By | September 21, 2015

The future of healthcare is not as far off as people think. We’ve already shared the six trends that are already affecting change throughout the industry, and discussed the specific changes affecting the IDD and HHS fields. Now, with recent legislation, we’re beginning to see the future of behavioral health change as well.

On September 15, 2015, President Obama released this Executive Order: Using Behavioral Science Insights to Better Serve the American People. The order directs departments and agencies to identify programs and policies that could benefit from applying behavioral principles, with the goal of improving the health and safety of individuals and communities. Obama asked government agencies to work with behavioral science experts to implement behavioral strategies and evaluate the impact of these strategies.

Examples of behavioral science you’re already exploring

The use of behavioral science to improve health, safety, and welfare of communities is nothing new to behavioral scientists (also known as behavior analysts). There have been many initiatives to apply behavioral principles and arrange the environment to increase desired behaviors in individuals and groups. Here are a few examples:

  • Actively Caring For People: An initiative to recognize any behavior that goes above and beyond the call of duty on behalf of health, safety or welfare of another person.
  • Automated speed enforcement: The use of street cameras to catch speeders and issue automated tickets in the mail. A study conducted in Washington D.C. showed that this program led to long-term changes in driver behavior and substantial reduction in deaths and injuries.
  • The Fun Theory: The use of fun (AKA reinforcement) to change people’s behavior for the better. This includes motivation for wearing seatbelts, recycling, using the stairs instead of an escalator, and so on.
  • Wearable fitness trackers: Wrist bands that can track your sleep and activity levels and provide individuals with motivation to change health related behavior.

The growth of behavioral science

Behavioral science is entering a new age of increased awareness and application. Fields such as eLearning, health and fitness, education, addiction recovery, parent education, business — to name a few — have all been seeing the benefits of the applications of behavioral science (also known as applied behavior analysis, or ABA). Practitioners in these fields are starting to turn to behavioral experts to help provide improved products and services that affect the health and safety of individuals and communities.

Originally, ABA received awareness from being an effective intervention for children with autism. Due to the number of research studies demonstrating its effectiveness, along with work from advocacy groups such as Autism Speaks, ABA is now covered by insurance companies in more than 40 states. In 2014, the federal government gave a directive to the Center for Medicaid Services (CMS) to step up the Medicaid-funded ABA treatment for autism. ABA has done so well in the field of autism that it’s often viewed synonymously with autism. With this increased demand for ABA services, there has been an understandable increase in Board Certified Behavior Analysts.  In the past 5 years alone we’ve seen almost a 300% increase! But the ripples spread further than that.  There is also an increase in university programs that provide the educational requirements to become certified.

What comes next?

With the adoption of ABA into medical coverage and CMS, ABA services for children with autism will likely follow closely behind mental health and substance abuse services, and become integrated into primary care. Imagine a scenario where a patient receiving care from a primary care physician receives prescriptive behavioral treatment by their doctor for autism spectrum disorder or in the long-term for a condition identified as behavioral, or a combination of medical and behavioral  (children with feeding issues, for example, or enuresis [bed-wetting], or sleeping disturbances).

Although this change could take many years, ABA service providers would be wise to pay attention to what is happening in the mental health and addiction fields.   The ways in which they are adapting to the integrated care is a sign of things to come for ABA service providers– because we will be next.

What does this mean for ABA providers?

What does this mean for our field?  Listed below are a few things ABA providers can start to do to support increased growth of ABA beyond autism and to prepare for high-impact changes in healthcare:

  1. Publish research on the effectiveness of ABA with other populations and with other problems (behavioral gerontology, mainstream behavioral problems, addiction, and so on).
  2. Publish behavioral research outside of behavioral journals.
  3. Join and learn from successful professional organizations (American Psychological Association, American Network of Community Options and Resources, The National Council for Behavioral Health). Consider presenting research at their conferences.
  4. Communicate and collaborate with other health fields in practice and research.
  5. Do a better job at showing the power of ABA by being better at marketing to the general public.
  6. Watch for the changes in the healthcare environment that were covered in the July post on High-Impact Changes in the Healthcare Environment: How Will You Adapt?

The future of ABA looks bright and active and gives us more opportunities to collaborate with healthcare professionals and provide service to a wider range of individuals in need. What are other things we as ABA providers can do to prepare for and foster growth and integration into healthcare?

Emaley McCulloch, M.Ed., BCBA

Vice President, Relias Institute||In 2008 Emaley McCulloch co-founded Autism Training Solutions, LLC and is currently the Vice President of Relias Institute at Relias Learning. She is a Board Certified Behavior Analyst and holds an MA in Special Education. She has over 20 years’ experience in the field of autism and ABA and has provided and overseen services to individuals between the ages of 18 months to 24 years in homes, schools and clinical settings. For eight years she served as a consultant and supervisor at agencies based in Hawaii and Japan where she trained groups of professionals and parents.

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