Applied behavior analysis (ABA) organizations are beginning to understand and experience the benefits of including other disciplines within their service offerings. For example, they may want to offer speech therapy, occupational therapy, physical therapy, and/or mental health services in addition to their ABA service. According to CentralReach CanaryBI data, multi-disciplinary services have grown 56% since 2021, a trend that is projected to continue going forward. There has also been the reverse where organizations specializing in speech therapy, occupational therapy, physical therapy, or mental health want to offer ABA in addition to their primary service. Like any change in organizational structure, there are benefits, potential barriers, and administrative logistics to consider before making the leap.
Benefits for Clients
Individuals with disabilities often require multiple services (e.g., ABA, speech therapy, occupational therapy, physical therapy, etc.). This requires an enormous time commitment and places a significant financial burden on families. When learners are able to go to one location to receive multiple services, and the barrier of travel is removed, they are more likely to attend all scheduled appointments. If appointments are scheduled consecutively, therapists are given the opportunity to discuss and collaborate on common goals. In some cases, two therapists may be able to provide their service at the same time (i.e., co-treat). When therapists work under one roof, they are able to work together to provide the best possible treatment for the learner. A positive relationship between providers ensures families that therapy is a "team effort" and that everyone is on the same page and working towards the same goal- the learner’s success.
Benefits for the Organization
The benefits of expansion are mutual, for both the learner and the organization. Providing multiple services allows organizations to cast a wider net within their communities by treating more clients with different diagnoses. In return, organizations will see a significant increase in their revenue stream. Quality of care increases when multiple providers collaborate on common goals to meet the multiple needs of the learner. Working hand in hand allows multi-disciplinary providers to hold one another accountable for efficacy of intervention. When therapists have the opportunity to observe each other's practices, they can learn how the learner functions in different environments and what other providers are doing to support that individual. Further, they may be given the chance to provide co-treatment. For example, if a client presents with behavioral barriers preventing progress in one service, behavioral providers can support with behaviors while the other provider renders their own specialty service. This can ensure that all sessions are safe and productive.
Considerations and Administrative Logistics
Before adding lines of service to your organization's scope, it is important to evaluate for the feasibility of doing so. Here are some initial questions to consider:
- Where will services be rendered? Clinic, home, or both? Community?
- Is your physical adequate for adding more providers? If occupational and/or physical therapy is being considered, do you have a sensory gym and/or area large enough for the equipment they might need and the activities they need to perform?
- Will new providers require training on co-treatment with other disciplines? How will you cultivate a cohesive and integrated care culture within training and service provision?
- What are the supervision requirements for each new line?
- What type of financial commitment will this take to get this started? For example, do you need:
- More physical space?
- More equipment (e.g., tablets, protocols, platform swings, tables, chairs)?
- Advertising expenses (for both clients and providers)?
- How much of the organization’s time will it take to get new lines up and running?
Adding new services not only requires time, physical space and money, it also requires additional staff, as it brings on a significant administrative load, billing differences, and scheduling challenges. Some additional questions to consider:
- Will you require more administrative support staff (e.g., schedulers, administrative assistants, billers)?
- How will you handle credentialling new service line providers?
- What are the reimbursement rates for the new providers? Will you need to add funding sources?
- Is billing different for your new service lines? Does your current electronic health record (EHR) support your new disciplines?
- What kind of documentation will you need from your new providers (i.e., state and funding source requirements)?
Remember the old saying, “Rome was not built in a day.” Multi-disciplinary service delivery works best when time, care, and research is put into developing a team that works well together and whose primary goals is to meet the needs of the client as a cohesive and cooperative group. If you find that there are barriers stopping your organizations from adding services directly, we encourage you to reach out to other organizations within your community to partner together. For example, an ABA center may partner with a speech therapy company and invite the speech therapists to provide co-treatment in their ABA center. Over time, organizations may find that this method works best for them, but they may also continue to work towards their original goal of providing multiple services under their single organization.