The Lessons I Should Have Learned
As a young graduate student in behavior analysis, I worked as an intern at a large institutional setting to gain experience. Some of these types of settings were incredibly low quality by modern day standards—actually, by any standards. I didn’t know that at the time, as I had no experience working with individuals with developmental disabilities. The clients were diagnosed with numerous types of disabilities ranging from very mild to very severe, both psychiatric and developmental. I got immediate experience with a very large number of different types of diagnoses.
My first assignment was to run the “reward room.” The institution was starting a new token economy. That meant that the teachers would provide the clients with tokens. When they earned enough tokens, they would trade them in and be taken to my room to enjoy the rewards for a few minutes.
I got there early on the first day to set up the reward room. I set up video games and I made sure that I knew how to work them. I had games and toys available. I had a large candy bowl of individually wrapped candies available. I didn’t receive any training. My only instruction was “just try to make sure the clients enjoy their few minutes in the ‘reward room.’ “
The first client came in with the teacher who was much bigger than me. The teacher told me how well he had done that morning, and then left me alone with the client. I enthusiastically greeted the client, but the very second the teacher leaves, he charged at me, knocked me over, and rushed immediately to the candy bowl. He started grabbing large handfuls of candy and shoving them all in his mouth with the wrappers still on. Panicked, I attempted to stop him from choking himself and called for help. The reward room only lasted a week or two at this institution, as it was clearly a poorly thought out plan.
I have often thought of this experience as a trial by fire. The extreme pressure and stress made me want to be successful and help people live better lives. Occasionally, I used to say you aren’t a real behavior analyst until you have an injury story. That is the culture in many places; sometimes you’re going to get hurt, it’s just part of the job. Although few people are likely to have a first experience as dramatic as I had, BCBAs are still making similar mistakes today. I hear all the time from staff that they were “thrown into difficult situations” with no training. Just like I was. I hear staff tell me about being in incredibly unsafe situations. Just like I was.
It took me longer than it should have to learn from these experiences. We should never let a staff person work with an individual if (a) They haven’t been trained to criterion on what do and (b) The working environment is not going to be safe for both the staff person and the client. That might seem obvious, but more than 25 years in the field have taught me that it definitely is not.