Sometimes people quit.
In the world of ABA service providers, employee turnover seems to come with the territory. You have probably been there before, or maybe you are there now, in an environment where it feels like people are always on their way out. Look around your company, how many people are still there from when you started?
But not all turnover is bad. At a certain level, employee turnover is a healthy part of every business as it allows the company to bring in people with new skills, perspective, and energy. It also allows people who are not a good fit to find better opportunities, or for people to continue their education.
But more often than not, employee turnover is a big headache.
As a team member this is frustrating because often you have to take on the workload when someone leaves, and you may see frequent turnover harming the quality of your services. Your time may also be devoted to training new behavior therapists who then wind up leaving just months later. As an owner or director you see those same effects, plus the overall impact this has on the quality and reputation of your company, and the massive expenses this incurs.
So how much does turnover cost?
The dollar cost of turnover per employee varies widely, from as low as 15% to more than 200% of an employee’s annual salary. Based on this, the average behavior therapist (you may call them technicians, tutors, associates, or another title) turnover costs around $5,000 per person. The price increases as more resources are spent on talent search, recruitment, screening, on-boarding, training, time to become proficient, and service gaps from lost staff. This means BCBA turnover is likely many times more than that, reaching well into the tens of thousands of dollars.
This does not account for indirect costs, such as lowered morale, loss of knowledge (especially if someone is really good at working with a particular client), and loss of continuity in client programming.
You can imagine how these costs can quickly add up!
What is “normal” turnover?
Unfortunately, comprehensive data on the state of turnover at ABA treatment providers is hard to come by (if you know of any please let me know! I have been hunting!). In my experience, around 30% annual turnover is not uncommon, and I have heard numbers as high as 70%. Kazemi, Shapiro, and Kavner (2015) found research suggesting turnover in similar fields like, in residential facilities, was between 45% to 75%.
Now you can’t stop all of this turnover, nor would you really want to. Some people you may want to lose because they are low performers (although this begs the question – why are they low performers?), this is known as involuntary turnover. Voluntary turnover is when someone decides to leave, and it is this turnover which is most changeable.
Why do people quit?
It may indeed be tempting to say that turnover just comes with the territory for ABA service providers, as it can be a tough job. I remember the first time an (adult male) client grabbed my hair with all his strength and yanked – I seriously contemplated my decision to work in this field.
But as any behavior analyst will tell you – “let’s look at the data first”, and we are fortunate to now have some data for this conversation. Kazemi, Shapiro, and Kavner (2015) surveyed 96 behavior technicians from 19 different ABA service companies, asking them about their organization and their intentions/openness to quitting (a good predictor of actual quitting). They found that four variables predicted about 37% percent of people’s intention to quit:
- Training – satisfaction with both initial and ongoing training
- Supervision -satisfaction with the behavior of their individual supervisors
- Pay – satisfaction with their pay (interestingly enough, this was not associated with the actual amount they were paid. Some people paid above average were dissatisfied with their pay, while some paid below average were satisfied.)
- The Job –satisfaction with things like how the company is run, and the meaningfulness of their work.
Each of these variables points to on-the-job factors, that can be changed!
How you decrease turnover, and retain your best people?
High turnover does not have to come with the territory for ABA service providers. If we look at the four variables identified above, each of those has been successfully addressed within the subfield of ABA, known as Organizational Behavior Management (OBM). Here are some references and examples of how behavior analysis and OBM has improved each of these variables.
Training – Teaching people to engage in new behaviors is what behavior analysts do. One model that has been successful in ABA service providers is the Behavioral Skills Training (BST) model, that involves brief instruction, modeling, practice, and feedback (Parsons, Rollyson, & Reid, 2012; Reid & Parsons, 2000). Additionally, therapists (and BCBAs) should be trained to mastery, rather than given pre-set amount of training.
Supervision – The amount of OBM literature on how people can more effectively lead others is immense. In short, effective supervision means leaders provide effective antecedents and consequences to encourage therapist behavior. Task clarification, job aides, goal-setting, feedback, reinforcement, and adequate support are a few examples of OBM approaches to leading others (Brown, 1982; Daniels & Bailey, 2014; Daniels, 2000; Gilbert, 2007; Jacobs, 2013).
Pay – Pay can be a tricky area for ABA service providers, but better pay practices not just giving people more money. A behavior-analytic approach to make pay contingent on high performance, in a way that allows people greater control over their income. (Abernathy, 1996, 2011; Bucklin & Dickinson, 2001; Jenkins, Gupta, Mitra, & Shaw, 1998). Such systems are also shown to improve worker satisfaction as well.
Job– Sometimes behavior therapists quit because of frustration with the amount of friction they encounter in doing their job.The sub-field of OBM known as Behavioral Systems Analysis (BSA) examines ways in which organization-wide contingencies can be changed to improve how the job gets done(Diener, McGee, & Miguel, 2009; Rummler & Brache, 1995). For example, one study reduced turnover by 43%, just by changing the staff scheduling system to make the job more consistent for staff(Strouse, Carroll-Hernandez, Sherman, & Sheldon, 2004).
High turnover does not have to come with the territory for ABA treatment service providers. While you are never going to stop all turnover, the same behavior analysis that is so effective at improving client outcomes can be used to build a place people want to show up to and do their best. Looking specifically at how you can use behavior analysis to improve training, supervision, pay and the job can be a great start at slowing down the revolving door, and keeping the best people.
This article was originally published on the Bsci21.org blog on 01/04/2016
Abernathy, W. B. (1996). The sin of wages. Memphis, TN: PerfSys Press.
Abernathy, W. B. (2011). Pay for profit. Atlanta, GA: Performance Management Publications.
Brown, P. L. (1982). Managing behavior on the job. New York: John Wiley & Sons, Inc.
Bucklin, B. R., & Dickinson, A. M. (2001). Individual monetary incentives: A review of different types of arrangements between performance and pay. Journal of Organizational Behavior Management, 21(3), 45 – 137. http://doi.org/10.1300/J075v21n03_03
Daniels, A. C. (2000). Bringing out the best in people: How to apply the astonishing power of positive reinforcement. New York, NY: McGraw-Hill Companies.
Daniels, A. C., & Bailey, J. S. (2014). Performance Management: Changing behavior that drives organizational effectiveness (5th ed.). Atlanta, GA: Performance Management Publications.
Diener, L. H., McGee, H. M., & Miguel, C. F. (2009). An integrated approach for conducting a behavioral systems analysis. Journal of Organizational Behavior Management, 29(2), 108–135. http://doi.org/10.1080/01608060902874534
Gilbert, T. F. (2007). Human competence: Engineering worthy performance (Tribute Ed). San Francisco, CA: Pfeiffer.
Jacobs, S. (2013). The behavior breakthrough: Leading your organization to a new competitive advantage. Austin, TX: Greenleaf Book Group LLC.
Jenkins, G. D., Gupta, N., Mitra, A., & Shaw, J. D. (1998). Are financial incentives related to performance? A meta-analytic review of empirical research. Journal of Applied Psychology, 83(5), 777–787. http://doi.org/10.1037//0021-9010.83.5.777
Kazemi, E., Shapiro, M., & Kavner, A. (2015). Research in Autism Spectrum Disorders Predictors of intention to turnover in behavior technicians working with individuals with autism spectrum disorder, 17, 106–115.
Parsons, M. B., Rollyson, J. H., & Reid, D. H. (2012). Evidence-based staff training: A guide for practitioners. Behavior Analysis in Practice, 5(2), 2–11.
Reid, D. H., & Parsons, M. B. (2000). Organizational behavior management in human service settings. In J. Austin & J. E. Carr (Eds.), Handbook of Applied Behavior Analysis (pp. 275–294). Oakland, CA: Context Press.
Rummler, G. A., & Brache, A. P. (1995). Improving performance: How to manage the white space on the organization chart (2nd ed.). San Francisco, CA: Jossey-Bass Inc.
Strouse, M. C., Carroll-hernandez, T. A., Sherman, J. A., & Sheldon, J. B. (2004). Turning over turnover: The evaluation of a staff scheduling system in a community-based program for adults with developmental disabilities. Journal of Organizational Behavior Management, 23(2-3), 45–63. http://doi.org/10.1300/J075v23n02