Who supervises your ABA therapist? Focus on autism: Supervisor support and therapist burnout

By Nestor Lopez-Duran PhD

In an effort to identify the predictors of therapists burnout, researchers examined the factors that affect the perceived self-efficacy and work well-being of therapists providing intense behavior analysis services for children with autism.

A review of:Gibson, J., Grey, I., Hastings, R. (2009). Supervisor Support as a Predictor of Burnout and Therapeutic Self-Efficacy in Therapists Working in ABA Schools Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-009-0709-4

One of the most common observations in clinical practice is that the therapists self-perceived level of competency (does he/she think he/she is effective?) and the therapist general work-related well-being can have an impact in the effectiveness of the treatment. Self-efficacy and general well-being can also have an impact on the risk of burnout, in that therapists may be more likely to feel burnout or even abandon the profession (or a particular case) if they feel that they are not effective or feel overwhelmed. For therapists providing ABA interventions with children with autism, this issue of great significance, since the nature and intensity of ABA treatment may lead to high rates of burnout among these therapists. However, despite the general adoption of Applied Behavior Analysis as standard care for many children with autism, there is little research on what factors affect the perceived efficacy and well-being of ABA therapists.

In a study scheduled for publication in the Journal of Autism and Developmental Disorders, a team led by Dr. Jennifer Gibson explored the potential contributors to perceived self-efficacy and well-being among 81 ABA therapists (76 females, 5 males) working at schools in Ireland. Specifically, the authors examined nature of the supervision provided to these therapists, the intensity of the work demands, and the degree to which the therapists displayed commitment to the underlying philosophy or tenets of ABA therapy.

The authors found that the experience of the therapist (number of months working) and perceived supervisor support predicted therapeutic self-efficacy . That is, those who had been at their current job the longest, and those who reported good supervision support, were more likely to report higher levels of perceived self-efficacy. A commitment to ABA did not predict perceived self-efficacy.

Two types of burnout were examined: 1) burnout due to emotional exhaustion, and 2) burnout due to low levels of perceived personal accomplishment.

In regards to burn out due to emotional exhaustion, high levels of perceived work demands, and low levels of perceived supervision support predicted high levels of emotional exhaustion burnout

In regards to burn out due to low levels of perceived personal accomplishment, low levels of supervision support also predicted this type of burnout. However, the association between work demands and personal accomplishment depended upon the supervision. For example, for those therapists reporting good supervision support, work demands did not appear to affect their feelings of personal accomplishment. However, for those with low supervision support, high levels of work demands were associated with low levels of perceived personal accomplishment.

In summary, the most striking finding was that supervision support, or at least the perception of good supervision support, was the strongest indicator of perceived self-efficacy, burnout due to emotional exhaustion, and burnout due to low levels of personal accomplishment. The role of supervision appeared to have an even greater impact on the therapists feelings of personal accomplishment, in that supervision support appears to mitigate the possible effects of feeling overwhelmed with work demands. These findings have major implications for parents who are in charge of coordinating their kids home ABA programs. The findings suggest that the quality of the supervision provided to their therapist may be a significant factor in determining the efficacy of the therapist as well as the possibility of turnover due to burnout.