Welcome back for part two of our series addressing employee turnover and engagement in ABA organizations. In part one, we asserted that high-performing organizations with low staff turnover rates tended to foster a performance-based culture. We focused on the organizational level of performance and shared four features of organizations that have helped leaders optimize employee engagement and establish a performance-based culture. These features included:

  • They have a clear purpose, including a well-defined mission, vision, and values statements.

  • Leaders are people-focused and utilize the science of human performance to help arrange conditions to support their people's optimal performance.

  • They invest in talent development and continuous performance improvement.

  • They have established a robust performance infrastructure and continue to provide capital for refinements, upgrades, and innovations.

As promised, we will now turn our attention to the individual/job-level of performance and describe what leaders and supervisors can do to promote and reward employee engagement in the individuals and teams they manage. To take full advantage of these strategies, it helps if you adjust the frame with which you view performance development from behavior to accomplishments. The accomplishment-based approach we use is called Performance Thinking®. In running our companies and consulting with others, we have found this approach beneficial in managing departments and teams and preparing people for certification, promotion, team effectiveness, or other goals. These factors, in turn, contribute to higher employee engagement and lower turnover rates.

Performance Thinking® Basics.

Performance Thinking® is an approach to analyzing and improving performance. It emerged from a field called Human Performance Technology (HPT) and emphasizes accomplishments (called work outputs), the valuable products of behavior. Additionally, it ensures that behavior learned and applied on the job is focused on work outputs that can be specified, measured, and contribute directly to business results.

 

This approach enables leaders, supervisors, and performance professionals to define and improve performance with two simple visual models: the Performance Chain and Six Boxes Model, and an easy-to-follow logic for thinking through performance challenges and opportunities. When organizations build a performance-based culture and adopt Performance Thinking® across their business, it helps:

  • Improve communication across functions and levels with a shared language about performance.

  • Increase collaboration for continuous improvement.

  • Accelerate results through the performance of people.

  • Create a culture that drives engagement by providing employees with a greater sense of purpose in their role.

Performance Thinking in Action.

The Performance Thinking® models help leaders and supervisors define performance in an actionable and measurable form and arrange conditions to develop and support desired performance in individuals and teams. If you are in a leadership or supervisory role in an ABA/behavioral health organization and are experiencing high staff call-outs, burnout, or turnover, consider the following strategies to increase employee engagement and satisfaction.

  1. Connect employees' contributions to business results.
    Business results are the large success outcomes leadership teams are committed to achieving with their organizations. They are the things that are most likely on the "dashboard" of the owner, chief executive, and investors, and also the way company achievements (e.g., revenue, client progress, parent/family satisfaction, employee engagement) are evaluated.

    As described in part one, leaders clearly and explicitly express the company's priority business results in organizations with robust performance-based cultures. As a supervisor or team leader, you have to be aware of the most important outcomes that the organization is trying to achieve. Understanding the business results is how we determine the purpose of our work. As supervisors, we must answer the question, "Why do we want to develop, improve, or support this performance?" By understanding what the organization is trying to attain, you can help your employees draw a line of sight from what they are actively producing in their roles (e.g., up-to-date graphs, session notes, converted appointments) to the organizational-level business results. To promote employee engagement and increase productivity, employees must understand how their accomplishments contribute to the organization's overall success.

  2. Set performance expectations focused on valuable accomplishments.
    Instead of providing your employees with an abstract list of duties or vague descriptions of behavior, describe the accomplishments (work outputs) you expect them to produce in their role. Most of us don't naturally think about our behavior products, particularly the less tangible ones -- like relationships, decisions, or solutions. We think and talk more about behavior itself. Shift the focus to work outputs to recognize and increase the value that people deliver to the organization. Ultimately, the only way to connect people's behavior to the organization's overall success outcomes is to identify the work outputs that people produce with that behavior and the value that those work outputs contribute to business results.

    However, merely identifying the valuable work outputs that each employee contributes to the business results is insufficient. It is also imperative to define the criteria (e.g., quality, quantity, cost, timeliness) for each work output, ensuring the requirements for a “good” one align with the organization's values. Be specific and succinct! A general, long, drawn-out list of criteria will frustrate employees and make it difficult to measure their performance. Possible actions you can take to help determine criteria for a "good" work output include:

     

    • Observe exemplary performers,
    • Identify the business results to which the work outputs must contribute,
    • Consult with recipients of the work output (e.g., supervisors, parents/caregivers, payers, department heads), or
    • Meet with the individuals working downstream in the process to understand better how they prefer to receive the output.
  3. Plan and arrange conditions that support optimal performance.

    We often hear outstanding directors and managers say to the people that report to them, "You don't work for me. I work for you!" These leaders and supervisors may use different words or terms to describe their rationale for said statement. Still, fundamentally, they understand that in their roles, they are responsible for producing positive behavior influences (i.e., variables or influences that affect behavior) to develop and support others' performance.

     

    In our own companies and our work with client organizations, we teach leaders and supervisors to use the Six Boxes® Model to analyze, develop, improve, and support individual and team performance. The Six Boxes® Model "is a comprehensive framework encompassing all factors or influences known from research and practice to influence human behavior" (Binder & Riha, 2016, p. 6).

     

    Leaders and supervisors can use this model to analyze the current conditions affecting an individual or team's existing performance and then coordinate the best combination of positive behavior influences to optimize the workplace conditions maximizing productivity and engagement. Further, research on employee engagement conducted by the Gallup Organization using its Q12 survey aligns perfectly with behavior influences encompassed by the Six Boxes® Model (Gallup, 2016).


    Using the Six Boxes® Model to guide collaborative conversations with direct reports enables leaders and supervisors to quickly learn what's working well and what factors obstruct or inhibit desired performance. Once armed with that information, they can more easily establish agreed-upon action steps or solutions for developing new or improving existing performance (Binder & Riha, 2016, p. 7). When collaborative discussions are regularly conducted to develop and support employees' ability to produce expected work outputs to criteria, supervisors become a valuable resource for their staff (i.e., supervisor support). Research indicates that this is positively correlated with lower burnout and turnover levels (Novack & Dixon, 2019; Plativeau et al., 2018).

  4. Arrange career development opportunities.
    Many people kickstart their careers in this field as behavior technicians. And many behavior technicians have career ambitions beyond delivering behavior analysis services under the direction and close supervision of a qualified supervisor. Suppose your organization has established an internal talent development program (see part one of this series), and you've set performance expectations focused on work outputs. In that case, we recommend you collaborate with your direct reports to identify and arrange career development opportunities within the company.

    Similar to how connecting people's contributions to business results increase "buy-in," which is pivotal for promoting engagement, establishing a clear path for advancement helps employees understand how they can achieve their desired career goals. Developing people for expansion, promotion, and other career goals is an effective strategy for sustaining high employee engagement and retention. To outline a career path for employees in your organization, try the following set of tactics.

     

    • Make the descriptions and measures of expected work outputs public to employees and encourage their review.
    • Tie measures of performance to roles (e.g., entry-level and advanced BT roles) and make the criteria for advancement public.
    • Use your regular coaching check-ins to learn about your direct reports' career goals; help them connect those goals to specific opportunities and initiatives within your organization.
    • Encourage employees to pursue higher-level positions within the company and inform them of internal processes/systems designed to support career development.
    • Arrange conditions that promote and reward performance development (e.g., incentives for participating in professional development activities).
    • Find ways to promote and reward managers for expanding their team's capability as it can be aversive for managers to "lose" a top performer to a new position.

Turnover rates are high in our field, but they do not have to be. By prioritizing employee engagement, investing in talent development, and continuous performance improvement across the entire organization, you can build a performance-based culture, focusing on the valuable accomplishments that each employee contributes to business results. Using Performance Thinking's simple but powerful models and straightforward logic, productivity, service quality, and employee engagement can all be improved while maximizing the return on the investments made in your company’s greatest asset, its people. Lastly, your employees will come to work each day knowing that what they put in truly makes a difference on an organizational level.

About the authors.

Shane-Headshot

Shane Isley, M.S., BCBA, LBA

Shane Isley is an entrepreneur, performance thinking® practitioner, and management consultant who earned his bachelor’s and master’s degrees in behavior analysis from the University of North Texas. He serves as a Senior Consultant for the Performance Thinking Network and leads the company’s emerging Performance Thinking® For Behavioral Health/ABA Organizations service line. In his role, Shane works with a team of organizational performance consultants to deliver performance improvement programs and services to companies of all sizes to help them establish or improve their performance infrastructure, processes, policies and procedures, job definitions, and management capabilities. Shane collaborates with business owners and executives to develop and implement solutions that increase profitability and improve operational efficiency, employee engagement, and service quality.

Shane has over fifteen years of specialized experience and expertise in the behavioral health care market as a business owner, executive director, and performance improvement consultant. Shane remains committed to helping behavioral health organizations lay the foundation for sustainable, ethical, and profitable growth, focusing on organizational alignment, leadership & management development, and process improvement.

Jen

Jennifer Castellanos-Bonow, PhD, BCBA-D, LBA

Jennifer Castellanos-Bonow earned her PhD in Behavior Analysis from the University of Nevada, Reno  (UNR), an experience that laid the foundation for her work with children with autism and other behavioral disorders. Jen has extensive experience leading clinical initiatives, designing training programs, maintaining best practices in delivering behavioral and psychological services, and developing and managing processes to support ethical and compliant service delivery. After serving for several years as the clinical director for Blueprints, based in Bellevue, WA, in 2019, Jen transitioned back to her hometown of Reno, Nevada. In partnership with a group of behavior analysts,  she has helped establish The Learning Consultants, which aims to provide behavioral support and services to children with autism and parents and families facing acute behavioral challenges.

Jen serves as the managing partner and CEO applying her experience administering performance  management systems, designing processes and implementation planning, navigating healthcare  funding of behavioral services, and developing and maintaining policies and procedures to ensure  regulatory compliance. She is also actively involved in the behavior analytic community, most recently by serving as the President of the Nevada Association for Behavior Analysis. While her roots are in early intervention, Jennifer’s foundation from UNR and recent work has provided her with wide-ranging experiences applying the science of behavior.

References.

Binder, C. & Riha, C. (2016). Performance thinking across the enterprise: Building performance-based culture with shared models and language.  Retrieved from https://www.sixboxes.com/_customelements/uploadedResources/121518_PerformanceThinkingAcrosstheEnterprise.pdf

 

Gallup, Inc. (2016). Gallup Q12® and employee engagement FAQs: Frequently asked questions about employee engagement and the engagement survey. Washington, DC: Gallup, Inc. Retrieved from https://hr.uci.edu/partnership/survey/pdf/01-Frequently-Asked-Questions-FAQs.pdf

 

Novack, M. N. & Dixon, D. R. (2019). Predictors of burnout, job satisfaction, and turnover in behavior technicians working with individuals with autism spectrum disorder. Review Journal of Autism, 6, 413-421, https://doi.org/10.1007/s40489-019-00171-0

 

Plantiveau, C., Dounavi, K., & J. Virués-Ortega (2018) High levels of burnout among early-career board-certified behavior analysts with low collegial support in the work environment, European Journal of Behavior Analysis, 19:2, 195-207, https://doi.org/10.1080/15021149.2018.1438339

About CentralReach.

CentralReach is a leading provider of EMR, practice management and clinical solutions that enable applied behavior analysis (ABA) and related behavioral health practices to deliver quality autism care for superior outcomes. The company is revolutionizing the ABA space with cutting-edge solutions including precision teaching, clinical data collection, scheduling, billing, learning management, fully-digital evidence-based programming and more.

 

Trusted by more than 100,000 clinicians and educators, CentralReach is committed to ongoing product improvement, market-leading industry expertise, world-class client satisfaction, and support of the ABA community to propel industry practitioners into a new era of excellence. For more information, please visit CentralReach.com or follow us on LinkedIn, Facebook, and Twitter.

 

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