A Day In the Life of an In-Home BCBA
A Day In the Life of an In-Home BCBA
Kristen Rollman
Although Board Certified Behavior Analysts can hold many roles, quite a few BCBAs begin their career by providing in-home services. For many, these roles are contract roles that consist of separate rates for travel time, billable hours, and non-billable time. In some companies, BCBAs only supervise Registered Behavior Technicians (RBTs), while with others the behavior analyst may be supervising Therapeutic Support Staff (TSS), behavior technicians, or even consulting directly with teachers and parents to train those individuals in implementation of an intervention plan.
In general, having a set schedule- with the ability to modify sessions- is incredibly helpful in organizing the day. While many professionals may value the 9-5 daily schedule, working in homes often means that BCBAs- and the staff they are supervising- are working early or late hours on a regular basis. Most agencies have a schedule protocol in place, and BCBAs should be sure to log their sessions on a calendar that can be viewed by offsite support staff as well, in case of any emergencies. Considering that most RBTs require about 8 hours per month of supervision, plan to rotate and see each RBT for at least 2 hours per week. Depending on client scripted hours, sessions may need to be longer, or staggered, to see multiple RBTs working with the same client in a given week.
Morning
Typically, in the morning, sessions are scheduled for early intervention clients, school consultations, or, infrequently, home sessions to support the home-to-school transition. When scheduling with your clients and their families, consider what time a client usually wakes up, and when the rest of the family may be available for a session.
Early Afternoon
This time-slot can be challenging, depending on the ages of clients. Younger children may be napping, while older clients may not be home from school yet for home sessions. Consider breaking for lunch during this time, taking a break to walk a local park, or browse a store to get in some movement. Additionally, this time can be a good opportunity to park in the shade, or stop by a coffee shop, and complete any additional documentation or writing needs. If you have a break in your work day, use it as an opportunity to take care of yourself!
Late Afternoon/Evening
Typically, these “afterschool” sessions are reserved for school-age students who may need support between arriving home from school and transitioning to home routines. These sessions may include compliance with homework expectations, leisure skills, safety skills, or support during dinner or bedtime routines. Again, bedtime sessions should be scheduled in a limited way to provide support, training, and to transition staff from the home prior to family time in the evening. If necessary, consider flexing the start time on the following morning so that if the BCBA or RBT works late on Tuesday night (i.e., until 9pm), that individual can start Wednesday morning a little later (i.e., 10am).
Overall, home services are an excellent way to provide direct support, supervision, and gain a wealth of experience as a Board Certified Behavior Analyst. BCBAs benefit from the experience of working other professionals and having a way to meet health, safety, and weather needs.
Tips for Success:
- Use a paper planner to plot out sessions, travel time, and any necessary breaks in the day. Record mileage on this paper planner so that it can be used as a log for taxes, as well as a record of travel time for timesheets or billing. Be sure to use coded client abbreviations, so that it could be provided in case of an audit, without disclosing privileged information. Paper may be more helpful than a phone app or web-based calendar, as reception may vary based on location and phone chargers can fail.
- Plan ahead for any lunch needs and pack a small cooler or lunch box to reduce expenses. A few water bottles and food that can weather the temperature (granola bars, applesauce pouches, or nuts) are always helpful in case a session runs long, traffic is unexpected, or there is an emergency.
- Keep an eye out for restaurants, big box stores, or nicer travel centers to stop at for lunch, bathroom breaks, and/or fuel fills-ups. These places can become a regular part of the routine on days clients in that area are seen.
- Consider a roadside assistance service, or review car insurance policies to see what is included. It can be helpful to have a number to call in case of an emergency.
- Pack a change of clothes, sweats, or scrubs to allow for any mishaps that may occur during a session. There are few situations as stressful as attempting to find a pair of back-up pants at a convenience store in between sessions.
- Maintain an appropriately open communication method with families and supervisees. For example, “On Tuesday I am traveling from across town, so if I am stuck in traffic, I will be sure to notify you. Would you prefer a call or a text?” If possible, group sessions geographically to limit travel time and the potential for traffic to disrupt schedules.
- Communicate with family members, or other caregivers, that the last 10-15 min of your session will likely be spent reviewing the session, finalizing documentation of the session, providing feedback to the supervisee, and collecting signatures from the caregiver for billing purposes. The more consistent this routine becomes, the easier it will be to transition from a session on time.
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