What Do People Think You Do?
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Most people don’t know the full scope of what I do on a day-to-day basis. Everyone knows I work primarily in a school, and that I work with autistic children. However, they don’t know if I work in the classroom with the children, or in a dedicated room outside of the school’s general population. The most common assumption is that I am in charge of teaching the children I work with, which is true to an extent, but, it is much more than that.
What Do You Really Do?
A direct therapist is in charge of executing a behavioral plan established by a Board Certified Behavioral Analyst (BCBA). This treatment plan can have a number of purposes depending on the person you work with, and it can cover anything from teaching new skills (such as brushing their teeth), to eliminating unwanted behaviors (such as screaming in class). As a direct therapist, you have the flexibility of working in one – or more – of the three main settings; in school, at home, or in a clinical environment.
Since the end-goal is to help the client reach a point where they can live autonomously – as someone without autism would – teaching in a school or home setting is done most frequently, and clients that require extra work may go to clinical time as well, when it’s available, as not all providers offer this service. The school setting specifically can be broken down into several subsets, with the two most common being working with a client in a dedicated special education room, or working with them in a regular classroom, also known as “inclusion”.
The availability for inclusion services varies between school districts, the support provider, and the client in question. However, inclusion is the goal more often than not as it allows us to help the individual obtain the social skills required for living what is considered to be a good life.
A Day In The Life
While my weekly schedule consists of days with different students, at different schools, I always start each day by meeting the student at their bus when it arrives at school. From there, we go to a dedicated area to allow the child to transition into being at school. Beyond that, the day differs between those students that go to inclusion and those who remain in a separate classroom.
As a direct therapist, we want to always be assisting the client to help them meet “social norms” to the best of their ability in order to help them fit into the social aspects of life. For children that take part in inclusion; the teacher leads the class – including the client – and we step in to address behaviors as needed, and to give extra support to the client. For children that are in a special education class, or entirely removed from other schoolmates, we take an increasingly hands-on role in educating the child. This is where behavioral teaching aspects such as discrete trials and naturalistic training really come into play; these help rigorously address gaps in a client’s academic or social performance, to help them reach the level expected from their peers.
My experience in this position has introduced me to students who take part in inclusion for the entirety of their day, students that spend their day working alone, and everything in between. This is where the variations in what you can expect on a daily basis occur as it will impact your schedule throughout the day. As can be expected when working with someone on the Autism Spectrum, how they interact with you and the world around them can change on a daily basis as well. Because of this, every day is a little different, even when you’re working with the same client every day, and the same can be said for after-school sessions, such as those conducted in the home. During the school year, working in-home with a client focuses more on life skills and enhancing social skills. This is where you will find yourself teaching a client how to get ready for bed, brush their teeth, prepare and eat a meal, all on their own. In some situations, you may just find yourself talking with the client to assist them in developing social skills to assist them in better communicating at school or work. As mentioned previously, the primary role of a Direct Therapist is to help ensure a client is able to live as normal a life as they possibly can, through teaching and support. Every client and every situation will be different, so learning to adapt to each scenario is something that a good Direct Therapist needs to know how to do, and also something that keeps the job exciting and especially rewarding when you get to watch the accomplishments of the individuals that you work with.
What’s The Average Income?
$15/hr is about the average, with slight room for a pay bump after becoming a Registered Behavioral Technician (RBT) through on the job training
What Education If Any Is Needed?
Most companies offer extensive training after the hire, so experience seems to be more important than education, and can come in the form of volunteering, past work, or even just exposure to family or friends who suffer from a mental illness. With that being said, I had minimal experience, but an extensive educational background in Psychology.
Something Important To Know
Although everyone is well aware of what their paycheck will be when they’re first hired, the most common complaint I hear is “I don’t get paid enough for this”. While there aren’t exceptionally long days – you’ll likely have issues filling a 40 hour week depending on where you work – the work itself can be extremely stressful, so burn out is another chief complaint. Many of the clients you encounter will have mental disorders beyond just autism, and autism itself can present in many different ways, so while some clients can be a breeze, others can be aggressive and very difficult to work with. Focusing on the positive moments is what gets most people to stay in the field because there’s nothing better than seeing all the hard work one of your clients puts into reaching a goal, and being there when they finally attain it.