Frequently Asked Questions
Behavioral health services can look a lot of different ways. Overall behavioral health takes a systems approach by looking at behaviors, the environment where they happen, the intent behind the behavior, and what is contributing to a continued pattern of behavior.
Some behavioral health services look like an intensive program where challenging behaviors are decreased through weekly sessions. Some just focus on communication or a specific area like toileting. The least intensive service is a bi-weekly consultation with caregivers to support behavioral health. The intensity of services will be based on a thorough assessment and the family’s availability for services.
ABA stands for Applied Behavior Analysis. It is a specific type of evidence-based therapy that aims to define and shape behaviors. This is done by looking at what comes before the behavior (antecedents) and what comes after the behavior (consequences). ABA uses data collection methods to track behaviors over time. Behaviors are identified, defined, and broken down into smaller steps that are specific to the learner. The overall goal of ABA is for the learner to be as independent as possible in the areas of communication, social skills, and daily living skills.
ABA is a science of behavior. Every living thing behaves and responds to their environment. At Bridging Worlds we believe that ABA is for everyone but it is seen as a medically necessary treatment for people with behavioral challenges and a diagnosis. Sometimes the accessibility of ABA therapy comes down to funding and insurance, how an insurance company will define treatment and who they will support. Bridging Worlds serves a diverse population, not just people with autism.
ABA has been harmful and traumatizing for a lot of autistic and developmentally disabled people, especially those who have been in an intensive program where compliance was the focus. Some examples of compliance programs that can be harmful include goals for forced eye contact or not letting the client leave the table (escape extinction). Programs, where forced physical contact is used in hand-over-hand prompting, do not allow for bodily autonomy and dignity for the client.
Bridging Worlds acknowledges that this is a very real experience for many of the people who have participated in ABA programs. It is a valid concern for families and caregivers. We want to amplify those voices. We aim to design ABA treatment plans that have heart. We care deeply about all of our clients and would never want them to feel badly for being the way they are. We use methods that feel good to our clients and build rapport and trust. We believe in the hippocratic oath and our intent is to do no harm to our clients. We seek to embody unconditional positive regard and even unconditional love for the individuals and families we serve.
We take a stand against any ABA that does harm. We speak out against it whenever we see it and we educate others to strive to make empathy a core aspect of all ABA interventions in the future. We believe that in many ways traditional ABA has lost its heart and soul as has much of our society. We believe in instilling heart and soul into everything we do as a company and as individuals in this world.
Heart-Centered ABA is different from a traditional ABA program because we infuse the programs with heart and soul. We care deeply about each family and client we serve. We work holistically with the whole family system. Bridging Worlds uses deep communication and empathy to amplify the client’s potential.
The traditional approach focuses on deficits. While BW uses the best of the traditional ABA practices, we believe that fostering a heart-centered connection is the most important part. Connection precedes all communication. Connection is the literal bridge that bridges worlds. When our connection is strong, then we are able to truly bridge worlds.
Heart-Centered ABA is developed through unique core values. Bridging Worlds fosters a learning environment and assumes that we are all here to learn from each other. In traditional ABA, a behavior technician will teach the client and caregivers. There is a hierarchy within the relationship. In Heart-Centered ABA, everyone is malleable and learning, evolving together. The tutor, consultant, and BCBA are all learners as much as we are teachers. Our clients and families are teachers as much as they are learners.
Bridging Worlds values connection and collaboration. If it doesn’t work for the client and family, then it doesn’t work. Empathy lays the foundation for deep communication to help work through the necessary problems we face in a family system. We value acceptance, meaning that we accept our clients and families exactly as they are. Lastly, BW values integrity so that our actions come from a whole and loving place.
Treatment will look different for every client depending on their age, skill level and specific needs. An initial assessment is done by a behavior consultant. The assessment will include the hours recommended, the goals that will be worked on across the next 6 months and relevant personal information.
A tutor is matched with the client. The tutor comes into the client’s home, creates a rich and fun learning environment, follows the client’s lead and incorporates the goals during activities and daily routines. The tutor also takes data on the goals to make sure that treatment is resulting in meaningful outcomes. Treatment can be as short-term as 6 months or it can remain in place for years, depending on the needs of the client. Home sessions tend to be between 2 and 4 hours. They can happen a few times a week or every day of the week, again depending on the individual’s need.
In collaboration with caregivers, a behavior consultant will determine how many hours per week it will take to best address all of the client’s needs. Based on the assessment, the consultant will make a recommendation. A more intensive program, for example, where a client does not have a consistent way to communicate might have 20-40 hours of treatment every week. Bridging Worlds will work with every family to make sure the client gets enough hours to make meaningful progress but without pushing hours, overwhelming the family, or leading to burnout for the client.
Tutors will be reliable, respectful of the client, empathetic, and friendly. They will meet the family where they are at and enter the home with a loving open heart.
Tutors are trained in a number of areas upon hire that includes a foundational understanding of ABA, ABA techniques, education about developmental disabilities, and professionalism. When tutors are first introduced to the family, they enter a phase of treatment that is referred to as pairing. Pairing means that the tutor pairs themselves with fun and engaging activities and gets to know the client and the family culture. This is also a time when the family is able to determine if the tutor is a good fit. After the pairing phase, goals are introduced and incorporated throughout the session.
In traditional ABA, tutors are referred to as behavior technicians but Bridging Worlds has not adopted this language because it implies that the individuals we work with are machines to be fixed or worked on. They are not! They are brilliant, unique human beings. We accept our clients as they are and tutors are there to connect and support, not fix.
We are collaborative in everything we do. There are nearly an infinite number of ways to address any behavioral challenge. We find the best approach that works for the whole family and team in the service of the client. Every treatment plan is put in place, implemented, and monitored by a team.
The team includes a Board Certified Behavior Analyst (BCBA), a Behavioral Consultant, the tutor, all family members, and the client. Behavior Analysts and Behavior Consultants will do the initial assessment. They are trained in identifying the needs of the client, the potential for the family to support the client, the amount of time that will be needed for the goals, and the communicative intent behind behaviors.