Latest / Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy / 424 | What's Wrong with Our Field? The Problem with ABA

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424 | What's Wrong with Our Field? The Problem with ABA · Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy

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  You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,
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  your source for centered and focused play therapy coaching.
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  Hi,
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  I'm Dr. Brenna Hicks,
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  The Kid Counselor.
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  This is the Play Therapy Podcast where you get
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  a master class in child-centered play therapy
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  and practical support and application for your
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  work with children and their families.
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  In today's episode,
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  we are
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  continuing with the What's Wrong with our Field series,
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  and we're gonna talk about ABA today.
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  And that's gonna be fun.
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  So we're gonna dive into that really shortly.
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  But I want to share a couple of things.
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  First of all,
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  I am just home from Colorado and Washington state.
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  And it was an absolutely incredible time.
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  And I just wanted to share a little
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  fun facts from the meetups that I did.
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  So I was able to do a meetup in Denver and then one in Seattle.
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  And it is so exciting to see
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  all over
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  the country.
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  CCPTs that love this work and love this model and love kids
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  and to sit
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  at a restaurant and hang out with
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  your people,
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  it's so encouraging and so refreshing.
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  I've gotten some follow-up emails just saying I feel invigorated again.
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  Thank you so much for
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  letting me be around other CCPTs.
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  I feel like,
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  you know,
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  I'm not alone.
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  I,
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  I feel very encouraged and supported.
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  That's what this is all about.
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  This work is not meant to be done in isolation
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  and
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  to be able to travel the country and meet up with other CCPTs,
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  it is one of my favorite things.
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  So,
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  to those of you all that came,
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  it was so great to hang out with you and some of you I'd never met before.
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  So it was great to meet those of you that I
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  was able to finally have a chance to be introduced to.
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  And,
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  you know,
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  I'll continue to do this when we travel.
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  This is the special component of being part of this field
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  and being a part of the child-centered play therapy world.
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  It's
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  big,
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  but it's small.
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  And so it was just so fun and I'm really excited that I was able to do it.
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  So,
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  I wanted to give you all a little update there
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  as we plan to travel more places.
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  I'll keep you updated with where we're going to do more meetups.
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  And
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  Speaking of community and being encouraged,
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  I do have a couple of spots left in
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  the upcoming coaching group that's starting this month.
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  So if you've been interested in training with me and coaching with me,
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  Play Therapy Professional program is open and I only have 2 spots left.
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  So,
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  if you've been waiting or thinking about it,
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  check the show notes.
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  You can schedule a discovery call with me,
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  and
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  I would love to have you in the group if you feel like you want to really master CCPT.
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  All right,
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  so let's talk about ABA.
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  Oh boy.
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  So,
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  I think it's important.
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  I talk about this in coaching a lot.
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  We do a whole week on this,
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  but when I was thinking about what are the
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  things that I consider to be problems in our field
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  and what are the things that are going on
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  that I think are concerning and or dangerous,
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  ABA was absolutely one of the things that popped into my head.
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  And so,
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  I know ABA is not part of child-centered play therapy.
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  But it is part of pediatric mental health.
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  And so in the broad scope,
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  this is part of our field.
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  And when you work with children,
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  you are inevitably faced with ABA.
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  And so I think that this is important.
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  I think I've done an episode on this before,
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  but
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  This is something that we have to be prepared to discuss.
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  We have to advocate.
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  We have to be able to speak intelligently about
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  what
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  needs to happen on behalf of kids.
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  I mean,
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  when we're advocating for kids,
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  ABA is not what we would advocate.
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  And so let's,
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  let's dive into this.
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  I'm going to hit some highlights because,
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  I mean,
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  I know that I've kind of talked about this on several other episodes before,
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  but
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  This is
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  what I consider to be the most egregious
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  problem
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  with
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  the way that
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  children on the spectrum
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  are treated.
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  So,
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  I'm gonna hit highlights,
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  high level view,
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  and then I want to talk about what alternatives are.
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  So,
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  first and foremost,
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  ABA in its origins,
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  if you go back and look at what it was originally designed and created to do.
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  It was to quote,
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  fix autistic children,
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  end quote.
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  In other words,
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  it was to make them normal.
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  So the entirety
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  of the premise of ABA.
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  Is to make an autistic kid not autistic anymore.
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  And that in and of itself,
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  granted,
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  this was back in the 60s,
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  OK.
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  So,
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  I mean,
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  we're talking about a totally different culture
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  and different world and different knowledge and,
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  and all of that stuff.
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  So,
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  we're,
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  we're talking decades ago.
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  ABA
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  was designed to
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  make.
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  Autistic kids normal and fix them.
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  That in and of itself.
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  Should give us an indication that it is no longer appropriate
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  because we understand so much more about autism now
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  and we understand that it's congenital
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  and
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  there's
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  no changing it.
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  The brain developed differently
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  and so the notion of making an autistic child normal
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  is
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  a fallacy
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  and it's wrong.
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  You,
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  you can't
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  take a neurodivergent child and say,
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  I'm going to make you neurotypical.
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  So the premise in and of itself is flawed.
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  And
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  if you look at
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  the approach
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  for ABA therapy,
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  It is
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  Corrective,
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  directive,
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  conditional,
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  achievement-based,
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  praise-oriented.
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  And it's intense
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  It's upwards of 40 hours a week.
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  And
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  that is too much for a child
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  in any
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  capacity.
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  That's too much for a child
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  in any circumstance.
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  40 hours a week
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  is
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  insane.
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  And
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  There's this expectation
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  that a child is going to comply.
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  And is going to get rewarded when they comply.
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  And it flies in the face of everything that we believe about children,
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  about honoring them,
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  respecting them,
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  what is age and developmentally appropriate for them?
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  How do we value them and unconditionally accept them?
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  How do we let them guide the process and trust them?
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  It's
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  the polar opposite
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  of CCPT in its nature.
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  And because
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  there are decades and decades of ABA.
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  We
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  are finally getting.
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  Data
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  and
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  articles and things that are getting published
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  about parents and children
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  that went through ABA
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  in the 70s and 80s and 90s.
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  Because think about it,
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  if its origins were in the 60s,
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  they wouldn't have technically had children
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  participating probably until the 70s.
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  And so we now have adult children.
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  That were a part of ABA in the early years of it
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  that are coming out and sharing their experiences and parents
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  of those children.
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  And
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  it's horrific,
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  the stories that they tell.
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  And
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  they're finally saying,
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  first of all,
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  it didn't help.
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  Second of all,
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  it was traumatic.
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  You know,
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  there are reports of parents
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  going down into the basement and turning the water
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  on and locking themselves in the downstairs bathroom so
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  they couldn't hear their kids scream for hours at
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  a time when the ABA therapist was there.
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  And you have kids talking about how traumatic it was and how defeating it was
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  and how awful it was and they still carry the pain that lingers
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  from ABA treatment when they were a child.
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  So we have all of this literature coming
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  out saying that the experience was negative.
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  And here's the irony,
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  y'all.
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  ABA is the most widely prescribed.
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  Intervention
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  for children on the spectrum still to this day.
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  The most widely prescribed.
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  You get diagnosed with,
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  with autism,
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  ABA is what you need.
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  It,
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  it,
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  they go hand in hand so quickly.
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  It's like a hand and a glove.
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  They're just one's supposed to be with the other.
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  And here's why.
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  ABA,
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  we,
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  we always follow the money,
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  y'all.
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  Always follow the money.
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  I hate to say it,
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  but it's true.
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  Follow the money.
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  Why is ABA the most widely prescribed?
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  Because it was the first one that was covered by insurance.
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  So,
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  is it most widely prescribed because it works?
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  No.
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  Is it most widely prescribed because it's been proven effective?
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  No.
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  Is it most widely prescribed because the experience is so
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  positive for the parents and the children?
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  No.
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  It's because it was the first
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  that insurance would cover.
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  Still remains largely the only one that insurance covers.
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  So therefore,
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  ABA is it.
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  And
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  If you dig into research.
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  It is not supported.
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  It is not empirically validated
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  that it is helpful.
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  If you actually look into
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  the evidence.
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  It says there is no statistically significant proof
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  that it is effective.
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  Why?
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  Because it was designed to fix kids.
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  So we have to stand on the front line of this fight.
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  And we have to say,
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  There are other options.
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  CCPT.
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  Is all the things ABA is not in the best ways.
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  CCPT is effective.
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  There are more and more and more studies coming out.
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  You want to talk about empirically validated studies.
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  We have all kinds of research coming out
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  how effective CCPT is with ASD now.
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  We've always anecdotally known it.
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  We've always experientially known it,
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  but now we have empirical support for it.
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  So we know
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  that a child's going to gain the 4 universal outcomes.
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  We know a child is going to
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  be able to be more regulated and
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  have higher self-esteem and have an expanded worldview
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  and
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  Have a greater emotional vocabulary.
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  We know
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  that these benefits
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  to children that are neurotypical or neurodivergent.
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  are expected.
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  We know that it honors the child's ability to speak or not speak,
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  to communicate or not communicate,
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  to express themselves or not or not.
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  There,
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  there's a tenderness and a gentleness
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  of neurodivergent children.
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  That CCPT respects that ABA does not.
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  And here's where
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  we kind of need to understand the,
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  the pain.
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  When a parent
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  is given
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  an ASD diagnosis for their child.
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  They're going to want to do everything they can
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  to
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  Help
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  There's a helplessness when your child is diagnosed with something
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  and you just are like,
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  OK,
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  well,
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  what do we need to do?
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  So there's an urgency
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  and there's this desire to make sure
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  that they're going to do everything they can.
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  So they're probably going to get them in speech,
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  they're probably gonna get them in OT,
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  they're probably gonna get them in ABA.
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  They're probably,
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  because they're gonna get referred for all these services
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  and they're just gonna say,
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  OK,
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  yes to all.
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  Well,
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  what ABA
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  promotes is we're gonna come into your home
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  and it's going to be a team effort.
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  So
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  you're going to be there for the sessions and you're
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  going to learn how to interact with your child.
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  And so there's parental involvement and CCPT does not do that.
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  And so often when a parent is desperate,
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  Especially if there are pretty major behavioral and emotional
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  issues at home.
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  A parent is desperate for support and help.
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  And so there's an allure
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  to have someone come in
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  and spend up to 40 hours a week with you.
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  And
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  I mean,
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  it becomes to a degree,
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  some childcare.
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  It becomes a coach in your home.
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  It becomes someone that can help you handle stuff.
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  And,
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  you know,
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  then other siblings and other parents and all that.
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  I mean,
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  everyone gets to be a part of this.
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  There's a draw to that.
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  Understandably,
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  If a parent is desperate for in-home support.
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  But we're trying to be
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  age appropriate and developmentally appropriate and
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  neurodivergent appropriate.
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  And
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  accepting and loving and honoring the child's pace and way.
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  CCPT obviously would be the therapeutic intervention,
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  but that doesn't necessarily involve parents.
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  DIR floor time.
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  is pretty adherent to CCPT principles.
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  It is not fully CCPT.
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  But it is pretty darn close.
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  And so if a parent is like,
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  oh my gosh,
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  I absolutely have to have
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  someone in the home helping us and supporting us and teaching us and showing us,
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  then we would recommend DIR floor time.
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  Because
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  there's a lot of crossover between CCPT
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  and DIR floor time.
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  So this is one of those moments where we stand up
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  and we advocate and we educate and we provide information.
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  And
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  a child cannot be an ABA and CCPT at the same time.
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  We draw a line there
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  because first of all they're going to be overtherapized to the nth degree,
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  and second of all,
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  it is.
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  Contraindicated to have a child in a child-centered play therapy approach
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  and then a directive ABA approach,
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  it's going to be so confusing and difficult for
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  the child to navigate that and the family too.
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  What the family's learning in the ABA therapy is going
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  to be completely counterproductive to what we're going to suggest
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  from the CCPT approach.
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  So,
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  the child cannot do both at the same time and obviously we're going to advocate,
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  let's do CCPT
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  and then let's determine if we still need or want to explore other options.
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  And so this is our moment
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  to help a parent understand that there are other options
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  because what they're going to be told is ABA,
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  but that is not the only one.
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  And
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  if you look at data,
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  it's not even proven.
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  So I would never want a parent to blindly move forward with a treatment.
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  Because
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  they were told to do it
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  without understanding
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  what that entails.
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  So this is where we provide resources and information.
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  And we say,
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  please be informed
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  before you make this decision.
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  I want you to have all the knowledge.
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  And
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  have those conversations.
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  They're important.
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  So I hope that that helps you.
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  Obviously,
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  this is stuff that's going to come up all the
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  time in our work with children and their families.
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  So,
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  we need to be knowledgeable about why ABA is not advised,
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  but also what we can offer as alternatives.
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  CCPT being the obvious one,
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  DIR floor time being one that would be in the home for support.
• 15:20
  I love y'all.
• 15:21
  Thanks for hanging out with me each week.
• 15:22
  We'll talk again soon.
• 15:24
  Bye.
• 15:25
  Thank you for listening to the Play Therapy Podcast with Dr. Brenna Hicks.
• 15:29
  For more episodes and resources,
• 15:31
  please go to www.playtherapypodcast.com.