The Personal Case for Using Skill Based Treatment

A woman in a pink sweater gently hugs a crying young girl with light brown hair in a ponytail. They share an emotional, comforting moment indoors.
In this compelling post, the author shares a personal perspective on the efficacy of skill-based treatment, shedding light on the transformative impact it can have in the realm of behavior services.

Picture this scenario: You’re hosting a dinner party with your family, including your three young children, along with friends and their families. Everyone’s having a wonderful time—the kids are sitting at the table, following directions, and eating nicely. Then suddenly your 3-year-old daughter melts down. She clearly doesn’t want to eat what’s served or sit at the table. She starts crying and screaming, refuses to stay in her chair, and wants to sit in your lap. Remember, you’re a behavior analyst—you’re supposed to know what to do! Put that behavior on extinction; don’t ignore the child, but ignore the challenging behavior. Ignore the crying until it stops, then address what they want after they follow at least one direction. Your friends, being behavior analysts themselves, understand. They can handle a crying child. After all, this is what you do for a living!

So that’s exactly what I did. I ignored my daughter’s crying until she stopped and followed my directions to sit in her chair. Then I reinforced that behavior by letting her sit in my lap while she ate. This is what I recommend, right? Isn’t this what I’ve recommended to parents countless times? Isn’t this what I believed was right? In theory, the challenging behavior would decrease over time, and she’d learn to ask nicely for things instead of crying. Right? But if this was the right approach, why did I feel so terrible? Why did it haunt me that night, the next day, and even two days later? Why did I feel compelled to apologize to my friends—not for my daughter’s behavior, but for my own?

After that dinner party, I realized I hadn’t done the right thing. I thought, “There’s no way I’ve recommended this procedure to my clients. There’s no way I believed this was the best approach.” Then it hit me: while ABA once recommended extinction-based procedures, we’ve evolved to embrace more child-directed and empathetic approaches like Skill Based Treatment (SBT). In both my personal recommendations and our company’s approach, SBT has become central to our treatment plans and parent support. We’ve moved away from ignoring client behaviors. Instead, we emphasize empathy and understanding why clients behave as they do. We focus on teaching them to make requests in their way and cope with changes to their schedules and activities.

So what did I do at home for my daughter?

While I didn’t follow the formal SBT process, I began using its language with my 3-year-old. I say things like “I understand that this is hard and it’s okay to be mad.” I give her time to feel angry and offer hugs when she’s crying—even if she’s crying in response to a request, throwing things, acting out toward her sisters, or having a tantrum. I provide time that’s exclusively “her way,” where we do exactly what she wants, how she wants, without questions. I’m fully present—no phone, no distractions, no demands. In return, she’s more willing to do things I ask, even if they’re not her preference because she knows she’ll get her time to do things her way.

This approach has reduced her tantrums, improved her communication with me, and strengthened our bond. We haven’t experienced a meltdown like that dinner party since I started using more SBT techniques. I feel I’m doing better by my daughter and her two younger sisters. I’ve become a stronger BCBA and feel more confident recommending SBT and showing greater empathy with our clients.

You might wonder why I’m sharing this personal story. Why expose my doubts about my parenting abilities, clinical recommendations, and skills as a behavior analyst? I believe it’s vital to recognize that everyone grows through experience, training, and time—both as parents and professionals. This story shows that behavior analysts are human too. We face the same parenting challenges as everyone else, and we don’t always get it right. But we can learn, grow, and adapt our approaches, both at home and in our practice.

Contact Graham Behavior Services about ABA therapy or our Purposeful Parenting program if you are experiencing challenges with your children.

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