Boundaries for In Home BTs!!!
Companies must prepare BTs better with expectations for what to expect in home! I’m an in home RBT. When I worked in the clinic we were constantly being reminded of rules and expectations which were easy to follow because I was there every week and knew what to expect. A couple of weeks ago I was feeling kind of burnt out, I have been with a certain family for about two years. In that time I have seen a lot of growth, and some setbacks. I have gotten way better at establishing and maintaining boundaries with them and reminding them of what my company’s policy is. A couple of weeks ago I was feeling kind of burnt out, I have been with the family for about two years. In that time I have seen a lot of growth, and some minor setbacks.
But anyways I was feeling burnt out specifically from the parents because I essentially have to continuously relay the same information and they often go against it to my client’s detriment. I know they are trying and I do have a lot of empathy for them but sometimes it is tiring to keep having the same conversations and to time when it’s most appropriate to have them because I also have to maintain good rapport. But I came to this sub and started searching for posts about having patience and empathy with parents only to stumble upon a host of posts of people complaining about parents, parents complaining about BTs, and parents and ABA practitioners arguing in the replies. But one thing that stuck out to me was how some of the BCBAs and BTs were reminding other BTs that they are medical professionals in someone else’s home and are not entitled to access anything aside from whatever the company and parent has agreed upon. There needs to be more education around maintaining appropriate professional relationships during in home care.
So I’m here to just give a word of my advice to my fellow in home BTs and share what I have learned. I don’t think companies, in my experience, really prepare BTs with what to expect during in home sessions. Those posts really opened my eyes and caused me to start moving different in a way that helped me detach from the family. I am by no means cold or rude but I genuinely have started minding my business and sticking to what pertains to my job and it is really improving my mental health at work and making me a better professional. For context there is a younger sibling who often does things that I feel obligated to do something about, like they will spill something somewhere and hide it from the parents and I’ll make sure I inform them which they appreciate. I am really good at noticing all of the details and am often able to somewhat accurately predict how all of the things will come together to impact my client. Sometimes we are good at our jobs and we start helping out with other things and it makes parents comfortable to do things like asking me to lie to the younger sibling about something because they want to avoid them having a tantrum or asking me to ask them to do something so they will listen. They asked me to do it because I had influence over them from building rapport with them while they played with me and my client. And I understand why they would expect that of me based on how I have helped with the child in the past if I see them yelling or refusing to comply with demands (wash your hands that sort of thing) but ultimately that goes beyond the scope of my job description. I saw the younger sibling taking food from the pantry the other day and I did remind them in passing that they are supposed to ask the parents first but the parents were occupied where I would have to go out of my way to inform them and it wasn’t my responsibility so I just told them and then went back with my client. Those are the types of things where before I would really try to tell them, but it is simply not my responsibility. There is something to be said about taking on more work than you are required to do and then getting burnt out faster for extra work you are not compensated for. I know a lot of our companies put us in unfair positions and will sometimes excuse parents asking us to do things outside of the realm of our job description but to the best of our ability we have to stay on track. Sticking to my actual job is a game changer so I implore you guys to take care of yourselves by setting yourselves up as best you can. I make sure I have a phone charger, water bottle, sanitary pads, toothpicks, toothbrush, extra pair of socks (I’ve unfortunately stepped on poop before and a lot of our kiddos also love slime so it’s good to have a backup), protein bar, pads for my knees, just anything that I may need during a session. Also having a portable charger for telehealth supervision days is very helpful and alleviates the stress of your phone battery draining. Check your local library, mine often has FREE crafts and activities for kids that can help bring something new to session that doesn’t cost you anything or make you have to jump through hoops with your company. Just make sure you know how your client interacts with materials and don’t borrow anything that they are likely to damage. Get a lock for your personal bag! I’ve seen too many BT’s lose keys in the clinic or have kids go in their bags. Sometimes I have to carry ibuprofen and things like that so I have a lock on my bag and many measures to prevent a kid from ever gaining access to that. I’m also planning to add a first aid kit, so that’s another thing I don’t want them accessing. I don’t ask the families for anything unless it’s “hey mom can client’s name and I use the scissors for this art project.” But I recently got my own scissors 😂. I keep all of my client’s materials in the materials bag and no longer allow the younger sibling to use things unless their BT is present and can ensure they will be returned to me. If we’re doing bubbles, puzzle, play-dough or something everyone can enjoy of course they are welcome to join but I cannot risk my client’s materials for the younger sibling to potentially lose, it’s not fair to my client who is my responsibility. We work a very stressful but rewarding job so do your best to leave behind the extra labor and focus solely on your client. Bring whatever specific things you will need during the session so you are never in a position where you NEED something from the family. They don’t have a right to put extra responsibilities on us and we don’t have a right to do it to them either. People are really struggling financially and mentally right now so do your best to care for yourself and maintain empathy for your client and their family. Also I would love to see some “what’s in my bag” or “what’s in my trunk content.” No one can give us better tips on how to prepare than we can. I hope you guys are doing well ♥️.