Create a Culture around Receiving Feedback

Many leaders I have worked with struggle with teaching managers to give feedback or even giving it themselves.  Perhaps a healthy dose of wisdom and life experience are needed to conjure up the confidence to give feedback to a team member that is supportive, helpful, and most importantly, well received.  Ask most people why they avoid it, and it is usually out of fear that their feedback will not be well received.  So they opt to not give it, or skirt around the issue.

There are a lot of articles and research around giving feedback.  We’ve all heard of the “feedback sandwich” where critical feedback is bookended with positive statements.  But I think many employees can perceive this approach as inauthentic, or perhaps as “beating around the bush.”  Why can’t we just be direct with one another, especially if it is coming from a place of caring?

One skill and potential cultural value that I believe leaders should focus more on is Receiving Feedback.

Here are some ways you can promote this value:

  1. Start by modeling – when you are in group or individual meetings, ask participants for feedback on your ideas or suggested approach to a problem.  Not that you have to be the one with all the ideas of solutions, but let’s face it, as a leader many people look to you for answers.  And everyone wants a confident leader.  FALSE!  Showing humility (“I don’t have all the answers!”), and an openness to different perspectives can not only generate novel solutions, but demonstrates to your team that being open to feedback is something you value and produces superior results.
  2. Encourage those around you to seek it – when managers come forward with difficult situations, it is not uncommon for the leader’s instinct to be to issue directives and seek to assign blame (often framed as “accountability”).  However, taking a moment to pause, and encourage managers to ask questions and seek more information to understand the issue can help them reposition critical (and potentially harsh) feedback as caring concern.  Saying, “I noticed something is off with your performance, and I wanted to see what’s going on and how I can help” can be a great conversation starter with a team member struggling with something at work, or perhaps outside of work.
  3. Praise and invite criticism – most people want to arrive at a consensus when discussing problems, and quickly.  Often, leaders do not want to dwell on problems for too long at meetings, and also want to reach a speedy consensus so they can “move on” to other topics.  But sometimes it is worthwhile to dig in by inviting additional discourse.  Asking questions like “is this our only option?” or “what are the risks to taking this approach?” can encourage team members who are holding back concerns to speak up.  And when they do, acknowledge that you value their opinion, even if you don’t agree, as it will send a clear message that it is safe to have a different perspective.

I try to remind new team members, myself and my children that coach-ability is one of the most important skills in life, not just on the playing field, if you want to continue to grow.  Letting people know that you are not only open to, but yearning for feedback will encourage more of it to come your way.  When feedback can flow through your team without friction, you will unlock tremendous potential in your team members and help everyone get closer to optimal performance.  So instead of worrying too much about how people give feedback, consider focusing on how they receive it, and opening up more lines of communication with your team!

Jamie C. Pagliaro

Executive Vice President & Chief Learning Officer

Mr. Pagliaro currently serves as Executive Vice President and Chief Learning Officer of Rethink, a global health technology company providing cloud-based treatment tools, training and clinical supports for individuals with developmental disabilities and their caregivers. Prior to joining Rethink, Mr. Pagliaro was Executive Director of the first charter school for children with autism spectrum disorders in New York City. The program has received national recognition from the media and a number of professional publications as a model for children with autism in the public school system. Mr. Pagliaro has worked directly with individuals with disabilities in all stages of life across a variety of home, school and clinic settings. Mr. Pagliaro has an MBA from Villanova University and a BA with honors in Psychology from Wesleyan University. He speaks nationally, serves on several professional advisory boards, and has authored numerous articles.

Easy Habits to Build Team Culture

Usually we think of habits as bad things. The flip side is that creating good habits is hard and takes discipline. I often wonder why it is so easy to fall into bad habits, yet good habits are so difficult to come by!

To establish good habits, I have found that they must be easy to repeat and produce pretty immediate or short-term value. Culture-building does just that. By caring for your team, you can unlock the potential of those around you, and create a scalable model for achieving your business objectives. Plus, people will thank you… immediately.

Here are three easy habits: 

Identify Your Values 

Source feedback from your team. Ask questions like “what do you value most about working here?” or “what is something you have done or been a part of here that you are most proud of?”  You can also elicit aspirations by asking “what is something our team should start doing?”  

Using small groups to have these conversations amongst team members, and documenting the themes, will help you hone in on a unique set of values for your organization. Then share them anywhere and everywhere you can!

Practice Your Values 

Create opportunities to practice behaviors that align with your values. Facilitated team meetings and planned breakout sessions can provide an ideal forum. Two values my team has are collaboration and open communication. 

Our monthly team meetings include breakout sessions, where small groups of employees from different teams get to collaborate. They are prompted to engage in conversations, through guided reflection beforehand, that require a degree of vulnerability. 

In fact, a group of recent additions to our team, who joined through an acquisition, were a bit surprised when we did an exercise asking everyone to share their personal weaknesses. Talk about being exposed!  

But this is how we practice and normalize our values. For our team, weaknesses are treated as opportunities for personal development, just like failures are treated as learning opportunities. The more we have people invested in helping one another learn and develop, the stronger we become as an organization. Remember that teacher who told you to practice what you preach?  Well, they were right!

Reinforce Your Values  

Let’s face it, a lot of times we forget to call out the positives, let alone encourage others to do so. Maybe we call out specific behaviors or actions that are above-and-beyond, or exemplify exceptional performance, but those don’t happen all the time. Perhaps we miss the opportunity to make a connection between what people are doing on a day-to-day basis and the values of our culture. 

The variety of situations and responses people may encounter makes it difficult to predict every scenario with policies, procedures and operating protocols. Sure, you may have key performance indicators, defined job expectations, and specific workflows. But making sure that people act in ways that align with the values of your culture during complex, difficult or ambiguous situations will definitely tilt the cards in your favor. 

Having a Team Gratitude Board can be an effective way to publicly reinforce specific behaviors that align with the values of your culture, so that it’s not just coming from you.

Team Culture Matters

If you’re not convinced that focusing on these habits is necessary, check out three reasons why team culture matters. I hope reviewing these habits inspires you to commit more time to culture-building activities. 

If you would like to see some examples of easy exercises that you can begin doing with as little as one hour per month, check out some of my recommended culture-building activities and tracking tools. Feel free to download, modify and make them your own!

Jamie C. Pagliaro

Executive Vice President & Chief Learning Officer

Mr. Pagliaro currently serves as Executive Vice President and Chief Learning Officer of Rethink, a global health technology company providing cloud-based treatment tools, training and clinical supports for individuals with developmental disabilities and their caregivers. Prior to joining Rethink, Mr. Pagliaro was Executive Director of the first charter school for children with autism spectrum disorders in New York City. The program has received national recognition from the media and a number of professional publications as a model for children with autism in the public school system. Mr. Pagliaro has worked directly with individuals with disabilities in all stages of life across a variety of home, school and clinic settings. Mr. Pagliaro has an MBA from Villanova University and a BA with honors in Psychology from Wesleyan University. He speaks nationally, serves on several professional advisory boards, and has authored numerous articles.

Don't Just Be Aware: Autism Acceptance Month

April marks the start of Autism Acceptance Month, a 30-day advocacy campaign that aims to increase visibility, raise money, and share information about life as a person with autism. But the campaign didn't start as an all-encompassing push for "Acceptance."

Moving From Autism Awareness to Autism Acceptance

Originally, the month grew out of an "Autism Awareness Week" that started in the 1950s. While important to discuss, the program primarily shared information about the then-misunderstood diagnosis and sought ‌a vague "cure." This framed autism as a medical problem that needed to be solved, instead of a neurodivergent diagnosis affecting many people who live whole and fulfilling lives. 

As time passed and people with autism began engaging in self-advocacy, they could express their concerns and alter the previous campaign, moving away from the term "awareness" and other outdated forms of support.

What Makes Autism Acceptance Month Different From Previous Iterations?

The new "Autism Acceptance Month" campaign grew out of the Autistic Self Advocacy Network (ASAN), which was formed in 2006 by a group of people on the spectrum. ASAN sought to share more accurate information about autism and promote fair support systems for people with autism. 

It moved away from finding supposed cures or solutions to autism—instead of trying to influence the societal perceptions of the diagnosis to make public spaces more inclusive. This means the ASAN shied away from the stereotypes of the disease, which often only featured extreme or misrepresentative examples. 

The new movement still seeks support for those most affected by the diagnosis, but it carved out extra space for people who live day-to-day with the diagnosis to talk about their daily life and how it could be positively impacted by those around them.

That cultural push centered on giving autistic self-advocates the floor in the discussion of the diagnosis. The "awareness" efforts of previous years were mostly conducted by advocates who were not on the spectrum. These people might be well-intentioned, but the self-advocates turned the conversation away from cures to highlighting issues or misconceptions.

ASAN and the change to "acceptance" culminated in a petition that asked the White House to officially recognize April as Autism Acceptance Month. President Obama signed that petition on October 2, 2014, officially recognizing April as Autism Acceptance Month. 

In his letter, President Obama wrote, "I hope that during this month we raise awareness about autism spectrum disorders, show compassion towards those with the disorder, and support efforts made by families and communities to enhance the lives of all individuals living with autism spectrum disorders."

The president's recognition of Autism Acceptance Month is an important step forward for the movement. But it's still just thata step forward. There is still a lot of work to do.

Speaking Out For Autism Acceptance

Because of the petition, many organizations and advocates now can promote autism acceptance. And they can leverage the high-profile advocacy month to raise money and share their stories without alienating those in the community that don't want a ''cure". Many people with autism take pride in their diagnosis, and with the acceptance month, they can visibly express that pride while helping others in the community who struggle.

There's no doubt that there is still work to be done. But this is also an exciting time for self-advocates and their allies because they are taking control of their own message. They are making sure that the public understands what it means to have autism, rather than allowing those people without an autism diagnosis to write the narrative. The movement is growing in size and influence. And it has been achieved with no significant professional support or funding.

The movement has come so far so quickly because self-advocates fought for their own rights. In doing so, they disrupted conventional wisdom about how society should treat autistic people and challenged long-standing assumptions about what is best for them. They are changing how people view the diagnosis, from something that needs to be cured or eradicated to something that is natural and that affects 1 in 44 children in America.

So as Autism Acceptance Month begins this April, consider the history of the movement and its advocates while learning something new about the diagnosis.

remote team meeting

Using Technology to Build Team Culture (Even Remotely!)

Whether you are using Zoom, GoToMeeting, Microsoft Teams or Google Hangouts, every platform offers similar tools that you can leverage to build team culture, which is especially important with so many employees working remotely due to COVID, or performing their jobs in geographically dispersed locations. With some planning, these tools can stimulate employee engagement, and help team members feel more connected to one another.

Technology Tools To Build Team Culture

Here are a few common technology tools that can help you build team culture:

Chat Function

Ask a question to begin your meetings. Immediately, people are paying attention and engaged with what you have to say. For example, on Valentine’s Day I asked team members to chat what they love most about their team. 

I also like to play some inspirational music at the beginning of team meetings (you can source suggestions from your team!), and prompt people to engage with the chat question while waiting for everyone to join. As people chat comments, I read some of them aloud. It always sets a positive tone for the meeting!

Breakout Rooms

I must admit that despite working at a tech company, I am sometimes intimidated by advanced features like Breakout Rooms. But this feature can be really valuable in creating interactive meetings when you have more than 5-10 people. 

When I run culture building activities, there is always a specific theme or topic, such as defining our team values. Breakout rooms offer an opportunity for everyone to speak and listen to one another. A question like “what do you value most about working here” can stimulate positive conversations and help team members get to know one another. 

You can also ask more provocative questions like “what are your weaknesses” or “what is something we should start doing” as you build trust with your team.  

Pro tip: give participants a reflection period before the breakout so they can write down their ideas. Not everyone enjoys being on the spot with colleagues if they haven’t had a chance to prepare. 

Team Vision Board 

This can be done with a simple Google Sheet. The board is a place for team members to post reflections and share more about their personal journey with others. Sharing your personal mission statement or communication style in a public form can help team members get to know one another. 

As a leader, it can also help you learn more about team members that you may not interact with regularly. It can also help you assess employee engagement, as participation should never be mandatory.

Resources for Building Team Culture

If you want to start or expand your focus on developing your team culture, check out some easy habits to build team culture, or if you’re still not convinced that focusing on team culture is worth your time, check out three reasons why team culture matters. I hope these reasons inspire you to commit more time to culture building activities.  

If you would like to see some examples of easy exercises that you can begin doing with as little as one hour per month, check out some of my recommended culture building activities and tracking tools. Feel free to download, modify and make them your own!

Jamie C. Pagliaro

Executive Vice President & Chief Learning Officer

Mr. Pagliaro currently serves as Executive Vice President and Chief Learning Officer of Rethink, a global health technology company providing cloud-based treatment tools, training and clinical supports for individuals with developmental disabilities and their caregivers. Prior to joining Rethink, Mr. Pagliaro was Executive Director of the first charter school for children with autism spectrum disorders in New York City. The program has received national recognition from the media and a number of professional publications as a model for children with autism in the public school system. Mr. Pagliaro has worked directly with individuals with disabilities in all stages of life across a variety of home, school and clinic settings. Mr. Pagliaro has an MBA from Villanova University and a BA with honors in Psychology from Wesleyan University. He speaks nationally, serves on several professional advisory boards, and has authored numerous articles.

Rethink Acquires Total Therapy - Live Q&A

February 15th, 2022 | 1:00pm EST


  • Larry Morgan, CEO of Total Therapy
  • Jamie Pagliaro, Rethink BH Division Director

About This Event:

With the recent acquisition of Total Therapy (Total ABA), we’d like to offer you the chance to learn more about the acquisition and ask any questions that relate to your account.

Join us for our 30-minute interactive session with Rethink BH Division Director, Jamie Pagliaro and the Total Therapy CEO & Brand Ambassador, Larry Morgan.

person typing on a computer

ABA Therapy Business Continuity Plan

Amid economic volatility and the public health crisis, not all businesses are prepared. The daily grind of running an ABA therapy practice can keep your plate full, and the last thing you want to think about is building a business continuity plan. 

As a business owner, being prepared is just as important as running your business. No business is 100% immune to interruptions. These interruptions can be cyber threats, server outages, or a health outbreak like COVID that prohibits staff from working. If these occur, what’s next? What will happen to your clients? What will happen to your business and employees?

Benefits of Business Continuity Plans

Many believe business continuity plans are for enterprises and large corporations, but even small businesses can benefit from having something in place. Here are just a few of the benefits:

  • Limit Interruptions - With a plan in place, you will have a standardized process and response to minimize downtime. Less downtime equals less stress and less revenue lost.
  • Lay Out Alternatives - There should always be a backup plan. This could be as simple as reducing hours, limiting capacity, or delaying services. If you actively communicate with clients using an email marketing solution, leverage that to communicate with all your clients in different ways.
  • Empower Staff - Having a plan in place will ensure that your team is on the same page. Employees will know what needs to be done to keep your business running, but it will also allow them to step up in places you may not have thought of. 

Having a plan in place will reduce your anxiety during a crisis. No plan will be perfect, but it will align all stakeholders on how to approach the common problem. 

How To Get Started? 

Before you get started on putting a plan together, first identify internal challenges. For example, if your emails and computers go down, who do you call? Does everyone in the office know what to do?

Planning for every situation is complex and hard to manage, but a lot businesses only need a basic plan in place. For the purpose of this article, we want to keep things simple. A simple plan you can put together is a spreadsheet of important contacts. This spreadsheet should include:

  • Name of Contact
  • Responsibilities
  • Phone Number
  • Email
  • Comments

These can be internal or external contacts. Make sure you communicate this spreadsheet with your staff, have printed copies available, and periodically update to reflect any changes made. 

That being said, for therapists that still rely on paper and pencil, it’s important to consider that those files are at an even greater risk if an environmental emergency occurs. As mentioned above, no business is immune to interruptions, but practice management providers have systems in place to recover data during worst-case scenarios. 

While some businesses may experience no issues, others may experience multiple over the course of their existence. At Rethink, we have multiple plans that are actively reviewed and updated in case of emergencies. During an emergency, the best any business can do is actively communicate with customers while addressing the problem internally. 

Three Reasons Why Team Culture Matters

Over the past two years, my team has experienced a lot of growth (from 20 to 100+ team members). Although we have always had a mix of remote and in-office employees, COVID has complicated this growth with all of our team working remotely. The combination of growth and fear of “losing touch” with people prompted me to put a lot of time and effort into developing culture in a more intentional way.  

I have come to believe that investing in my team’s culture is one of the most important ways for me to spend my time as a leader. Despite all the day-to-day issues that consume my time, and the endless stream of emails, I have committed to several habits that help me maintain a focus on culture building. Here’s why:

One Word: Turnover  

I probably don’t need to state the obvious here, but the job market is super competitive right now, and switching jobs is a common occurrence for many professionals. Bigger companies may be offering richer pay or benefits, while smaller companies may promote “perks” (e.g., flexible schedules or special titles) and be more nimble (less red tape). 

Regardless of your size, or the size of your competitors, everyone wants to be a part of something greater than themselves and feel a meaningful connection to their work. When team members are focused only on their individual performance, or feel siloed within your organization, it makes it much easier for them to leave or be open to a change. 

Highly engaged team members, who are inspired by a larger vision and committed to the team’s success, will not be as easily lured away from your company for a few extra dollars. They don’t want to let the team down.

All Hands On Deck!  

As you scale, you need problem-solvers, even when you are not in the room. There is no way one person can solve all the problems of an organization. Many of us have joked, if I could only clone myself, or a talented member of the team. Newsflash: you can’t! 

Not only will there be problems that you cannot solve, but there will also be problems you cannot even see from your vantage point as a leader. While you may observe symptoms of a problem, you may not be close enough to the root cause to diagnose and solve it. Therefore, having a team that is motivated and empowered to solve problems is critical as you scale.

You Need Ambassadors  

Everyone must be invested in sharing the culture with new team members. Just like with solving problems, you may not be able to personally acclimate each new team member and model your expectations. You need everyone within the organization to do that if you want the “newbies” to understand and embody the values of your culture. Say it with me now: I can’t do it all!

Build Your Team’s Culture

If you want to start or expand your focus on developing your team culture, check out these easy habits to build team culture. I hope these reasons inspire you to commit more time to culture-building activities. 

If you would like to see some examples of easy exercises that you can begin doing with as little as one hour per month, check out some of my recommended culture-building activities and tracking tools. Feel free to download, modify and make them your own!

Jamie C. Pagliaro

Executive Vice President & Chief Learning Officer

Mr. Pagliaro currently serves as Executive Vice President and Chief Learning Officer of Rethink, a global health technology company providing cloud-based treatment tools, training and clinical supports for individuals with developmental disabilities and their caregivers. Prior to joining Rethink, Mr. Pagliaro was Executive Director of the first charter school for children with autism spectrum disorders in New York City. The program has received national recognition from the media and a number of professional publications as a model for children with autism in the public school system. Mr. Pagliaro has worked directly with individuals with disabilities in all stages of life across a variety of home, school and clinic settings. Mr. Pagliaro has an MBA from Villanova University and a BA with honors in Psychology from Wesleyan University. He speaks nationally, serves on several professional advisory boards, and has authored numerous articles.

three different color pencils on paper

5 Reasons for Moving Away from Pencil & Paper (Manual) Documentation

As therapists, we are well aware that change can be difficult for our clients and for us. Once we get accustomed to doing something one way, we typically prefer to keep things the same. However, we also know that adapting activities to make them easier and more efficient is a key to what we do for both our clients and ourselves.

We understand that therapy practices or therapists within these practices may have a strong relationship with documenting manually, either using pencil and paper or using Word or Google Docs. As an industry, we are now at a point where those methods are antiquated and can impact your practice negatively. By pivoting to an Electronic Medical Record (EMR) and using other online tools, you can quickly take your practice to another level in critical areas, such as billing and scheduling.

We're now going to provide five reasons for moving away from manual documentation. We expect you'll be tossing away your pencils & paper after reading this regardless of how you feel about change.

1. Meet HIPAA Requirements

A solid EMR allows you to protect client information and only provides access to specific providers in your practice. A robust EMR typically contains these features:

  • “Access control” tools like passwords and PIN numbers, so practice owners can limit access to authorized individuals
  • An “audit trail” feature which records who accessed documents, what changes they may have made, and when those changes occurred
  • Methods for sharing documents with other providers working with your client

By completing your documentation within the safety of an EMR, you avoid situations where many employees have access to a file cabinet where your client records are stored. It also prevents the situation where an employee is completing documentation on a personal laptop that other people in their family may use as well. These situations put your company at risk for a HIPAA violation.

Completing all documentation within an EMR will help avoid the costly impact of a HIPAA violation.

2. Standardize and Improve Documentation While Saving Time

By setting up systems within a robust EMR, you can ensure that documentation follows a standardized format that meets requirements set by your funding entities. No more encountering a situation where payment is denied for services because of inadequate documentation. Your notes can be set up with required fields, and formatting can ensure that progress towards objectives is clearly documented.

In a solid EMR, demographic information will pull to your therapy reports and notes, avoiding situations where a nickname might be used and result in denials. When notes are completed, much of the information will auto-populate, saving your therapists valuable time.

Robust EMR systems often allow therapists to pull up previous therapy notes, and then modify them based on the client’s performance on that date. Assessment templates reduce the time spent by your providers in completing their report. Again, these features reduce the time that your therapists spend completing their documentation, thus allowing more time with their clients.

Reducing documentation time, while improving quality, helps your practice in several ways:

  • Improved employee retention due to job satisfaction
  • Improved client outcomes because of more time spent directly with clients and families
  • Increased revenue with therapists spending less time on non-billable activities

3. Improve Quality and Coordination of Care

Documentation within an EMR also allows access by authorized users to improve coordination of care. Your speech and language pathologist can log into the EMR, and quickly review the occupational therapist and BCBA’s notes prior to providing their session. Reports and notes can also be shared with providers who work remotely and rarely come into the center.

If a therapist needs to refresh their memory from a previous session, they can quickly pull that previous note up in the EMR and review. This HIPAA compliant access for authorized team members improves quality of care for your clients.

Another reason for completing documentation within an EMR is that parents can access your notes easily and securely. Many funding entities require documentation showing parent involvement and training, which can be partially accomplished through sharing your documentation. Making documents available to families helps avoid situations related to “information blocking”, another HIPAA requirement.

4. Ensure Documentation is Complete and Timely

When using a robust EMR, you can set up methods to require that documentation is completed and track any sessions where that documentation might be missing. An internal audit process can be developed and completed quickly on a regular basis to track any missing or late documents that could interfere with patient care and billing. The EMR will eliminate situations where you are asked for therapy notes for a specific time period, and you realize notes are missing for specific dates.

Additionally, most EMRs will track when a note was completed, which some insurance companies require. This information helps you manage your team and the expectations set by your practice. You can then run regular internal audits to identify any notes that are not being completed in a timely manner, according to the expectations set by your practice. Timely documentation is critical to quality client care, and accurate reporting of that care.

5. Ensure That Your Company is Audit-Ready

With more insurance companies and other funding sources performing audits of service providers, it is critical that you have an easy way to provide the information that these auditors request. One essential component of these audits is documentation showing progress, along with full documentation to support all billed services.

By documenting within a solid EMR system, those records are all at your fingertips quickly. And as discussed earlier, you have standardized your documentation to meet insurance requirements, making the audit process a successful one for your practice. If timely documentation is a requirement of that funding source, you have that information ready to share with the auditor at a moment's notice. If parent signatures are required, you can easily show that as well.

A robust EMR with good internal auditing processes will make audits less painful and more successful. At Rethink, we have multiple solutions that can help you migrate from paper to a digital format. Our newest product, Rethink Total Therapy can help with the transition, especially if you are expanding to other types of therapies.

Two women sitting and talking

How to Start an ABA Therapy Practice & Clinic: A Step-By-Step Guide

Due to the staggering impact of Covid-19, in 2020, the global autism spectrum disorder therapeutics has reached a whopping 3.6 billion US dollars. If you have dedicated your life and your career to providing your community with specialized ABA (Applied Behavioral Analysis) therapy services, you might consider taking your commitment to the next level. 

As a board-certified behavioral analyst (BCBA), you’ve had the chance to supervise behavior analysis and mentor ABA therapy providers. However, by starting your own ABA clinic, your expertise and experience can become irreplaceable assets for your community, especially in this moment of unprecedented need. 

If you are unsure where to start in your pursuit of launching your own ABA therapy clinic, check out this step-by-step guide by Rethink

Benefits and Potential of Starting an ABA Clinic: Understanding the Market

If you are launching an ABA practice to serve your community, you might be doing so with a humanitarian, compassionate mindset. Nonetheless, it is essential to keep in mind that you are, in fact, running a business. It’s not strictly going to be using the ABA therapy skills that you’ve developed.

For how enriching this venture is, there are some new skills you have to learn when running a company. Let’s start with one of the most important ones: understanding the market.

Starting an ABA clinic represents a significant financial investment. At this time, the market is in the midst of a full global boom, which has both positive and negative ramifications.

In particular, ABA therapy providers represent the fastest-growing segment within the “communication & behavioral therapies” category within the autism spectrum disorder therapeutic sector.

While there is certainly not a lack of business opportunities, the competition for new ABA clinics is fiercer than ever. The main competitors you will have to deal with include:

  • Other local and multi-state clinics and practices
  • Franchises
  • Private equity-owned and large corporations

Nonetheless, local practices are the pillars of community wellbeing and sector growth. Join this thriving industry with the tips below. 

Taking Care of Your ABA Therapy Business’s Administrative Side

While the goal of a local ABA practice is to provide a service to the community, some thornier aspects of owning a business cannot be overlooked. The administrative side of things might not be the most exciting aspect for you, but that’s where the help of a trusted accountant and attorney come into play!

Develop a Business Plan

Whether you are looking to start a small, local business, or you are looking to build out a franchise, you will need funding. There are several pathways you might consider, including:

  • Self-funding
  • Investors, angel investors or family members
  • Loans through specialized lenders or banks
  • Grants - such as the ones offered by SAMHSA or HRSA
  • SBA Line of Credit 
  • Local government and private company grants

No matter what type of funding you are hoping to get, you will need to craft a business plan for your ABA therapy practice. Your business plan should include your value proposition, mission, vision, financial forecast, target market insights, competitor analysis, and details about your unique selling points. 

There are two main reasons why you should not skip this step:

  • A business plan defines a clear roadmap for your business and helps you keep track of your goals, achievements, and efforts
  • A business plan is needed by investors to verify your credibility and understand what is worth investing in your ABA business. After all, a return on investment is their number one concern. 

Choosing Your Business Model and Registering Your ABA Business

The business model and type of business for your private ABA clinic should be chosen wisely. Some of the most popular options include:

  • Sole proprietor - a sole proprietor or sole trades is the only owner of an unincorporated company. A sole proprietor only pays personal income taxes, and can keep the rest of the profits. It also comes with unlimited liability, which can cause you to struggle to get capital funding. 
  • Partnership - partnership, limited partnership, and a limited liability partnership are business types used to get into business with a co-owner. After paying taxes, profits, losses, and liability are shared among the partners. 
  • Limited liability company (LLC) - LLCs are legal entities regulated by the state or country they are in. They can be treated as a sole proprietorship, partnership, or corporation, depending on the number of owners. While there is plenty of paperwork linked to starting an LLC, this business structure can help you protect yourself and your company from significant losses. 

Generally, the best option is to register your private ABA clinic as an LLC. Setting up a sole proprietorship or partnership might seem easier, but it might not offer you the legal protection to operate with peace of mind. In any case, since each practice is unique, consulting a specialized lawyer or accountant can help you understand the pros and cons of each. 

Once you have decided on your business entity, you can register it with the IRS here

Policies, Legal Contracts, and Compliance

Policies and legal contracts are what determine the relationship between the ABA provider and its clients, and they are the backbone of a business - especially for ABA companies. These include:

  • Billing and fees - some payment models include fee-per-service and predetermined per-person payments. Your contract will also outline billing schedules, cancellation fees, and payment types
  • Confidentiality, nondisclosure, and privacy policy - privacy policies and terms and conditions of service are essential aspects to consider, especially because your ABA therapy clinic and providers will handle sensitive data such as a patient’s medical history and conditions. 
  • Liability release - when operating as an ABA therapy provider, your business entity will carry a liability. If you have registered your clinic as an LLC, you might only be subjected to limited liability, but legal contracts can help you keep losses at bay.

In terms of compliance, before opening a business you will need to:

  • Obtain your employer identification number (EIN)
  • Set up your business taxes
  • Determine your forms of payments
  • Select a payment processor, if taking credit and debit cards
  • Decide on whether you will be accepting insurance

Legal contracts and complaints are essential to shaping your business, so make sure you are working in partnership with a specialized lawyer. 

Finding the Right Premises and Location

To determine what location will work best for you, you will need to answer these questions:

  • Will you offer in-home services?
  • Can you deliver services via online platforms?
  • Do you need a physical space for your practice?
  • Can you rent an office space hourly?

The cost of buying or renting depends on location and size. It’s hard to give an estimate, but larger cities tend to have higher costs, while rural areas are lower.

Deciding on Your Company Name

The name you decide to give your ABA therapy company can influence your marketing strategy and brand image. Some key factors to keep in mind when choosing a name include:

  • Ensuring it is easy to spell and remember
  • Checking that it is unique - you can check this in the state’s business registry
  • Making sure the name you choose describes what you do
  • Don’t make your name too specific as this could limit your company’s future development 
  • If you are using an abstract name, double-check the meaning of it in different languages
  • Check domain availability. If possible try to get a .com domain and avoid dashes or numbers.

Insurance and Enrollment

ABA clinics develop important relationships with insurance providers. Accepting insurance as a form of payment is an excellent option which can add considerable value to your business, make your ABA therapies more accessible, and expand your practice’s reach. 

If this is the strategy you have chosen, there are different factors to keep in mind:

  • Each insurance provider has different requirements, payout timings, and reimbursement rates.
  • You must create the right insurance contracts with the insurance providers in your network to maintain control over your cash flow
  • You need to be aware of the credentialing process

Both you and the insurance provider need to agree that you will be able to offer insurance as a payment type. The process of becoming a certified care provider on an insurance provider’s panel is called credentialing. During the credentialing process, the provider will verify your education, certifications, and training to ensure your clinic meets its network standards. 

While getting credentialed is essential for your budding clinic, the process can take longer than a year. Thanks to the right practice management software, you can effortlessly keep on top of your Enrollment and Credentialing tasks and focus on what’s important. 

Putting Together a Team 

Your clinic’s team will be your most important asset, and ideally, you should focus on a diverse team. Below are some team members to consider:

  • Registered Behavior Technician (RBT) - covers similar roles and tasks to the BT, but also offers a certification issued by the Behavior Analyst Certification Board (BACB) for meeting their strict requirements.
  • Board Certified Behavior Analyst (BCBA) - these independent practitioners have graduate-level certifications and can supervise the administration of ABA treatments by the BT and RBT.
  • Board Certified Assistant Behavior Analyst (BCaBA) - this is an undergraduate certification that allows practitioners to work under the supervision of a BCBA or BCBA-D. BCaBAs can assist with tasks above the level of competency of BTs and RBTs.
  • Biller - this person will be responsible for billing, revenue cycle management, eligibility checks and insurance verification. This position is extremely important because cash-flow is the lifeline of any business. You may consider doing this yourself or leverage our outsourced billing services so you can focus on increasing billable hours and providing more care to clients. 

Supporting tasks of your business can be delegated to experienced contractors, such as marketers, billers, accountants, IT professionals, and attorneys. You also have the option to hire these positions in-house, but when starting a new business it might not be the right time to do this.

Investing in the Right ABA Therapy Clinic Technology

As businesses become more reliant on technology, ABA practices must as well. However, technology can represent a significant cost for a young ABA practice so understanding what is needed, beneficial, and profitable is essential. 

Here are some pieces of tech that you shouldn’t skimp on.  

Choosing a Practice Management Solution

A tailored Practice Management Solution is the most important system to integrate. Whether you are running a small practice or you are planning on opening multiple outlets, a Practice Management platform designed to meet your unique needs can:

  • Collect and analyze data
  • Help you manage your clients
  • Streamline appointment scheduling
  • Manage billing, fees, and insurance reimbursements
  • Increase the level of cybersecurity of your practice
  • Provide better, more customized services to your clients
  • Give authorized personnel immediate access to necessary documents and information
  • Streamline the channels of communication with your clients

All this not only helps you cut down costs, but can help you prevent financial losses, damage to your practice’s reputation, and customer dissatisfaction. 

Try to resist the urge to default to paper and pencil. We understand it’s easier to get started, but in the long run it can be overwhelming. The right practice management system is highly scalable, so you can entirely focus on expanding a company without having to switch or adapt systems. 

Setting Up a Business Email Address

Your clinic will require a custom business email address, which you can set up via Google Workplace or Microsoft 365. There are other valid alternatives, but these two options are the most widespread and provide a high level of integrations, spreadsheets, documents, calendar features, scheduling benefits, and team management features. 

Depending on your budget, you could also set up a professional address for your customer service, ABA therapists, and BCBA professionals, so that your clients can communicate directly with their providers and have a direct channel of communication with your clinic. 

Installing a Phone System

An integrated phone and VoIP system that connects multiple lines is an efficient solution to streamline your ABA clinic’s communication channels. These solutions are affordable even when you are getting started. 

If you end up using Google Workplace, you can sign up for Google Voice which integrates with your email system. Again, it’s easy to use your personal phone number, but we highly discourage that. Over time your phone number will be picked up by sales people and you will receive a lot of solicitations. 

Devising a Marketing Plan to Grow Your ABA Therapy Business

Now that you have set up your ABA therapy business, you will need to make it more easily visible, accessible, and discoverable by potential clients. To start growing your ABA business, you will need to design a marketing plan that is suitable for your goals and target market. 

If you are already focused on managing your practice and supervising ABA therapies delivered in your budding clinic, you should consider letting a professional marketer devise a strategy to attract patients. 

Some of the aspects to cover include:

  • Deciding on your brand voice and visual identity - The key goal of marketing campaigns for ABA businesses is to gain the trust of clients and patients. Creating a trustworthy voice and visual identity can not only help you increase traffic, but also improve your reputation!
  • Building a business website and focusing on Search Engine Optimization (SEO) - Having an online presence is essential to build trust and make your new business more discoverable. Use local SEO techniques to help patients, who are already looking for your services in your area, discover your practice. 
  • Gaining visibility with a Google Business Profile - Registering for a Google Business Profile is essential for any business. Thanks to this service, your clients will be able to immediately know your contact details, reviews, operating hours, and location. 
  • Create a social media community - While social media channels might not seem like the best marketing channel for your practice, there are many ways to use these platforms to your advantage. For example, giving them free advice, tips and suggestions can offer you unparalleled returns!  
  • Generate reviews and testimonials - Reviews help your organic visibility, but also help convert prospects into potential patients. It’s also important you are following the Ethics Code for Behavior Analysts guidelines regarding reviews.
  • Network with other practices and ABA clinics - Not all providers are your competition! By expanding your network and cooperating with other providers, you can help your clients enjoy better care. 

Keep The Future (and Scalability) of Your ABA Practice in Mind

According to the Bureau of Labor Statistics (BLS), businesses in the social assistance sector are among the longest surviving ones. However, the rate of survival of businesses has been shortening over the past 20 years. 

Around 25% of businesses survive past their 15th anniversary today, and over 65% of new businesses fail within their first 5 years on the market. These statistics tell us that the first years of your business are the most crucial ones. 

During this delicate time, it is important to focus on what investments can help your ABA therapy company grow and become more resilient.

Launching an ABA Therapy Clinic: Your FAQs, Answered!

  • Who can start an ABA therapy clinic?

To start an ABA therapy clinic, some states require you to be a Board-Certified Behavioral Analyst. Please check with your state’s requirements before fully investing into an ABA Therapy business.

  • What accreditations do I need to start a credible ABA therapy practice?

While you just need your training and certifications to get started, you can increase the credibility of your practice by getting accredited by BHCOE.

  • How much does it cost to start an ABA therapy clinic?

There is no clear data on this as it depends on various factors such as your personal goals, location, etc.

Get Started on Launching Your ABA Therapy Today

In this guide, we have explored the steps required in order to build an ABA therapy clinic. However, don’t forget that what makes it successful is the relationships you build with your customers. 

Partnering with the right contractors and professionals such as accountants, attorneys, and marketers will put you in the position to create these new relationships. But in order to increase reliability and growth, which is a contributing factor and result of building strong relationships, consider partnering with Rethink to integrate a personalized Practice Management System. 


the right hand of a female taking notes

Free ABA Data Sheets & Forms - Updated 2022

At Rethink Behavioral Health, we offer all-in-one behavioral health solutions for Applied Behavior Analysis (ABA) providers. We believe that technology allows providers to grow quicker through efficiencies, but we understand some still prefer paper and pencil.

At the end of the day, we want to be a resource for everyone, because when it comes down to it, all we’re trying to do is improve care for those who need it. With that in mind, we developed several data sheets that ABA providers can use to track their data.

These free ABA data sheets are easy to download. We encourage you to customize each sheet to meet the needs of your clients or service delivery model. If you’d like to learn more about our clinical and practice management solutions, please contact us here.

To download our Free ABA Data Sheet, please fill out your information below:

What’s included

We’ve broken this bundle of free ABA data sheets down into two primary categories, they are:

  • Programming
    • Skill Acquisition (SA)
    • Behavior Reduction
  • Supervision forms

Programming includes any goals that are trying to be accomplished to increase a variety of skills, such as daily living, communication and social skills, along with behavior reduction strategies, which includes any forms dedicated to tracking challenging behaviors.

Supervision forms will include any Procedural Integrity (PI) forms, Inter-Observer Agreement (IOA) and other tracking forms which we’ll go into more detail on below. These are more for program and staff evaluation.


As mentioned above, Programming pertains to any goals that are to be accomplished to increase skills and replacement behaviors, and decrease problem behavior. Programming is broken down into two categories; Skill Acquisition and Behavior Reduction.

Skill Acquisition

The first component related to programming is SA. In this section we’ll review Task Analysis (TA) and Discrete Trial Training (DTT), as well as several methods of data collection.

Task Analysis (TA) Data Collection

Clinician monitoring parent-caregiver behavior with complex behavior chains use this method to break them down into smaller steps.

A sequence of brushing teeth, washing hands, then going to bed is a common example.

Additional steps and targets can be identified by understanding each step.

Discrete Trial Training (DTT)

One of the most common ABA teaching methodologies is Discrete Trial Training. It is a one-on-one approach aimed at teaching students new skills in a systematic way.

DTT allows for massed or interspersed trial options. In our DTT Data Sheet, clinicians can track up to 10 individual trials and track accuracy and independence in responding.

Cold Probe Data Sheet

Cold Probe Data Sheets are ideal for tracking skill acquisition with many targets within a program.

They allow the parent or therapist to probe correct or incorrect responses at the beginning of the session prior to teaching. This can be used instead of trial by trial data collection.

Rate Data Sheet

The Rate Data Sheet helps track both the frequency and rate of targeted skills. These two factors are related, but have different definitions.

Frequency is defined as the number of times something occurs, while rate is the frequency of that same activity over a specified period of time.

Interval Data Sheet

Tracking intervals allow for an observer to set any amount of time to monitor the occurrence and/or duration of a behavior, and is an estimate of how often behavior is occurring. This sheet has space to track 20 intervals, which can be defined as whole, partial or momentary-time sampling (MTS).

Whole means that a behavior occured for the entire interval, partial describes a behavior that occured at any point throughout that interval, and MTS tracks if behavior is occurring at the end of the interval.

Duration Data Sheet

These sheets allows clinicians and therapists to track the lengths of time of each occurrence of behavior for each skill.

Behavior Reduction

Behavior reduction focuses on any maladaptive behaviors targeted for decrease. The two primary sheets that will be used in this component are the Antecedent Behavior Consequence (ABC) Data Log and Scatterplot Data Sheet.

Additionally, the Rate, Interval and Duration sheets detailed above can be used for tracking behavior reduction.

Antecedent Behavior Consequence (ABC) Data Log

The log provided is an unstructured ABA data log, as opposed to structured. This log can be edited to create a structured data sheet per client, which can be helpful for parents and caretakers as it makes the process more objective. Parents can select from a menu of options as opposed to writing their own thoughts down.

ABC Data allows parents to see patterns in behavior, including challenging behaviors such as tantrums, aggression, self-injury, etc, what causes them, and what follows them. This sheet helps track a specific behavior during an activity, along with the antecedent (before), consequence (after) and possible function.

Total duration is also an important component to track here, as duration may decrease before frequency of episodes decreases.

Scatterplot Data Sheet

Our Scatterplot Data Sheet helps to determine behavioral patterns with regard to time.

These sheets allow clinicians to track when behavior occurs in 15, 30 and 60-minute intervals over a 24 hour period.

Supervision Forms

Supervision forms included anything related to Procedural Integrity (PI), Inter-Observer Agreements (IOA), and additional forms used for tracking, but not necessarily related directly to client behavior.

Their purpose is to record data on parent and caregiver performance, so supervisors can provide feedback to improve performance as needed.

Task Analysis (TA) Procedural Integrity (PI) Data Sheet

When it comes to Task Analysis, procedural integrity is essential. PI is defined as how accurately a program is consistently implemented as it was intended.

This method is used by a clinician monitoring parent-caregiver behavior with complex behavior chains and breaking them down into smaller steps. Examples include a sequence of brushing teeth, washing hands, then going to bed. By understanding each step, additional steps and targets can be identified.

With TAs, any type of skill can be targeted. Our TA PI Data Sheet allows clinicians to track trials for pre-teaching behaviors, in-session steps and space at the end for error correction.

Discrete Trial Training (DTT) Procedural Integrity (PI) – Data Sheet

This is a structured method for teaching a new skill. Because of this, it’s especially important that caregivers implement trials as programs.

It is also used to evaluate a parent or caregivers implementation of DTT trials. This free ABA data sheet tracks up to 10 individual trials, along with pre-teaching, within-session and error correction responses.

Natural Environment Training (NET) Procedural Integrity (PI) Data Sheet

Last, but not least, is Natural Environment Training. NET is less structured than DTT, and allows clinicians to capture teaching opportunities as they occur naturally.

A child may be able to learn a skill in a structured environment, but may struggle to generalize the skill in the natural environment. This is an important factor for educators to understand, so they can tailor instruction so students can apply lessons learned naturally.

Similar to DTT, this free ABA data sheet tracks up to 10 individual trials, including pre-teaching, within-session and error correction responses.

Inter Observer Agreement (IOA) Templates

IOA data sheets are designed to evaluate accuracy in ABA data collection and identify observer drift or bias.

With IOA data collection, two people will observe a child or client at the same time, and record data on the target behavior or response. Once completed, they will compare their data.

The process helps determine if behaviors are well-defined, recorded accurately and consistently. This is also known as program correctness, and highlights the importance of recording data accurately.

Behavioral Skills Training Tracking Form

The Behavioral Skills Training Tracking Form is used to teach a new skill to a caretaker or caregiver. This may be an especially effective method of training with telehealth services.

The instructor provides a set of instructions and models for parents what to do step by step. The parent practices while the ABA therapist or supervisor watches and provides feedback, and this process continues until the skill has been mastered.