The need for board-certified behavioral analysts (BCBAs) who provide applied behavior analysis (ABA) has dramatically increased in recent years.
In 2023, the number of open job listings for BCBAs even outstripped the total number of practicing clinicians.
To help create more BCBAs and create a pipeline of trained clinicians, ABA provider Helping Hands Family has developed an intensive fellowship program that offers participants training, supervision and career development.
The program creates a pool of well-trained clinicians to help address the BCBA clinician shortage overall, according to Jessica McGlone, director of training and education at Helping Hands Family and trained BCBA.
“The ratio of newly certified to experienced [BCBAs] is very uneven,” McGlone told Autism Business News. “It’s awesome that our field is growing, but there was such a wide variation in supervision experience that some of our newly hired BCBAs were coming to us with.”
King Of Prussia, Pennsylvania-based Helping Hands Family is an ABA provider with locations in Connecticut, Maryland, New Jersey, New York and Pennsylvania. The provider accepts major insurance plans, including ComPsych, Aetna, Cigna and UnitedHealthcare.
“We decided we wanted to really be mindful and thoughtful and build out a program to ensure not only are they getting the hours they need on paper and meeting the qualifications and requirements of the board, but getting all those things that we think are absolutely necessary to become a successful practicing BCBA in medical model ABA,” McGlone continued.
Helping Hands Family has a BCBA workforce of 107, including clinical directors. It employs 514 RBT-level behavior technicians as of the time of publication. Of those, 67 are currently enrolled in the BCBA fellowship program.
The highly-structured program lasts approximately 18 months, though some fellows take longer to complete the process. Initial coursework is focused on creating strong RBTs, McGlone said, and then evolves into an immersion-style program where they work in tandem with one or two other BCBAs.
Thus far, fellows have entered the program one at a time. Beginning in 2025, Helping Hands Family will admit new fellows through a cohort model to encourage peer support and collaboration.
Helping Hands Family pays for all RBT certification costs, an annual $100 stipend for continuing education and study materials.
RBT-level staff who are employed by Helping Hands Family and in an approved ABA master’s program are eligible for participation in the program.
About three-quarters of Helping Hands Family’s RBTs join the workforce without a specific certification. The company puts new hires who are not already certified through a “pretty rigorous boot camp” along with shadowing and practice competency. Typically, new RBTs must finish their RBT certification before entering the fellowship program, and often do so within 90 days.
To complete the full program, fellows are required to stay employed with Helping Hands Family for 18 months after completion as long as the company has an open position.
The program creates a pipeline of well-trained BCBAs, McGlone said. Additional clinicians also help more children get services as quickly as possible.
“Our RBTs are great and critical, but without a BCBA, we can’t provide services to kiddos,” McGlone said. “If we have those BCBA spots being filled, we can pull kids off wait lists and provide services sooner, more thoroughly and more effectively. That’s a huge return on investment for us.”
In addition to creating more BCBAs, the program fosters a positive culture that encourages clinicians to stay employed with Helping Hands Family, McGlone said.
Even above a desire to add and retain staff and get children in care, the program seeks to create quality clinicians to practice in communities. Even if fellows do not stay with Helping Hands Family long term, they will still provide quality ABA services elsewhere, according to McGlone.
The best measurement of the program’s success, McGlone said, is that most graduates stay on with the company.
Of the 33 fellows who completed the program, 20 are currently practicing with Helping Hands Family, and five are planning to begin practicing as a BCBA within eight weeks.
Other ABA providers also operate BCBA training programs. For example, Indianapolis-based Hopebridge trains potential BCBAs through its Hopebridge Fellowship. The company recently opened the program up to non-employees.
Fellowship programs across the industry have differing levels of success, according to McGlone. She said that Helping Hands Family’s program differentiates itself because it was built, and continues to be updated, based on information from RBTs and fellows gleaned through focus groups and feedback opportunities.
More fellowship programs could be one method to addressing the national BCBA shortage, a deficit that can lead to long wait lists for care and difficulty filling leadership roles within autism therapy companies.
“In our industry and autism therapy right now, we’re at a pretty pivotal place where we are really regarded as a healthcare specialty and discipline,” McGlone said. “There’s a lot of responsibility that goes into maintaining a certain level of quality and expectation from the field and the clinicians. This is just one of the many ways we can contribute to the level of clinical quality, consistency, and those clinical standards.”
