Here is my experience with ABA: https://lifeoflieu.com/2022/01/22/i-was-part-of-the-good-aba/
Working in ABA was genuinely traumatic for me. Every night, I woke up in a sweat, nightmares plaguing me with how I was treated and my powerlessness. When I worked my next job, I had a hard time expressing myself because I was so scared of being hated for being autistic. I didn’t just burn out, I imploded.
To gain sanity with a situation where I was gaslit daily, I started speaking out. I never intended to become an advocate, but I naturally found myself in advocacy when I needed validation that what I was experiencing was as bad as I felt.
It’s incredible that it’s been a year since I left my job in ABA. So much has been accomplished in such little time. I’ve been able to tell my story to over a million people, have received letters from countless practitioners thanking me for helping them understand the problems in their field, and was able to get an autism diagnosis.
But the first-year traumaversary is always the worst. You start getting triggered over the most random things, nightmares rear their ugly head, and emotional flashbacks come in waves. So, to put that energy somewhere productive, I’ve come up with some takeaways from my experience.
While reflecting on this year, here’s a list of 5 things I learned about myself and ABA.
1. Don’t sign a contract that requires you to pay money if you quit.
When you want to work a job badly enough in a field you’re passionate about, it’s easy to overlook the warning signs. Seems obvious, and yet I still did it, so you could too. It indicates high turnover and locks you into the company. It’s the “don’t marry a man you just met” of the professional world.
Because ABA often hires young 18-22 yrs old fresh out of high school, many are inexperienced with the professional world. This leaves them vulnerable to exploitation from their companies and toxic power dynamics with their superiors.
I’d imagine my experience with this is also not uncommon. Companies that do this restrict their practitioners from leaving which leads to bad outcomes for everyone involved.
2. ABA is omnipresent and restricts access to services.
ABA is EVERYWHERE. It has dominated autism therapy. Even other therapies like occupational therapy and speech-language therapy are now using ABA. If you don’t want ABA, you’re out of luck in most places.
ABA shuts down valid critiques by dismissing them as “not understanding ABA” or having some vendetta against the science. It has portrayed itself as the “only cure to autism” to the point that other therapies are no longer available and shuts down the voices of the population it serves. I’m not the only one that believes this. Researchers have remarked that it’s “ideological warfare.”
Callahan et al. (2009) ran a study where they de-identified ABA and TEACCH (a therapy focused on working on the underlying elements of the behavior of autistic people) and showed that when they removed the labels ABA and TEACCH, people rated the treatment by their descriptions as equally effective. This finding was contrary to the “ABA is the only way” advocacy done by ABA professionals and parents. ABA advocates present non-behavioral interventions as not evidence-based, which is just false.
This attitude is pervasive among ABA professionals and parents. I remember ABA presented as a miracle cure for autism. This evidence supported changing problematic behaviors like self-harm and aggression while increasing communication.
It came as a shock to me later that there weren’t investigations into outcomes other than behavioral as far as what was considered successful. ABA was replacing other evidence-based practices and claiming it was the only one. It made all of these claims and yet didn’t educate its practitioners on fundamentals like communication, autism characteristics, and other therapies.
3. Unethical practice isn’t usually committed by “Unethical People.”
“It requires conducive social conditions, rather than monstrous people, to produce heinous deeds.” – Albert Bandura.
To sum up my experience, people that cared deeply about autistic children committed the unethical practices I witnessed. This care doesn’t excuse their actions, but it was astonishing to watch the step between having excellent intentions and doing horrible things. The two are much closer than is comfortable.
So, how does abuse happen? When you believe what you are doing has such profound consequences that you are saving another person, it’s easy to justify any “momentary discomfort.”
Discomfort is inevitable in life. What becomes necessary discomfort vs. unnecessary? It’s easy to see how someone might believe what they are doing is necessary discomfort when comparing it to the usual things we encounter in life. Particularly if that person is neurotypical, they may not fully grasp the physical pain experienced by sensory stimuli that they find as just annoying.
My supervisor wasn’t a monster. She was an overworked, underpaid practitioner who genuinely wanted to help the children she worked for and tried to study contemporary literature/practice. She was in a clinic run by a woman who viewed herself as saving her son with “severe autism” through ABA, which enabled the social conditions for anything to be justified in pursuit of a cure.
And that’s why my supervisor objected to me “calling her actions abuse.” In her mind, it wasn’t abuse. It was “allowing mom a moment of free time,” “keeping the child safe from extreme behaviors like self-harm,” and “teaching him to tolerate the sensory harshness of the real world.”
I want to emphasize that what she did was absolutely abuse. She tortured a kid for 20 mins to make them cry and laughed about his PTSD symptoms exhibited after. But, it’s understandable how she committed that unethical act despite her attempting to be an “ethical person.”
4. The BACB is one of the most ineffective ethical bodies.
The BACB has incredibly loose guidelines around ABA’s ethics, allowing almost anything to count as ethical. Most of the ethics focus on treatment fidelity, not on client dignity. And for them to investigate a case, you must come with documentation. They will not investigate themselves, only look over the evidence you present. It’s why I ended up not reporting.
They are also not overseen by any department. State to state, there are differences in how licenses are involved, but there is no overarching licensing body that is not tied to ABA. Unlike therapists, they are not required to report to a “state ABA licensing board”. And even in states that allow BCBAs to be grandfathered in as licensed practitioners, RBTs are often not.
And that’s not to mention they allow shock devices to be used with autistic people due to this loose ethical code like in the case of Judge Rotenberg Center. Shock devices. In 2022. This isn’t the “ancient” history of doing barbaric things to psych patients. This is modern history and not only legal, but ABA’s main ethical body also approves of it. If that’s considered an acceptable aversive, pretty much anything goes.
Carol Millman puts it well: “Only three subsections in the Behavior Analyst Certification Board’s professional code of ethics even address the wellbeing of the learner…The BACB says nothing about inflicting pain. There’s nothing in the BACB ethics code [that] says you can’t use electric shock. In fact, it doesn’t say anything at all about what type of ‘aversives’ are acceptable.”
I remember first learning about shock devices as a practitioner, and my gut reaction was, “well, our clinic doesn’t do that!”.
To practitioners reading this, listen closely. The problem is more extensive than shock devices (though that should be a red flag). The problem is that the governing ethics body allows the use of shock devices, which means that there’s a lot of unethical conduct that they also allow.
Just because you haven’t had the BACB contacted, or you have, and they deemed your actions ethical, does not mean that you are acting ethically. And that’s a poor standard for an ethics body.
5. Trust your gut.
Okay, this one seems obvious, but it’s easy to lose yourself at a job. Capitalism is a cruel master that conditions you to trust your boss and enforces a strict hierarchy. As an RBT, you are motivated to shut up and listen to your BCBA. This creates a culture of compliance. I’ve seen it now in other clinics and the one I worked at where BCBAs will try to use ABA on the RBTs they supervise. This is wildly inappropriate and not within their scope of practice. Not to mention is a massive break in consent.
Something deep inside you lets you know whether what you’re doing is moral. We’re all biased towards believing we are moral (and often ignore signs that we’re not), but if you’re questioning whether a decision you made is ethical, it’s a sign to take a step back and assess the situation. Get opinions outside your field, especially from the clientele you serve. Reach out to ethics hotlines and ask the internet. Find information from unbiased sources. And listen to your gut. If something feels off, it probably is.
I’m so grateful to be out. I’ve learned a lot from my experience, and I hope this can shed light on others’ situations so they don’t have to learn the lesson I did the hard way.
It’s funny how the most traumatizing experiences can fundamentally shape your life. I can thank my old clinic for that. It showed me I was autistic by ruthlessly punishing autistic expression and gave me a direction for the therapy career I’m pursuing. So thanks, I guess.