're going to leave, partially because I live in a military town. So I actually have an entirely new census, kids and staff. every two and a half years as a business. And it's always been that way. And my first partner was a Marine who died. And this is the population I choose to support. It's a value. So I knew that going into it, was going to be hard, you know, that that was going to be something. So I had to expect that part of our system, not like our professional system is that when everywhere is hiring and you can get a job anywhere, it makes it Right. It reinforces the job changing, which led to the retraining of our BTs, which leads to the BCB. Right. This all connects. Plus, ⁓ when there's so much variability, people can go to different places and we're not uniformly even applying the science. So even if I understand DRO. with April and then I go to Steven and he's doing it differently, right? It's this variability, the inconsistency across our field is really what's biting us in the behind over and over again. speaker-1: So I have to direct, like, I could talk to you forever. But so there is like this underlying truth that I get to with almost all business owners. And the truth is if I don't do it, nobody else will. And yeah, I mean, kinda, right? Like you are ultimately responsible for this thing that you've created. And so that seems to be a really hard thing to give up, right? I can't give up billing. because if I don't do it, is somebody else gonna do it wrong? Or if I don't do the hiring, I'm not gonna be able to do it. Do know what I mean? And so like, do you have any suggestions on how to break that? speaker-0: So I think the first part is about ⁓ acknowledging their experience. So I have had two billers that almost put me out of business for their performance. And both of them speak at conferences. These are well-known people, right? ⁓ And the reason I say that is because we have to come... speaker-2: 100 % speaker-0: that thought it's about reality testing. you telling me that that's not true. I don't hear anything else you say because that actually is true and was my experience. That actually happened to the person. Then we want to say, yes, I see why you feel that way here. That did happen. Here are your choices. You're either going to continue to do billing then or you're going to speaker-2: history. speaker-0: come up with ways to find an increased likelihood that the next person doesn't do that. But if you're choosing to continue to do billing, then you have to start saying it that way. I'm choosing to continue to do billing because that is a choice. maybe you like billing. Like there's been periods in my life when I've enjoyed billing because I'm starting and finishing something and every other thing as a owner is. ⁓ open and hanging and as a never-deferred task completion is a high-value reinforcer. So now I will do laminate, like I'll make materials sometimes because I just need to start and finish something. But I had to be able to see why am I doing this other task. It is providing something for me. And the owners you're talking about, Stephen, what if, my guess, I would always be curious because I'm not them. My thought would be it provides reassurance that the billing is done correctly. So that's what they don't want to give up. So really it's about when you hire the next person. Part of the onboarding is every week at the end of the week, you want an update of where things are. So it's never going to get so far away from you that you can't catch up. Then the reality testing becomes, yes, I got screwed before and I've taken steps to do it differently this time. So it can't happen that way again. And that's not a feeling. That's my system. That's my process. speaker-2: that. speaker-1: Yeah, and that's the thing having like a putting in a system that you can trust right and you can also be aware that systems are gonna break just like you said like hey this system worked for two years and now all of a sudden it doesn't work why not right but then being able to figure that out bring in the experts and and and fix it from that point forward but then I just have one more question and then if you have it I'm just curious about your thoughts on AI right and Cause again, this is a concern of mine is I think the average experience level of a BCBA in the field right now is around three years. It may be a little bit more, but maybe less now. I think it's less. And, and so you're putting in their hands the entire knowledge of ABA, right? And, and maybe they haven't earned it yet. Right. And, and so like, You know, you were saying before, right? Like we're giving these 100K, 120K, $150 an hour salaries to brand new BCBAs, but then they have GPT in their pocket and they're able to look these answers up and do these things that is 100 % outside of their scope. speaker-2: have the discretion to know if they're speaker-0: harass speaker-1: Right. Yeah. And so I just curious. speaker-0: So I don't pay people 150 an hour and I don't start them at 150 K a year. We start people low and then they earn ideally over the first year. They should be getting six raises to get up to what our actual BCBA salary is because it's competency based. Everybody tells me at interview that they know how to do that. And I have consistently seen maybe you, you know it at the level that you think is adequate. That is not near my and my, you know, up in the ethers expectations, like some expectations that I've worked to realistically, you know, define. I can't give it. I'm not. You remember cash on delivery, CODs? I don't know how old you guys are. I'm 44. So CODs were a thing. was like, you can pay for this or cash on delivery. People were out here fronting like selling drugs. Like I'm going to front you this. washer dry, I'm going to front you this ounce of marijuana, right? Whatever it is. And then I'm going to expect you to bring the money back. We can't do that. We just can't operate that way anymore. So I need to see you demonstrate these things and then I can give you more. Otherwise, I'm constantly pulling the reins back. Like I had told you when I sort of had to let two thirds of this or chose to let two thirds of the staff go because it was such a big shift that I think that's part of this system. So if we aren't just giving people stuff, non-contingently, which we know does not change behavior, ⁓ then we wouldn't have quite as much of the reliance on AI because I think folks use that to close the gap between what they know and what you expect them to know. I want to close that gap because I can make sure you get it, you know, accurately, concretely, you know, in the ways that I think you need. But I'm also sending you the message then you're not. speaker-1: Yes. speaker-0: independent, like I care about you, you're important, you're exactly where you're supposed to be, you still have stuff to learn. And I'm actively teaching that to you as part of our mentorship program, which is, you know, every report gets reviewed, every, you know, programming stuff gets reviewed. And so when there's adequate human support, you don't need this AI support that I think is being used as a like a shortcut, which is okay for some stuff, but we're talking about humans. This is another shot. I picked psychology because I experienced trauma ⁓ more than one early on and most of it was not intentional. It was well-informed clinicians providing me care at a residential treatment facility that was abuse and its impact over intent. I don't care that you don't think you're hurting, you're not intending to hurt anyone using chat GPT. You are doing harm by having a position that you don't know. the job, how to do what's being asked of you. And I'm not saying that's your fault 100 % of the time. I am saying it is 100 % each of our responsibility to not do harm. And so if you're being asked to do stuff you don't know how to do, it might mean it's not a great fit position. And then we want you to ask for help, but then we're kind of back to this. But then you're going to have to take a pay cut and you're going to to, and you're going to get feedback that maybe you don't know everything yet. And all of these things are uncomfortable. And so how do we tolerate the discomfort? speaker-2: I want to switch back really quick to the AI conversation about skill set, skill deficits and whatnot, also time, and like, you got to get it out, got to get it faster. ⁓ okay. So these treatment plans are taking you 15 hours to complete. These assessments are taking you 15 hours. Well, I need you to get it done in three or you can only bill for X amount of hours. speaker-0: Uh-uh. upstream. That means the issue started systemically in our field work, which is that people are signing off on ours without making sure that folks are getting to fluency and competency. This is our profession doing it to ourselves again. ⁓ speaker-2: But it's also the system because of the financial piece of it. Right. Because that's of my big soap boxes is like, you have to train your staff, you have to support your staff. And then talking about what that looks like, which means that you're going to need to have the money in your business to provide said training because it's not all billable. You're barely going to hit the surface. speaker-1: Yes speaker-2: providing the training and the support within those billables. I'm not saying you can't, but you're very limited, right? So it's also like just kind of feeding that whole mentality of you got to get it done quicker, you got to get it done quicker, you got to get more done. ⁓ And it's okay, like if you don't know how to do it, just get it done the best you can. I I've reviewed many treatment plans where, you know, just like across multiple, I'm going to be careful here, but across multiple learners. speaker-0: Ugh. speaker-2: I was like, hold on a minute, did I just read this treatment plan? ⁓ no, the name's different. And then really question, right? Had a lot of questions of like, why are these two treatment plans almost identical? I'm pretty sure that there's a lot of differences in these two humans. So that's a whole nother story. speaker-0: But that's still part of our upstream system, right? I took the job where I have too big of a caseload because I have all this five, five and five, six. So I have to write these reports that still take me 15 hours because no one made sure that I knew that before because I was getting feedback. I was getting no feedback, which I interpreted to mean I was doing a good job when in reality somebody just wasn't actually reviewing it. And now you're giving me competing information saying it's not good. Well, you're the problem because confirmation bias is a real thing. You know what mean? Like it's understandable. These cognitive traps. I think what's hard for me is that, ⁓ hard's not the right word. What's a, I don't know the right word. I guess it's emotional marbling, right? I'm feeling a lot of feelings about it is we know this though. We teach folks these exact things. We teach how to do case conceptualization. We're teaching about functionally equivalent alternatives. We're teaching about schedules of reinforcement. We are teaching about behavior change. And the things that we're doing are actively contributing to the exact things we don't want to see. think our and it's it's not a BCBA fault or a PE fault or an owner fault or a it's a it's it all is this constellation that comes together. when everyone continues to do the same thing, it's not going to change. ⁓ But we are uniquely trained to be able to break these. complex behavior chains down into the contributors. speaker-1: Yeah, and I think like, you know, I hope that it goes that way, right? I hope that people are more open and and but my my concern about AI is that it's just going to it's like like programmers, right? Well, we need it. We used to need 20 programmers to do this and now I need to. And so all it it's done is eliminate human jobs and it's increased the productivity. So. You used to take you 10 hours to do a treatment plan. Well, now I expect you to do 17 in that same amount of time. and, and, and so it's very, it, if we're relying, yeah, that the, and then the incentive structure, right. Because all of these practice management softwares are adding AI, which I think in certain scenarios, it is helpful. But, you know, my, when I put my tin foil hat on, right. speaker-2: could be a tool you when you speaker-1: If their AI system is helping the BCBA come up with the amount of hours that is required for this child, every incentive for them is to say, you know what, if we program the AI this way, we can get them to do 10 % more hours. And that means we make up on the back end, we make more revenue because we're now every one of our BCBAs within our system is increasing their hours. So, and because of the lack of experience, and the increased push for billables, it's like, okay, I guess, yeah, that makes sense to me, right? And there's no pushback because we don't know it. speaker-0: We're seeing the change that we're seeing these OIG reports. We have handed the payers the data that they are now using to decrease benefits, to cut benefits, to reduce any telehealth service provision. ⁓ it's similar has happened in behavioral health, like traditional talk, like psychotherapy with programs like Headspace and the text stuff, because people used AI and did not see a difference between what humans did and what the AI did, or humans were using so much AI, however this came to me, then reimbursement rates tanked because why would I pay you more when a computer can do it? And we're living it in behavior analysis. again, we've, like, we've, contributed. So I think you're right. And we're seeing that shift. Tricare was one of the first to or DHA to cover ⁓ ABA for kids with autism in the early 2000s. And so what we've seen over the years is that what Tricare, everybody was villainizing Tricare and it's, are they a challenge? Sure. But ⁓ I understand why. And others are going to start doing it too. And Tricare has gotten more and more restrictive. And we're seeing, just yesterday there was a vote in North Carolina about our Medicaid that is gonna be a significant change. And it was, it did go through. ⁓ And that's exactly right. We are gonna see, I've been telling folks, there's gonna be a lot of people with four letters after their name and no job, unfortunately. And I don't mean that in a funny way. It's actually very sad, because I think our science is powerful and we can do a lot of good and God knows there's a lot of need out there. But I don't know that we're, equipped to use it yet in the way that is the full power of what we could do. And I agree with you that we're going to start seeing much more manualized, not manual, like automated systems specifically for the BCBA. Because let's be clear about whose role is not going to be done by AI. So I'm going be the technician. So the 9153, the direct work is not what's going to be taken over by AI. It's going to be me who's sitting. next to the RBT or who's doing parent training. It's going to be reported parent modules. That's significantly less expensive. And that's now a missed CPT code, right? A missed opportunity for me. It's going to be report 97151. Maybe they'll put the kids in front of a computer and that'll like, keep working. I'm going to say it anyway. So I disabled the AI on all of our EHRs and practice management and data collection. And I do not permit using their report functions. writing is a like, am vehemently like that professional writing is part of communication. Communication skills are critical for your success as a human because we are humaning with other humans. If I can't let you not develop that skill. speaker-2: There's research now, right, that's showing that potentially, like, it decreases your IQ. speaker-1: potentially yes the more you use chat GPT the lower your IQ is and it makes perfect sense because I like I had to stop using chat GPT for emails because like I am just being I would I would forget I even wrote it I be like I didn't yeah you're right like right I didn't write it and and so I I didn't even remember sending that email so like it it obviously yeah I mean speaker-2: using this I didn't write it. speaker-1: I know that there could be some things that it's potentially good at. I don't think we have a choice, right? It's almost like Google, right? Like it's, it is here. It's here. speaker-0: We get to decide right so we get I get to decide how it's used in my organization for some people that's enough for them to say No, I that's right. Okay, that's your choice You know, I get to decide how I use chat GPT because I I use it for so like I think I probably use it more like ⁓ Expanded Google search which I'm sure is in a certain but that's so far what I kind of use it for it It can be helpful. I think there's very few things that are all good or all bad. It's under one conditions does this fit for me at this time. speaker-1: Right, yeah, I just like with the power that a BCBA has and you're putting this through AI, like you are creating your replacement, right? Like you are creating your replacement. And I can't remember who came on the podcast and told us, maybe it was Dr. Cox, but they put treatment plans done by AI and treatment plans done by BCBA. And then they had BCBAs review them and say which one was done by AI and which one was done by BCBA. And it was very difficult to... It was almost almost, I think that there was still, it was still noticeable-ish. But it was almost indistinguishable, right? And that, yeah, like you said, like they're not coming after the text job. speaker-2: They said it was like, yeah speaker-0: the first step in a change process is accurately labeling your snag. And I think, ⁓ you know, like, how can we start doing what we know needs done? I think that's the precipice we're on, right? It's like, here's all these things that we need. What's that first step going to look like for each person? And that that will have an impact on the profession, because a profession is made up of humans. So as humans change, the profession changes and we each get to be a contributor to whether that goes in the way that we feel good about or in a way that we don't feel good about because we all have power in the now that's that mindfulness, right? How things were yesterday, yesterday doesn't exist, neither does tomorrow. So thinking about spending our time here in our head in those time zones isn't helpful. Present now in this interaction, am I showing up with you all the way that I want? If not, let me change it. If I am, keep going. speaker-1: the time check that you recommend doing for the week. It's a 24 hour time check, right? So if I have like a panic attack at two in the morning, I open my computer and do some work. need like. speaker-0: So you get to decide how you do it. For me, I do want that much data because what I've, I hate work-life balance. I think it's a terrible phrase. makes it sound equal, is part of the problem, right? Language matters. So it's about integration. And so I am an integrated, holistic human, no matter where I am. Some work weeks, work needs more. And some work weeks, home needs more. I need to be, success is determined by my ability to integrate. and flex based on need, which PS is also what we ask our kids to do. So, a parallel process. But when I'm doing that, I want all the data because when stuff doesn't get done during the work day and it's a work task, it doesn't disappear. do it at home. really what is my work day? How much am I working to include? How often am I checking emails when I'm outside of work? For me, that actually was a... something I was doing a lot. And it's because I think like the owner you mentioned, it was giving me reassurance that things were okay. Yes. When there were no emails in there, but then I felt tethered to my email. So I do batching and I check it once in the evening and that's it. And it's much easier to do because I've learned how to reassure myself. Right. So I would say do all the data, you know, do all the time just so that if you're going to do something, do it, do it the whole way. But. Sure. But I also acknowledge that when someone's feeling really burned out, what they're saying is, I can't do one more thing. so don't let the two o'clock panic attack stop you from doing the time study because that's too much. So get in where you can't start, where you can, if you can do it for a day, that will be a good start. And it might build momentum. But again, that's that. burnout and that's self-care piece, right? When people say they're burned out and we say, well, you need to take a day off, you need a vacation, you need to get more sleep. Well, now we've just victim blame, not the victim, but we've like just blamed like you didn't do something when it's a systemic breakdown. speaker-1: Yeah, you need to do more, right? Essentially. yeah, yeah, it's, it's, yeah, it sucks. speaker-2: Okay, well, we want to respect your time and we want to respect the time of those listening. mean, I could just sit here and take all of this in. I love learning. I love learning, you know, even when I come into something thinking, ⁓ I already know about this. I love being able to be curious and open and seeing someone else's perspective. So my ask for those of you who are listening today, maybe. ⁓ I know you've already heard this podcast, but maybe rewatch it, like, re-listen and think about it, like, maybe step back and be open to taking in a different perspective or just being curious about how your own self plays into some of these things. speaker-1: And if a business owner hears this and says, I need to talk to Becca, like, is that something that you offer? ⁓ Consulting mentorship? Is that something that. speaker-0: Yeah, I do. ⁓ If there's availability, That's what you're saying. No, it's hard and important. Open about what I believe that's part of my self-care. ⁓ And so it allows people to opt in or out as early as possible. And I'm okay with both. So I don't always have the ⁓ capacity for like an ongoing relationship, but it is something that I do ⁓ a good bit of. I enjoy because it's ⁓ been there. It's hard. speaker-1: It's hard. Yeah. Yeah. Yeah. Yeah. And it's lonely, right? It can be lonely and very difficult. Yeah. Yeah. So speaker-2: Well, so on that note, I will remind listeners of our support group. It is completely free. There are strings attached and we chose Discord just because that was the way we were able to provide it to you at no cost and be able to access it. ⁓ And so if you are interested in joining that support group, just the link is in the show notes and you can go, you'll fill out a little, little, not application, a little. speaker-1: Yeah, a far. speaker-2: And then our amazing ⁓ coordinator, Melanie, will reach out to you and help you to get that all set up. And then like I mentioned earlier, if you have any comments, questions, stories, ⁓ if you disagree with us, anything that you want to chat with us about, just ⁓ call the podcast hotline and that number is also in the show notes. And then we'll also link how you can reach Dr. Becca Tagg. We'll put all of that in there as well. So thank you so much, truly, for spending time with us today. I really appreciate it. All right. Well, thank you so very much. And we'll see you all next week. Thanks for joining us on ABA Business Leaders. speaker-0: appreciate it. I appreciate it too. ⁓ speaker-1: See ya. We provide mentorship, courses, handbooks, billing support, credentialing, HIPAA support, web design, and more. Everything you need to build an ethical and sustainable ABA practice. speaker-2: You can find all of our resources at 3pi2.com speaker-1: Don't forget to subscribe and share this podcast with other ABA business owners. speaker-2: We'll see you next time and remember you don't have to build your practice alone.