This is bad. Time for a big change.

Following a rough year with three clients who were admitted to hospitals due to crisis escalations, the BA feels good about her decision-making but also wants to feel even more prepared for future cases. She decides to attend a workshop an ABA about the intersections between common medications and the assessment and treatment of crisis behavior.

An adult client’s self-injury is consistently at crisis levels. Following two assessments and several modifications to the behavior plan, the behavior analyst and psychiatrist agreed that an inpatient stay was indicated. However, the client and her caregivers were not willing for her to be admitted to a hospital. The BA was asked to write a statement on why an involuntary admission was necessary. He had to consult his state’s laws for the criteria of involuntary psychiatric treatment.

A client’s crisis behavior escalates when he returns from weekends with his mom. It was always accepted that this was the case, but now it seems to be getting worse and the client is shouting novel statements such as “Lock that door!” and “Let me out.” The BA decides to submit a report to the protective agency.

When a client continues to struggle with escape-motivated aggression and is not making progress at school, the family begins to wonder about alternative school programs that may be better equipped to provide an engaging curriculum and individualized instruction. The BA tells them that he completed his supervision hours at a great private school and offers to set up a meeting with the director.

When the BA arrives at the school to see her client, the staff are holding the client’s arms and blocking his escape from his desk. The BA takes a step back and realizes that the behavioral escalations and staff training need some attention. She calls the parents and school administrators to tell them the situation has escalated to crisis and she needs 10 hours per week for the next 8 weeks in order to keep everyone safe from harm.

An adult client is being transitioned from a group home to a more restrictive residential facility due to ongoing aggression toward housemates. The behavior analyst takes some time to put together the files he created to securely transfer them to the BA at the new facility. He also makes sure the new BA has his contact information and offers to set up a phone call to discuss the case.