Professionalism

1. How to Demonstrate a Good Rapport with Caregivers

We work very closely with caregivers and patients. It is important to make sure that we work to build a positive and beneficial relationship with them.

Here are some actions you can take to demonstrate a good rapport with caregivers:

• Follow through with your commitments.
• Make sure not to promise things that you cannot deliver.

EXAMPLE

For instance, do not assure a caregiver that you will work on Sunday nights from 7-9 p.m. if you cannot guarantee your schedule.

• Make sure to refer caregivers to a Board Certified Behavior Analyst, or BCBA, when you do not know the answer to a question.

EXAMPLE

“I don’t know why we haven’t targeted the potty program yet. Perhaps you should speak to your BCBA.”

• Encourage caregivers to take up their complaints or concerns with their BCBA, not you.

EXAMPLE

“Thank you for trusting me with that information. Please make sure you speak with the BCBA about that.”

• Don’t complain about your co-workers to caregivers; it weakens the team.
• Should you have concerns about the company or policies, please direct these to your center or organization leadership and not patients’ families.

It is also important that you not discuss with caregivers how their child will do in treatment, as this can develop false expectations. It is not the place of a technician, regardless of experience level or patient knowledge, to discuss the patient’s prognosis. Refer all questions of this nature to the BCBA. Lastly, do not enter into discussions about patients that you have worked with who eventually “recovered” and what they were like.

It is important to build rapport with caregivers and families as we are modeling and teaching caregivers the important skills to work with their child.

Show a positive attitude with patients and their families, and keep the following in mind as you strive to develop a good rapport with them:

• Often our sessions do not go as well as we would like; however, our amazing days usually balance out the "okay" days.
• Make sure that your emotions about a situation do not overshadow the actual experience. Take a minute to gather yourself if needed before debriefing about a difficult session.
• You should always be truthful with caregivers, teachers, and other staff.
• You should choose your words carefully when presenting information as it is difficult for a parent to hear about a struggling child.
• You are considered a professional and are highly respected for the work that you do. Your work may be held in very high esteem, so make sure to think everything through before you speak.

think about it

Think about how you word statements when you speak to caregivers.

IN CONTEXT

Let's explore some examples of what to say (expressing a positive attitude) and what not to do (expressing a negative attitude) when you engage with caregivers.

Positive attitude: “Today was a little harder than most with Samine regarding her hitting behavior. I have brought it up with the BCBA, and they said we will make sure to address it with everyone at the clinic on Thursday.”

Negative attitude: “This is the worst day Samine has ever had with me. Did she get off her meds or something? She bruised my arm, and I think I will have to go home for the rest of the day.”

Positive attitude: “Social skills are challenging, and we’re working on building Falyn's skills to follow conversations and identify common interests. I can have the BCBA reach out about this program.”

Negative attitude: “Falyn just doesn’t understand social cues. She’s terrible at following conversations and doesn’t care if people are uninterested.”

---

2. How to Demonstrate a Good Rapport with Co-Workers, BCBAs, and Staff

In order to demonstrate a good rapport with the people you work with, make sure you adhere to your ABA therapy schedule:

• Be punctual; you should be settled in and ready to start at your scheduled time.
• Do not change or discuss schedules with patients; instead direct all scheduling questions or concerns to your BCBA.
• Give the maximum notice possible before canceling a session or shift.

These strategies will help you to maintain a good rapport with your co-workers:

• Do not criticize your co-workers; keep in mind that you are all working together toward the same goal, the patient’s success!
• Take up important problems that you have with your co-workers with your BCBA.

To that end, here are some helpful tips on how to demonstrate a good rapport with your BCBA:

• Try to have a good attitude. Sometimes the issues that we are discussing are heavy; however, keep in mind that we are all here to ensure our patients get the best treatment possible.
• Make sure to schedule regular appointments with your BCBA so that they can offer you guidance about your future employment, possible educational opportunities, and much more.
• Remember that your BCBA was once a technician too and they should understand where you are coming from.

Lastly, it is important to maintain an appropriate appearance at the office, in patient homes, in schools, etc., by following these guidelines:

• Abide by your organization’s dress code and policy.
• Dress so that you can comfortably play, be very active, bend over, sit on the ground, etc., without revealing anything inappropriately.
• You may need to wear long sleeves, remove jewelry, or tie your hair back for aggressive patients.
• Don’t wear anything that you would mind getting dirty.
• Review your organization’s employee handbook for dress code guidance. They often recommend wearing closed-toed shoes and not flip flops.

---

3. Aversive Stimuli

An aversive stimulus is an object or event that is unpleasant to the individual. This is something that, when presented, a person would want to avoid or escape (it is a negative reinforcement). It may also serve as a consequence designed to decrease a behavior in the future (punishment).

A stimulus is aversive if it is noxious, uncomfortable, painful, or if it evokes fear when presented. An aversive stimulus can be

• Physical: This includes corporal punishment, spanking, shock therapy, etc.
• Emotional: This refers to purposefully provoking negative emotions (sadness, fear, embarrassment, nervousness, etc.) by the presentation of certain stimuli.

big idea

We do not support using aversive stimuli to decrease behavior excesses.

Patients may find some learning items or activities to be aversive, in which case we should work to make these activities fun and exciting.

EXAMPLE

For instance, if a patient dislikes cleaning up, this would be considered as an aversive activity. Or, if a patient gets upset at the sight of a cup because caregivers have switched from using a bottle, or a patient screams when they see a toothbrush, these items serve as aversive stimuli.