Why is it important to provide care with uncompromising integrity? According to Christine, uncompromising integrity helps improve quality of life and sets people up for success all the way from childhood through to adulthood.

Christine is a mother, a BCBA, and an entrepreneur. She is pursuing her mission to provide the best support available to children with autism and their families by opening her own practice in the Seattle area. We had the chance to speak with Christine. We spoke about her philosophy of care, her first experience working with a BCBA, and the role of mental health support & technology in her practice.  

After a successful career spanning from New Mexico to Washington, you are about to open your own practice; congratulations!

Can you please share with us why it is important for you to open your own practice at this time, and what makes you most excited about this opportunity?

Since transitioning from public school to private practice, I have worked with some of the bravest and most incredible children and their families. The science of ABA opened up the opportunity to have an impact on the world, one person at a time. I’ve always been an optimist, a dreamer, and I am driven by the desire to have an impact. I am now opening my own practice so that I can do just that.

When I first began teaching, diagnostic rates were about 1 in 150. Diagnostic rates are now 1 in 59. In 20 years, 1 in every 59 young adults will have an autism diagnosis. At these rates, this is not a diagnosis that will affect just the individual and their family members, this will impact society as a whole.

Early, intensive intervention can change what that journey into adulthood looks like. It can help ensure that these future young adults have a skillset that allows them to be productive community members. Most importantly, it can help them have the best quality of life possible.

Some waitlists are up to two years in length for diagnosis and another 18 months for ABA therapy. Many families are often missing the critical window for early intervention, which is between 2-5 years of age. We need more BCBAs, more RBTs, and more agencies providing the highest quality of treatment available.

Opening my own agency will allow me to ensure that the families I serve are receiving the best treatment possible, and that it is delivered with uncompromising integrity. It allows me to continue to be a part of success stories, not only for my clients, but of the employees who are part of my team.

When you meet with families for the first time, what are some things you do to help them build trust in you as a therapist, and in the practice of ABA as a whole?

No two stories are the same. I’m a professional and parent of a child on the spectrum, and I have experienced challenging moments that seem insurmountable at times. Meeting a family with understanding and working together to identify the most important goals for their child are the first steps in building trust as a valued member of their child’s team.

One by one, families will begin to experience hard won successes like first words or calmer home routines. They will see their child light up to greet their clinical team. All this helps build trust in myself, the team, and the practice of ABA.

Family education and involvement are also key components of any good, trusted ABA program. As parents see what they feared was impossible for their child happening every day, as they witness the devotion, hard work, and joy of their clinical team, parents naturally become part of that team. Parents who are involved help bring consistency in all environments. This allows their child’s progress take on a remarkable trajectory.

ABA can dramatically increase the developmental trajectory of every client who receives it. It is truly remarkable to have a resource like this available. I always say that ABA is hard work, but it is heart work, so it makes it all worthwhile.

It’s an honor to work with children and their parents. I always keep that in mind, and strive to live up to that honor by providing the highest quality of care.

Thinking back on your first experience working with a BCBA, can you tell us what inspired you to follow that path yourself?

The first time I had the opportunity to collaborate with a BCBA, I was teaching a special education kindergarten class. One student was experiencing significant challenges and he was homeschooled while he went through a medication change. I had the opportunity to work with his ABA team during his home instruction.

My previous education and teaching experience had taught me to spend a significant amount of time focused only on behavior management. I learned that with ABA, the focus is on learning new skills with positive reinforcement serving as motivation.

I was in awe of the ABA team’s ability to motivate this student. His skill acquisition rates were very impressive. ABA methods allowed this child to make significant progress that I had not been able to achieve in the classroom.

The moment that truly inspired me to transition from teaching into clinical practice was when I observed this student interacting with his mom at the end of a session one day. Many parents of children with ASD often find themselves feeling overwhelmed with each task, which can have an impact on the whole family. This mom was able to calmly and effectively use ABA methodology to navigate daily tasks with her son.

At that moment I realized ABA was really about improving the quality of life not only for the child, but the whole family. That’s when I knew I had to follow this path.

Can you speak to the importance of addressing mental health challenges as part of your therapy?

An ASD diagnosis is rarely a single diagnosis. ADHD, Depression, Anxiety, and medical diagnosis such as epilepsy co-occur at a very high rate. Depression to the point of suicidal ideation and debilitating anxiety to the point of not leaving home is a common story I hear from parents of children with ASD.

It is imperative that ABA extends beyond early intervention, into adolescence and adulthood. The skills the learner needs to acquire change over the course of a lifetime, but the need for assistance may not. An effective ABA practitioner has an expanding repertoire of skills to address the diverse needs of their client. Acceptance and Commitment Therapy, and Relational Frame Theory offer excellent tools for our clients to successfully navigate mental health challenges.

Are there any innovations in technology that you think might help practitioners better address challenges in delivering care?

An ABA clinician should always consider themselves part of a larger team for all of their clients. Collaboration with other skilled clinicians such as SLPs, OTs, PTs, Medical and Psychiatric providers is imperative for true success.

One of the biggest challenges in this collaboration is effective communication. Communication between parents and all team members can ensure that critical daily information can be shared efficiently and make the difference between a challenging day or a successful day.

Each clinician is devoted to success of every one of their patients and coordinating care can be difficult with competing schedules. Technology allows opportunities for better continuity of care. Telehealth allows clinicians to remotely view another practitioner’s session with a shared client which can truly allow for the best co-treatment. Web-based data collection platforms offer the opportunity for real time viewing of data collection and sharing of these strategies and resources.

Technology can ensure that all private health information is securely stored and protected while allowing members of the clinical team to communicate and collaborate frequently and efficiently to better provide exceptional client care.  

Christine is looking for a partner!

Christine Domschot, BCBA, is opening her own clinical ABA practice in Seattle, WA – but she can’t do it alone. She is looking for a partner to join her and help grow her business. If there are any readers who are dedicated to ensuring that clinical integrity is never compromised, please reach out to Christine on LinkedIn.

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