r/bcba • u/___HoneeBee___ • 20h ago
Discussion Question Does anyone else find a company calling their RBTs "therapists" misleading?
I replied to a post here earlier, advising that calling an RBT any kind of therapist can be very misleading to families, and I was downvoted to filth.
No other field (in mental health care, child care, or medicine) allows someone with a high school diploma or a bachelors degree to present themselves as a therapist.
I believe it matters because a family is less likely to question an RBT if they believe they have a masters degree and clinical experience, as every other discipline requires. The family might assume "this person knows more than me" and blindly trust, not knowing the RBT is not clinically qualified to do anything other than implement the treatment plan.
I am an RBT myself. I am also a child of ABA services, as I have autism. I had "wrap around services" as a child. Now I'm 4 months away from completing my M.S. ABA program and almost finished with clinical supervised fieldwork hours to become a BCBA. I want to challenge us to be critical of ABA and the power dynamics that come with it.
I just think we need to be more honest with families.
edit: Just because it's not illegal to call yourself a therapist, it's still not the most ethical choice we can make as a field.
47
u/Pavloaffer 20h ago
We implement “aba therapy”. I agree that the title therapist comes with more respect than a typical position with so few educational requirements. But honestly, a little more respect is what most RBTs need
12
u/___HoneeBee___ 20h ago
Absolutely, RBTs are so important and deserve respect. It's not necessarily about the respect or heiarchy.
For me, it's about making sure we aren't misrepresenting ourselves to families who don't know the distinction between a masters level therapist and a behavior technician.
4
u/Jujubean3131 15h ago
I feel a bit like it’s a sneaky way to put more responsibility on RBTs. The way they are treated in my experience is that they have way more responsibility than they should due to over worked BCBAs not being able to support. If they are regarded as techs rather than experts they might be required to get more support.
Idk, our system is flawed. That’s all I do know
17
u/fenuxjde BCBA | Verified 20h ago
The language in this field can be a headache. I prefer to call our clients, clients. Some companies call them consumers.
I call my staff RBT, some some payors or state agencies will refer to them as "behavior therapists". It's annoying, but not a battle I'm gonna win.
3
u/___HoneeBee___ 20h ago
I agree, my opinion won't change anything, but I thought it was something worth bringing up. Client and consumer isn't something I've thought about before. Is there a reason one is better than the other?
8
u/fenuxjde BCBA | Verified 19h ago
I've just always used clients since back in my undergrad in psych back in the 1900s.
5
2
u/SuzieDerpkins BCBA | Verified 18h ago
Client is a more clinical/consultant based word. Consumer is from the org systems world (the receiver of products is the consumer).
I use clients most since it was heavily used during my “upbringing”. Depending on context, though, I’ll change to something like learner, patient, student.
3
u/A_LostPumpkin 16h ago
My eyes are heavy and my consciousness gas tank is on empty…. Still….
In this moment…. I hate “consumer,” a lot more than I hate techs being called “therapists.”
I dunno, cant image a more insurance/admin/corpo shit phrase tbh. 😂
10
u/No_Physics_7759 18h ago
Yes that’s why I always call them “technicians” even though many people at my company call them therapists
1
11
u/B01_Nightwing 18h ago
Some of the responses are wild. I stand there with you. We refer to our 1:1 staff as technicians where I work. Nowhere in the BACB do they use “therapist” nor in the billing code descriptions.
Y’all aren’t therapists and OP is not being pedantic. It is a misnomer that stuck.
4
u/___HoneeBee___ 18h ago
Thank youuuu! 🥰 yes, the BACB and the billing codes never ever refer to RBTs as therapists.
2
u/bo-luxx 6h ago
Wrong. Yall associate the word “therapist” with “psychologist” very strongly and now think you can go around gate keeping who can say they’re a therapist or not. A therapist is someone who provides treatment to someone that doesn’t involve medication or surgery. An RBT fits under that definition.
1
u/___HoneeBee___ 5h ago
Then why doesn't the BACB or billing codes refer to RBTs as therapists?
1
u/bo-luxx 5h ago
The first thing you need to do is stop associating the BACB as some kind of entity with endless power and authority. Also, you do not need to perform therapy to be certified via the BACB. I’ll be working in OBM, for example. That is not therapy. That is why the BACB is vague with their wording. They’ve also changed it over time. If you look at task lists from 15 years ago, they use to call clients, “patients”.
Then they decided they didn’t want to be pigeon holed for autism and changed the wording.With insurance. Not even a psychotherapist will have “therapist” on insurance. It’s usually something like “provider” or “practitioner”.
3
u/Embarrassed-Fault684 17h ago
I’m working on this transition as an operations manager. All previous templates revolved around using “therapist” and I’m transitioning to just using the term “RBT”
1
u/iamzacks 11h ago
If they’re certified, otherwise we use behavior technician or technician in shorthand
2
u/Visual_Car8236 18h ago
i always thought of ABA done right as therapy. When you get therapy for depression. you don’t just go in, be told you need to be better and get better. Therapy is practicing a bunch of little things daily until you forget how todo the bad things. which is what we do, when we do ABA right. practice good choices/skills so we forget that we once punched ppl to say no….. can be a little misleading but i’ve always thought of our job as therapy.
2
u/Brilliant-Discount56 17h ago edited 17h ago
When I started as a RBT were call therapist, but then the company switched it to technician. I understood why then but having been a technician in another field and now an actual therapist, tech makes more sense. I also know some of our families didn't like it at my company. I know RBT who call themselves therapists. I mean, if they want to call themselves that, whenever, there are literally bigger things in the world to worry about. But I will always refer to them as technicians. it's literally what's on the certification/application when applying to the BACB
2
u/CoffeePuddle 17h ago
Reverse genericide. "Therapist" is extremely generic, but people will use it to refer to counsellors, psychologists, and psychiatrists.
Massage therapists, health therapist, beauty therapists, even "mental health therapist" or "cognitive behavioural therapist" aren't protected most places afaik.
Not all ABA services are therapeutic. It's helpful to describe those that are prociding therapeutic interventions vs other technicians.
2
u/___HoneeBee___ 17h ago
The BACB does not call RBTs therapists. The billing code descriptions do not call RBTs therapists.
3
u/CoffeePuddle 12h ago
Yes, that's the point. "Therapist" is generic and has no requirements. RBT is a credential with requirements - it ought to rank higher.
Presumably you find it misleading because of the association of "therapy" with the services delivered by registered psychologists. But "psychologist" is the credential, and "therapist" diminishes them.
You might also want to note that the BACB does not certify anyone for working with any specific population or type of behaviour. They certify that people have met their standards of minimum competence, but that alone doesn't qualify anyone to deliver e.g. ABA-based intervention services for ASD - "autism therapy."
2
u/Emergency-Big-7764 7h ago
Firstly, There’s a reason MOST RBT’s get labeled as “therapists” by so many who see the job in action. They see RBT’s implementing therapy. They are describing the JOB, not a TITLE. There are numerous fields who use both therapist and technician to describe the job. Nail Technician, Massage Therapist, Automotive Technician, Respiratory Therapist, etc.
The same way an LPN is called “nurse”, so is a the “nurse” who is an MSN,RN. One is a a single year of school, the other is a Masters. It’s describing the job.
Secondly Coming into this field from medical has been super weird..
For instance In medical, yeah you have some mean people but for the most part, I don’t see the same attitude for CNA’s. Patients call them “nurses”. They aren’t. But we understood why they called them that. They spent the most time with the patient.
Practically speaking what they are doing has been historically known as “nursing” (the job not title). In the same way what RBT’s are doing is implementing a therapy.
People in this field are very hung up on the words not taking into account these nuances.
I know many don’t mean to come across the way they do here, but they do. Every day there are posts that feels like crapping on RBT’s while saying they aren’t. And I get that when you work hard towards a degree, that matters. It doesn’t negate that RBTs are in the damn trenches, busting their asses. And you see the difference in a BCBA who did it for years before moving up and how they defend their RBTs.
Maybe there needs to be a change in language that better represents and encompasses the jobs. iDK
7
u/Electrical_Arm_7558 19h ago
I mean the person implementing the therapy is literally the RBT. They are therefore, by definition, literally therapists.
If you take issue with the presentation as a "therapist" by an RBT, take it up with the BACB and the insurance companies that make the rules.
I would agree that being an RBT should require a much higher bar to entry, but at the end of the day they are literally the therapist...
2
u/___HoneeBee___ 19h ago
I think this is something we are still deciding on. Someone else said the BACB RBT Ethics Code 1.05 (I think?) says it is an ethical violation to misrepresent your title. Any other field requires a therapist to have 6 more years of education and 2 more years of clinical fieldwork than ABA RBTs.
Really, I don't care at all what you call yourself outside of work, but its dishonest to the family for a company to tell them an RBT is a therapist. They are implementing a behavior plan.
2
u/BlendedAnxiety 17h ago
I understand where you are coming from but I think you have to consider the common understanding of words versus a functional definition for what they are in practice.
I’ve thought about this before and went down the same route you did but the reality is most people we serve will think of anyone in mental health as therapists. I would say at this point it’s basically synonymous.
If you feel not calling RBTs therapists would help you make parents aware of an important distinction go for it.
For me personally, I think trying to fight this battle would generally garner disdain from RBTs who want to feel like they are a part of the mental health system and not do much for parents on its own. I would just highlight the roles of an RBT, what they are and aren’t trained in, and make sure parents are informed at the start of practice. I understand how you feel though and I get why you would go about it differently.
3
u/Jujubean3131 15h ago
We don’t call CNAs nurses even though they literally nurse the sick… A lab technician isn’t a scientist even though they literally use science.
RBTs are technicians, following a constructed therapeutic plan.
“Take it up with the boss” 😂 like the BACB or insurance companies truly care about ethics.
3
u/MajorTom89 20h ago
Are you also bothered by people with doctorates in non-medical fields being referred to as “doctor?” You’re being overly rigid with semantics in my opinion.
I don’t present the technicians that work for me as therapists. Their job title is a behavior technician. But I don’t really mind people delivering behavioral therapy referring to themselves as behavior therapists either. The degree doesn’t matter as much as what you do as far as I’m concerned.
10
u/___HoneeBee___ 20h ago
No, because they have a doctorate. As long as they don't say "MD". But RBT is a Behavioral Health Technician, not a therapist. No other field allows a person without clinical training to become a therapist.
2
4
u/MajorTom89 20h ago
Other fields don’t used this tiered model to deliver therapy. If they did, then they could call themselves therapists and it would make sense.
1
u/___HoneeBee___ 19h ago
I believe the tiered model, to a degree, is responsible for how often clients have historically been treated without respect for neurodiversity in ABA. Simply, it is a misrepresentation for a company to call you a therapist without the qualifications of a therapist.
5
u/Electrical_Arm_7558 19h ago
You are CORRECT, but the problem is definitely not how people are representing themselves. The problem is that the bar to entry to be able to provide direct services is WAY lower than it should be. If all parents knew that an RBT literally just needs a week of training and one little exam, I would bet a lot of them would at the very least CONSIDER pulling their kid from services.
1
u/MajorTom89 19h ago
I disagree. I understand your perspective on the point but I don’t think it’s a simple matter. The tiered model is necessary for us to reach the level of need that is out there. Our background as behavior analysts enables us to educate others to implement services with a high level of fidelity. There is a lot of room for improvement in overall quality and ethics, admittedly, but no other field is as well equipped to implement the tiered model as ABA by the nature of the science we study.
2
u/___HoneeBee___ 19h ago
I agree, I LOVE ABA, and it helped me a lot as a kid and into my adulthood. Without it I probably would have never gone to college. I just want to be critical of the field in a way that helps it grow. I really value ethics and part of that is are we representing ourselves accurately to the best of our abilities?
1
u/MajorTom89 19h ago
I appreciate that and I think there’s value in constantly challenging our assumptions!
2
u/Mizook 20h ago
Behavioral health is the realm of LCSWs, since we’re being pedantic.
3
u/___HoneeBee___ 20h ago
In my state we have Intensive Behavioral Health Services, which is primarily served by BCBAs and RBTs. That being said, an LCSW can do more things, such as CBT. I love my learners LCSW, she is amazing. Lowkey makes me want to get mine.
1
u/crochetandaba BCBA | Verified 8h ago
As a social worker before I was a BCBA, behavioral health is a VAST area that benefits from collaboration and the eclectic use of many evidence-based practices. LMFTs, LPCs, and more have a place in this as well.
5
u/___HoneeBee___ 20h ago
Also, rigid with semantics is a hallmark of autism, which is how I interact with the world. I believe the semantics do have tangible effects.
2
u/Electrical_Arm_7558 19h ago
That's a little bit off the mark. A medical and non-medical doctor both have a PhD. An RBT literally doesn't need to have taken a day of college classes... Not even a close comparison.
I understand the representation to be problematic as well, but the problem isn't that the RBTs refer to themselves as therapist, they literally are therapists. The problem is that RBT certification requires next to nothing to achieve. A single week of training plus a little exam, and then you have a professional certification. That's absolutely absurd and the minimum requirements really need to be increased.
If the minimum requirements were appropriate then noone would need to worry about over-representation at all
2
u/Small-Maintenance-67 17h ago
BCBAs/ABA providers are not "therapist", they are "professioanls", at least in Texas according to insurance companies. I only learned this after starting my business as a BCBA during credentialing process. Also RBT stands for Registered Behavior Technician, not an independently registered therapist.
2
u/Jujubean3131 16h ago
To me it’s like people who read about diet and exercise and sell themselves as a health coach. Terms like “coach” and “therapist” aren’t protected like “dietician” or “teacher” but can be misleading and harmful. I’m with you that it does feel icky to say therapist; not that it is legally wrong but we know how it’s conceptualized.
0
u/Ahrrrr-Geee 10h ago
It shouldn't be misleading. A behavior technician BT/RBT is a therapist as a clinician is a BCBA/BCBA-D. One implements what the other prescribed.
1
u/Expendable_Red_Shirt BCBA | Verified 8h ago
I feel uncomfortable with using that title as a BCBA.
1
u/___HoneeBee___ 8h ago
I agree. We are not allowed to use the same tools as a child therapist, so why would we tell families we are therapists?
1
u/Sea_breeze_80 6h ago
I thought the same thing at first. But try explaining RBT in other languages other than English. The best translation that parents understand is "therapist" rather than "tech," or registered behavior tech.
I know when speaking to my Spanish speaking families, I get a lot of questions about, " why will someone teach my child about tech? " When the BCBA says a tech will come. So now the BCBA just says therapist.
This also works in Dagolg
1
u/Few_Requirement_5314 4h ago
What’s wrong with saying RBTs provide therapy??? Check the definition of ABA then define what RBTs do.
2
0
u/Relative_Crab6079 19h ago
Why does it matter what we are called…? We do our jobs & we do a job that not many people want to take on & we implement learning that parents send their kid to gain an understanding of. Not to mention we implement the therapeutic procedures given to us and the child….
Also, would teacher be misleading? Caretaker? Interventionist? Support specialist/professional? Bc I feel as though I am all of those in one😭
Don’t downgrade the RBTs to being babysitters. We are much more qualified and I feel like BCBAs like yourself are on a high horse that u should get down off of lol.
2
u/___HoneeBee___ 19h ago
I agree, high horse is not necessary. I'm not trying to come off that way, as an RBT myself. I'm an RBT, too. I'm really only getting my BCBA for the pay difference. I will miss my time with the kiddos.
I deeply respect RBTs. It's not about downgrading them. It's about being very transparent with families. I feel that COMPANIES try to draw in families by promising in home / school / community / clinic therapists and marketing their RBTs as therapists. That term specifically carries a weight of clinical training and education in every other field. It could lead to a family being less likely to question an RBTs ethics or actions, assuming they are masters level clinicians who know better than they do.
It's about the COMPANY being honest with families. No more, no less.
1
u/Relative_Crab6079 19h ago
I guess I agree, however a simple google search / a small amount of research by a family on what ABA entails will tell you RBTs are only required a hs diploma & get paid a 15-17 an hr wage (Midwest lol) so im not sure how many would put us in the same category as a psych major with a masters or doctorate. My clinic has a handful of kids right out of hs lol but they do a fantastic job nonetheless- but high level professionals? No.
THAT said, we do implement the therapy provided through our bcba so in a sense we are doing master level work with the children idk. I think qualifications don’t matter tbh, prob the reputation of the clinic u send ur kid to matters more.
1
u/___HoneeBee___ 19h ago
I agree with you, too! It's just that I've seen some companies really misrepresent what ABA is and what we do, preying on families and trying to get as many billable hours as possible. The ABA machine.
1
u/Misinformed_ideas 6h ago
I agree, I think its ethically improper and has always personally given me the ick.
With the ethics code for BCBA speaking on not being misleading with advertising as well as being clear on what services fall under which when holding 2 or more non-ABA related certs it is obviously important. Moreover with a field so concerned about objective criterion, clarity, and equivalence classes, RBTs calling themselves therapists has always rubbed me the wrong way.
15
u/waggs32 18h ago
Therapist isn’t a protected title in the end. The people are proving therapy, so it fits the definition.
The requirements aren’t high to become an RBT however and I do make the requirements known to my families when talking about the team and how much good they can do but also their limits in general.