Psychology Public Health Hub

Your go-to source for comprehensive
information on global health

The Person Sitting on the Floor Matters More Than the Program

I’ve worked as an ABA Behavioral Therapist for just over ten years, most of that time providing direct, hands-on support to children in homes, clinics, and public school classrooms. My days have rarely looked like the tidy session plans families are shown during intake. They’ve looked like sitting cross-legged on a living room rug while a child tests every boundary, stepping into overstimulating classrooms where the schedule changes without warning, and quietly coaching parents through moments they didn’t expect to feel so heavy. If there’s one thing experience has taught me, it’s that the effectiveness of ABA often hinges less on the program itself and more on the person delivering it.

ABA Therapy vs CBT for Autism: Which is Better?I learned that lesson early on. In one of my first long-term cases, I followed a treatment plan exactly as written, running drills with precision and collecting clean data. On paper, the numbers improved. In the room, the child disengaged more each week. It wasn’t until a supervising analyst asked me to slow down, sit with the child without demands, and rebuild rapport that anything real changed. That moment reshaped how I see my role. Being an ABA Behavioral Therapist isn’t about executing instructions perfectly; it’s about reading the room and adjusting in real time.

Families often assume that behavioral therapists are interchangeable, but they aren’t. I’ve taken over cases where a child had already worked with multiple therapists in a single year. Each transition erased progress that had taken months to build. One family I supported last spring told me their child stopped responding to his name after yet another staff change—not because he couldn’t, but because engagement had stopped feeling safe. Consistency isn’t just convenient; it’s foundational, and a good therapist understands how fragile early trust can be.

Another misconception I run into is that an ABA Behavioral Therapist should always be “in control” of a session. I’ve found the opposite. Some of my most productive sessions came from letting go of the plan when a child clearly couldn’t access it that day. I remember a morning when a child arrived visibly dysregulated after a rough school drop-off. Pushing forward would have looked productive to an outsider, but it would have failed the child. We spent most of that session regulating—quiet activities, minimal language, shared calm. The skill acquisition came later, and it stuck because the foundation was there.

That doesn’t mean therapists should be passive. I’ve seen real harm done by staff who avoid challenging behaviors out of fear or discomfort. Avoidance often teaches the wrong lesson. The balance is knowing when to press and when to pause, and that judgment only comes from experience and supervision that values thinking, not just compliance. I’ve had to unlearn rigid habits more than once, especially early in my career, when I equated structure with effectiveness.

Parents sometimes ask me what separates a strong ABA Behavioral Therapist from an average one. I don’t talk about credentials first, even though I carry the required certifications and ongoing training. I talk about observation skills—whether the therapist notices small shifts in body language, understands why a behavior is happening in that moment, and can explain their decisions without hiding behind jargon. I also pay attention to how they speak about the child when the child isn’t listening. Respect shows up there.

After a decade in this role, my perspective is grounded and specific. ABA works best when behavioral therapists are treated as skilled practitioners, not interchangeable staff, and when they’re encouraged to think critically rather than just follow instructions. The work is demanding, often emotional, and rarely as straightforward as it appears from the outside. But when the right therapist is sitting on the floor, paying attention, and adjusting moment by moment, meaningful change becomes possible in ways that feel real to families—not just measurable on a chart.

Scroll to Top