POOGI for ABA

I attended a presentation given by a famous behavior analyst, who spoke about an almost unbelievable success story. The child had extreme problem behavior that was very successfully treated. In addition, the child had learned many great language skills, social skills, and academic skills. The data were incredible. Yet, the parent was complaining. How could it possibly be that a program with this level of incredible success did not have a happy client? I think this problem is not uncommon. Why? What’s going on here?

If you go to a restaurant and get a great meal, excellent service, for a good price, you are likely to return. But what if after that one great experience, the meals were lousy? Eventually, you would get annoyed and stop returning, right?

Something about behavior analysis makes us think our services are different from any other service. I suspect it has something to do with the emotional energy put into the work. If you talk to many of us when a client is unhappy, we start to tell the story of the great success we have achieved with this client. That’s not going to work. We deliver a service, like any other. We are in the business of What Have You Done for Me Lately?

Can you imagine a restaurant fixating on their past service, while ignoring what’s happening in the present?

Customer: This meal is not what I ordered, it is cold, and there are bugs on the plate.

Restaurant Manager: Yes, I know we are having some trouble today, but remember when we gave you a great meal two years ago?

In many situations, once you have solved the client’s initial complaint, that is just the start. In most situations, after we solve one problem, there are usually lots of other problems that need to be addressed to help clients live rich, full, and meaningful lives. We are paid to solve problems.  As soon as you are not effectively solving problems, expect to have complaints.

One of the most frustrating things practitioners experience is when we spend the time to train a staff member or a parent to implement procedures, and the person simply doesn’t do it when we aren’t there.

“I don’t understand why they aren’t doing it! Don’t they care at all?”

Our first reaction is often to get angry, blame the staff person or the parent, and resort to name calling (e.g., they are just so lazy). Of course, as BCBAs we know this is foolish. There are a whole variety of reasons why the staff member or parent won’t implement your procedure. Maybe the person doesn’t fully understand. Maybe they don’t have the tools needed. Maybe they don’t realize they are doing it incorrectly. Lots of possibilities. Our first step should be to analyze the problem methodically. There are several ways of doing this. I like this one. But there are others that are fine too.

In my experience though, even behavior analysts that use a systematic tool to analyze this type of problem are likely to overlook one major cause of why parents or staff might ignore what you are training them to do. Could it be that your suggested procedure sucks? A procedure might be lousy because it isn’t producing effective behavior changes, or is simply impractical in a particular situation.

One of the most underrated skills in management is selecting the right behavior changes to focus on with your staff. If you are training someone to implement a behavior plan, it better be both practical and reducing the behavior problem significantly. If not, there is virtually no chance the person will continue doing it. The aversive natural consequences of dealing with the problem behavior will be impossible to ignore. Staff might even pretend that they are going to implement your plan, especially if they are afraid to tell you the truth.

There is a strong tendency to ignore the possibility that the plan stinks, and instead assume the staff or parent isn’t implementing due to laziness or inability. When someone isn’t performing to our expectations, we sometimes go down the rabbit hole of behavior modification. Did I set clear expectations? Did I give feedback on performance? Did I provide reinforcement for good behavior?  Sure, use your best performance management interventions. Just realize that it is not going to work if you don’t have a good plan in the first place. Often, that is the last thing we consider. In my view, it should be the first.

I was in a doctoral seminar with my friend Dave maybe twenty years ago or so. There was an uncomfortable discussion happening, and Dave was getting attacked. I was able to smooth things out a bit by saying something like “I think what Dave means to say…,” and happily the discussion went somewhere else. That night, a few of us were at dinner at my house, and Dave recounted the story of what happened. He ended it with “Barry is the most tactful person I know.” Well, my wife Cheryl nearly choked on her food, and couldn’t stop laughing for an absurd amount of time.

Dave and I moved to different parts of the country. But this became “a thing” around my house. Whenever I said something that was not tactful, I could always say “but I’m the most tactful person Dave knows.” Several years later, I met up with Dave at a conference and he, of course, doesn’t remember the story at all. So, when I tell it to him, he says, “I guess I didn’t know a lot of people back then.”

It is important to be careful with comparisons. Though I possessed enough tact to smooth over the argument at the seminar, clearly Cheryl believed there was room for Poogi. I think BCBAs fall into the comparison trap all the time. We might be doing much better than Program X, but that doesn’t mean we are doing well. In some organizations, when I have suggested things that would produce massive POOGI (very tactfully, of course), a BCBA is likely to say “It’s just not practical. Look, this is what we are able to do. This is dramatically better than he would have received if he was at X.”

The fact that our program might be better than a completely non-scientific, poorly run program is no excuse to have low standards. Low standards are bad for your clients, bad for the profession, and bad for your own mental health. The only way to POOGI is to be constantly looking at what can be improved, not being satisfied that you are “the most tactful person Dave knows,” or that you are better than that absurd non-science-based programs offered somewhere else. Avoid comparing yourself to low performers. Set high standards.