The field of Applied Behavior Analysis (ABA) is expanding rapidly, driven by rising diagnoses, insurance coverage mandates, and growing demand for services. Industry data show that therapy appointments are projected to grow significantly, alongside steady increases in revenue, service hours, and insurance payments (CentralReach, 2025). From a distance, this growth looks like progress. Up close, it looks like burnout. The system is expanding faster than the workforce can keep up with, and the burden is falling on the lowest-paid workers in the field: the Registered/Behavior Technician (R/BT).
For the purposes of this article, entry-level workers in ABA will be referred to as "R/BTs," though it is important to note that RBTs are certified (must pass an exam, maintain supervision, and periodic competency checks).
Persistent staffing shortages remain one of the defining features of the ABA industry despite the rapid increase in certified professionals. Overwork and exposure to a variety of seasonal illnesses lead to chronic illness and fatigue, increasing call-outs. The work is stressful, physically and emotionally. Researchers have documented that demand for behavior analysts and technicians continues to outpace supply, leaving families on waitlists and organizations struggling to retain staff (Nastasi et al., 2024). Client cancellations often mean R/BTs don't get paid, which means they'll need to work additional jobs or quit out of financial frustration. Put simply, the shortage is not simply a pipeline problem: it's a retention problem.
When R/BTs turnover, BCBAs need to adapt the treatment plan for new technicians as they work to rebuild trust and rapport with the family. This can lead to service interruptions, "pauses," and even skill/behavior regression for children, and tremendous frustration for families, who endured a long wait list only to have a rapid turnstile of workers serving their child. There is no data on the effect that this may have on the young children who meet, grow to trust, and then eventually lose their R/BT over and over again. It would be easy to hypothesize that this type of cyclical abandonment is harmful at best, traumatic at worst.
The data are clear: Workers are leaving the field because conditions make long-term employment difficult, if not impossible, to sustain.
High turnover has become normalized across the industry, yet the underlying causes are remarkably consistent nationwide and from company to company. Studies examining burnout among Behavior Technicians (BTs) and Registered Behavior Technicians (RBTs) have identified recurring themes, including difficult working conditions, dissatisfaction with pay and benefits, inconsistent supervision, and career stability (Nastasi et al., 2024). These findings align with industry reports indicating that employee turnover remains a persistent challenge for providers and directly affects the continuity and quality of care delivered to clients (CentralReach, 2025). Turnover is often treated as an unfortunate but inevitable feature of the field. The research suggests otherwise: It is a predictable response to working conditions.
The Problem We Saw Coming
More than a decade ago, researchers were already warning that the structure of the ABA workforce could create exactly the problems we are now experiencing. In a widely cited 2016 analysis of the newly created Registered Behavior Technician (RBT) credential, scholars raised concerns that the rapid expansion of entry-level staff with limited training requirements could lead to reduced service quality, workforce instability, and increased commercialization of the field if not carefully managed (Leaf et al., 2016) . The authors specifically cautioned that the minimum training standards for technicians appeared inconsistent with the level of skill required to deliver high-quality intervention and warned that economic pressures would likely encourage organizations to rely on the least expensive labor available. They also noted that the growth of certification systems, combined with rising demand for services, could accelerate the commercialization of ABA and create incentives that prioritize expansion over workforce development. In retrospect, these warnings read less like speculation and more like early diagnosis. The high turnover, inconsistent training, injury rates, and workforce shortages documented across the field today are not unexpected outcomes. They are the predictable consequences of structural decisions identified years ago, long before the current crisis became what it is.
Safety concerns further illustrate the structural nature of the problem. Surveys of behavior technicians working with severe problem behavior reveal that workplace injury. In one national study, 75 percent of technicians reported sustaining a work-related injury while performing their job, and more than one-third reported that their client also experienced an injury during service delivery (Ralston & Brown, 2023). Injury types range from minor cuts and scrapes, to concussions, fractures, and severe bites. These findings reflect the physical demands of the work and the reality that technicians are frequently assigned to challenging cases without adequate preparation or ongoing support. Working in the community poses its own risks: a behavior technician, Charles Kinsey, was shot by police while attempting to help his client, a young man with autism, get out of the road. According to news reports, before he was shot, Charles was heard saying:
"All he has is a toy truck. A toy truck. I am a behavior therapist at a group home"
Female RBTs experience sexual harassment from caregivers. Black and queer RBTs are "taken off cases" when a family feels "uncomfortable." In the name of expanding access to services, employers in the ABA space are putting workers through emotional and physical trauma on a daily basis.
Training and supervision practices remain inconsistent across organizations, contributing to both safety risks and burnout. Research indicates that some technicians enter high-risk situations with minimal preparation: 13 percent report no initial training and 29 percent report no ongoing training while working with clients who exhibit severe problem behavior (Ralston & Brown, 2023). At the same time, as highlighted by Leaf et al. (2016), the formal requirements for entry into the RBT role remain relatively limited. The credential requires a high school diploma, a background check, and completion of a 40-hour training program prior to certification (Leaf et al., 2017). While supervision by BCBAs is intended to supplement this initial preparation, the quality and availability of that supervision vary widely across providers. There is a national shortage of BCBAs, with the BACB reporting 81,566 currently certified, while some industry analysts estimate demand for 132,307, growing 10-30% year-over-year.
These workforce problems are not occurring in isolation. They are unfolding alongside a rapid transformation in the industry's ownership structure. Over the past decade, private equity firms have moved aggressively into autism services, attracted by reliable insurance reimbursement and growing demand. Between 2017 and 2022, private equity firms completed approximately 85 percent of all mergers and acquisitions in autism services, making the sector one of the most heavily consolidated areas of healthcare (Batt et al., 2023).
Most of these investments did not involve building new clinics or expanding services. Instead, they involved purchasing existing providers and restructuring them to generate rapid financial returns. In some cases, companies were burdened with substantial debt after acquisition, creating pressure to reduce staffing, cut training, and increase billable hours (Batt et al., 2023). Researchers and clinicians have warned that these financial strategies can undermine both job quality and patient care by prioritizing profitability over stability (Batt et al., 2023).
The collapse of major provider networks has illustrated the risks of this model. After a private equity acquisition, one of the largest autism service providers in the United States closed more than 100 sites and ultimately filed for bankruptcy, leaving workers unemployed and families scrambling to maintain services (Batt et al., 2023). The first RBTs who organized a union in Oregon attempted to push back. Oscar Lemus-Arellano and Mica Rudich organized their coworkers to improve their working conditions, fighting for better pay and more frequent breaks. The AFT quoted Oscar, who had worked at CARD for 2 years, as saying:
“The turnover rate interfered with the mission. People would come in, stay for a few months, and leave. But the longer you work with a child, the better the therapy you provide because you build a better rapport.”
After the vote, the company closed down operations in the entire state. Events like this are not just business failures. They are workforce shocks that ripple outward through entire communities.
The structure of the workforce itself reinforces instability. The RBT role is often framed as an entry-level position rather than a sustainable profession, leading many workers to view the job as temporary. Researchers have described the position as a transient or poorly defined career path, contributing to ongoing workforce turnover and dissatisfaction (Nastasi et al., 2024) . This instability affects not only workers but also the children and families who rely on consistent therapeutic relationships. Frequent staff turnover disrupts treatment progress, increases workload for remaining staff, and undermines organizational stability.
Workers themselves have been clear about what would improve retention and job satisfaction. Studies consistently identify competitive pay, reliable benefits, consistent supervision, and opportunities for professional development as key factors influencing whether technicians remain in the field (Nastasi et al., 2024) . These recommendations are neither radical nor unrealistic. They reflect standard employment practices in most healthcare professions. Their absence in many ABA settings highlights the structural nature of workforce instability.
Burnout in the ABA workforce is often framed as an individual issue requiring resilience or stress management. However, the research literature defines burnout as a response to environmental stressors in the workplace rather than a personal deficiency (Nastasi et al., 2024). Low wages, unpredictable schedules, high caseloads, and insufficient training create conditions that increase the likelihood of burnout, regardless of individual motivation or dedication. RBTs are not failing at their jobs - their jobs are failing at being a reasonable way to make a living, and providing a sustainable method for young children to get the support they need.
The rapid growth of the ABA industry has created a paradox. Demand for services continues to increase, yet the workforce responsible for delivering those services remains unstable. Organizations expand operations, open new clinics, and serve more clients each year, while the underlying labor conditions remain largely unchanged. Financial investment has accelerated this expansion, but it has not solved the fundamental workforce problem. In many cases, it has intensified it, with quarterly KPIs replacing compassion, and the field's reputation is increasingly damaged by these malignant practices.
Addressing these challenges requires more than incremental adjustments to training programs or retention initiatives. The problems facing the ABA workforce are fundamentally labor issues involving compensation, safety, workload, and professional voice. Historically, workers in healthcare and human services have improved these conditions through collective action. Unionization provides a mechanism for workers to negotiate wages, establish safety standards, secure benefits, and participate in decision-making processes that directly affect their work. As of 2026, there are 6 clinics with union representation, but no group has yet signed a bargaining agreement with an employer. These victories are important, but the ultimate goal - establishing better conditions and protections for ABA workers - remains elusive.
The future of the ABA field depends on the stability of its workforce. Without meaningful improvements to working conditions, turnover will remain high, children will go neglected, staffing shortages will persist, and the reputation of the field will continue to decline. The research is clear about both the problems and the solutions.
The ABA Workers Union resolves to be a part of the solution. We encourage all workers to strongly consider organizing. At the end of the day, our working conditions are the client's learning conditions, and these kids deserve the best.
