Independence in ABA

Building a Successful Solo Practice as a BCBA

INTRODUCTION

Since 2010, the demand for individuals holding BCBA or BCBA-D certification has increased annually, reflecting the growing recognition of the benefits of Applied Behavior Analysis (ABA). Despite the expansion of ABA agencies and an increase in funding resources, there remains a substantial unmet need for services. A solo practice model, a subset of the independent practice model, offers a solution to this issue by enabling clients to access services directly from a BCBA without the necessity of the more traditional, tiered models.


TIERED MODELS VS. SOLO PRACTICE MODEL

Many ABA practices operate using a tiered model, where multiple professionals provide different levels of service to a client. For example, a BCBA might oversee a technician who delivers direct services, while a supervisor manages the technician under the BCBA's guidance. While this model can be effective, it can also lead to communication breakdowns, delays in treatment, and a lack of consistency in service delivery.

In contrast, a solo practice allows a BCBA to take on all roles in the treatment process, including assessment, consultation, caregiver training, and direct services. This model ensures continuity of care, with the BCBA fully controlling and executing the treatment plan. Solo practitioners can address a wide range of skills and behaviors, including communication, social interaction, self-care, motor skills, and maladaptive behaviors, all without the complexity and potential pitfalls of a tiered model.


UNIQUE ADVANTAGES OF A SOLO PRACTICE

Operating independently as a BCBA offers numerous benefits that may not be available within traditional employment models:

  • Autonomy: You have complete control over decisions that affect your clients and your business. As the sole decision-maker, you can tailor your practice to meet the specific needs of your clients.
  • Schedule Flexibility: Solo practitioners have the freedom to set their schedules, allowing for a better work-life balance. Whether you need time for family, friends, or personal pursuits, you determine when and how much you work.
  • Client Selection: You have the power to choose who you work with, which payment contracts to accept, and which professionals to collaborate with. This autonomy allows you to align your practice with your values and expertise.
  • Geographical and Environmental Flexibility: You can choose where to provide services, whether it's in a client's home, school, community, or a combination of settings. This flexibility can enhance the effectiveness of your interventions by meeting clients in their natural environments.
  • Creative Freedom: As a solo practitioner, you can utilize a variety of behavior analytic approaches and methodologies to best meet your clients' needs without being constrained by organizational policies.
  • Financial Independence: Without the restrictions of a salary or hourly wage, you can set your rates and achieve financial freedom. This allows you to earn what your services are truly worth.
  • Optimal Practice: You can showcase your skills and experiences, work within your scope of practice, and always employ best practices, ensuring the highest quality of care for your clients.
  • Serving Underserved Populations: This model allows you to extend services to populations that are often overlooked, such as those on waiting lists, those who don't qualify for services from local organizations, or those living in remote areas.
  • Tax Benefits: As a business owner, you can take advantage of various tax deductions. Consulting with a tax professional can help you maximize these benefits.


FACTORS TO CONSIDER WHEN SETTING UP YOUR PRACTICE

While the freedom to design your practice is enticing, it also requires careful planning and consideration. Here are some factors to keep in mind:

  • Business Model: Determine if you will operate as a sole proprietor or collaborate with another clinician to share legal ownership of a business. In the latter model, each provider operates as a solo practitioner with their clients but various aspects of operating a business are shared, such as business expenses, office space, or materials. Each model has its advantages and challenges, so consider what aligns best with your vision and resources.
  • Service Environment: Decide where you'll provide your services—whether in homes, schools, community settings, hospitals, or an office setting. Your choice will impact both your clientele and the logistics of your practice.
  • Service Delivery Approach: Identify how you will offer services, such as in-person or via synchronous or asynchronous telehealth. Each method requires different tools, training, and marketing strategies.
  • Scheduling: Establish a clear plan for managing your time, including how you'll balance direct client work with the administrative tasks of running a business. Consider how you'll handle cancellations and maintain a manageable caseload.
  • Treatment Philosophy and Approach: Identify the ABA methodologies you'll specialize in and the specific services you'll offer. Your treatment philosophy will guide your practice's structure and the types of clients you attract.
  • Collaboration: Consider who you'll collaborate with, whether it's parents, teachers, other professionals (e.g., speech pathologists, psychologists), or all of the above. Collaboration can enhance your services and expand your practice's reach.
  • Funding Sources: Determine how you'll get paid for your services. Funding sources might include private insurance, public insurance, state-funded programs, schools, non-profits, or private pay. Conducting a market analysis will help you identify the best options for your practice.


CURRENT CHALLENGES AND HOW TO OVERCOME THEM 

Starting a solo practice comes with its own set of challenges, especially in today's rapidly changing healthcare landscape. Here are some common hurdles and strategies to overcome them:

  • Navigating Insurance Contracts: Working with insurance companies can be complex and time-consuming. To manage this, consider hiring a business mentor who specializes in the ABA field, such as a consultant through TreSource, or utilizing a billing specialist or practice management software designed for ABA services. Additionally, stay informed about insurance changes and advocate for fair reimbursement rates.
  • Managing Business Operations: Running a practice requires skills beyond clinical expertise, including marketing, accounting, and legal knowledge. Seeking mentorship from other independent practitioners and investing in business training can help bridge this gap. For relevant courses and access to other professionals that can provide valuable support, check out the Independent BCBA Business Support Facebook group, BCBAs Connect & Collaborate networking group, and services offered through TreSource’s ABA Business Mentorship Program.
  • Balancing Workload: As a solo practitioner, you may find it challenging to balance client services with business responsibilities. Time management techniques, such as setting aside specific times for administrative work and client care, can help. Additionally, consider outsourcing tasks like bookkeeping or marketing to free up your time for clinical work.
  • Keeping Up with Industry Trends: The field of ABA is continually evolving, with new research, techniques, and regulations emerging regularly. Staying current through continuing education, attending conferences, and participating in professional groups is essential to maintaining a high standard of care.


PREPARING FOR THE JOURNEY 

Becoming a solo ABA practitioner may be your dream come true, but it requires more than just clinical expertise. It demands a deep understanding of both ABA practices and business operations. To prepare for this journey, consider the following:

  • Self-Assessment: Identifying your knowledge gaps will help you focus your learning and seek out the resources you need. Two critical questions to ask yourself are, “What do I know about practicing independently?” and “What do I not know that I need to learn?” 
  • Market Research: Conduct a market analysis of the following three key areas:
    • Funding resources: Identify the funding sources available in your area, such as private insurance, Medicaid, or private pay. Knowing your market will help you make informed decisions about which contracts to pursue. 
    • Competitors: These are the BCBAs or ABA organizations that are offering similar services. However, I encourage you to view them as prospective partners that you could learn from and potentially work with to meet the needs of our communities.
    • Target market: Learn about their pain points and how you can meet their needs. Identify who is funding their services and evaluate who they are going to for assistance or a referral for ABA services. 
  • Networking & Collaborating: Build relationships with other professionals, such as medical professionals, speech pathologists, psychologists, school personnel, and other BCBAs. Collaboration can expand your practice and enhance the services you provide. Resources like the Independent BCBA Business Support and Independent BCBAs Facebook groups, and BCBAs Connect & Collaborate networking group have been created to facilitate communication between BCBAs. 
  • Mentorship: Seek out business professionals or mentors who can guide you through the process of setting up and running your practice. TreSource specializes in offering mentorship programs to meet your specific needs. 
  • Continuous Learning: Join groups that offer information specific to independent practice, such as those mentioned above, and attend courses or trainings to gain the tools and knowledge you need to succeed. TreSource’s library of free resources, on-demand courses, and ongoing mentorship opportunities can be invaluable on your journey.
  • Business Support Plan: Writing a plan helps you identify your target market, prospective referring agents, and funders, identifies the strategies, tools, and procedures you’ll offer, assists you in making data-based business decisions, and will prepare you for potential challenges and opportunities. For assistance with developing your plan, check out TreSource’s free BSP template created specifically for ABA practitioners.


CONCLUSION

With the demand for BCBAs continuing to rise, now is an ideal time to consider practicing independently. This model offers numerous advantages, including autonomy, flexibility, and the ability to make a significant impact on underserved populations. However, it also requires careful planning, a willingness to learn, and the courage to navigate the challenges of running a business. By understanding both the opportunities and obstacles, you can embark on this journey with confidence. As B.F. Skinner wisely said, “A scientist may not be sure of the answer, but he's often sure he can find one.” In other words, you've got this!


NEXT STEPS


Prepare to build a successful solo practice by taking the following steps:

  1. Download and utilize the Business Support Plan Template, Independent ABA Practice 12-Month Timeline for Success, and Checklist for Starting an ABA Practice from the Downloadable Tools page here: LINK
  2. Participate in monthly meetings of the social networking group BCBAs Connect & Collaborate: LINK
  3. Join supportive communities, such as the Independent BCBA Business Support Facebook group: LINK
  4. Listen to the Independent Behavior Analyst in Business Podcast: LINK
  5. Create a profile on the exclusive directory for ABA practitioners, TreSource.com: LINK
  6. Utilize the guidebook The Business of Behavior: The Behaviorist's Roadmap to Independent Practice for step-by-step instructions on how to complete your plan. Author-signed copy available for purchase here: LINK
  7. Obtain ongoing guidance by enrolling in an ABA Business Mentorship Program. Learn more here: LINK


REFERENCES


Posted September 30, 2024 - By Charity Steele, MS, BCBA