Stop Funding the Three Tier ABA Machine (and Start Funding Assent)

Let’s talk about the ABA model that most families get funneled into.

You know the one. BCBA at the top. BCaBAs in the middle. RBTs and technicians at the bottom.

On paper, it sounds efficient. In real life, when this model is driven by insurance contracts, productivity targets, and limited provider networks, client care can get pushed off the table. Especially assent, the basic idea that a child is not a project, not a checklist, and not a compliance robot.

The part nobody says out loud

Insurance funded ABA often creates a situation where parents feel trapped. Not because parents are weak, or naive, or not advocating hard enough. Because the system is built to restrict choice.

If it took you months (or longer) to get a diagnosis, then months to find a provider, then months to get authorized, you are not exactly in a position to shop around. And when your insurance plan has a limited network of providers, the “choice” can feel like this.

Take what’s available or get nothing. That is not a real choice.

And when families are stuck, the power imbalance grows. Some companies know it. Some companies exploit it. And some companies are so deep in the machine they do not even notice they are doing harm.

“All ABA is the same,” right?

No. Not even close.

There is ABA that is built around assent, dignity, collaboration, and skill building that makes life easier for the whole family.

And there is ABA that is built around forced compliance, adult convenience, and “because I said so” with data sheets taped on top.

Both might be labeled ABA. Only one deserves your trust.

How assent gets crushed in the three tier model

Assent is not a vibe. It is an ethical obligation for behavior analysts.

But here is what happens in a lot of insurance driven three tier setups:

• The BCBA is spread thin across too many cases.

• The day-to-day therapy is run by staff with less training and less authority.

• Staff are pressured to “run programs” the same way, the same pace, for the same hours, because that is what gets authorized and billed.

• Parents are told to accept it, because this is how ABA is done.
  

When you put those contingencies together, you get a system that can produce high compliance and low humanity.

“If you don’t take data, then I am not going to potty train your child.”

Read that again...

A trainee recently told me a BCBA said this to a parent in 2026. That is not clinical excellence. That is coercion dressed up as professionalism. It takes a family who is already overwhelmed and turns support into a hostage situation.

Potty training is a real-life skill. It is supposed to reduce stress, increase independence, and help the child participate more comfortably in daily life. Using it as leverage to force parent compliance is the opposite of assent based care.

Yes, you can report unethical behavior analysts and technicians

Most parents have no idea this exists, so here is the plain version:

• If the person is certified (BCBA, BCaBA, RBT), you can report alleged ethical violations to the BACB Ethics Department through their reporting process, which includes submitting a Notice of Alleged Violation.

• The BACB also publishes reporting resources and considerations specifically for reporting BCBAs and RBTs.

• If the person is licensed in your state, you can also report to the state licensing authority.
  

A quick note on expectations. Reporting is not a magic wand. It is still worth doing when there is a real ethical concern, because patterns only get addressed when consumers speak up. This is not about revenge. This is about consumer protection.

What we do differently

In my practice, we do not treat “the three tier model” as the default solution.

We center the BCBA’s role where it belongs, directly supporting caregivers, building practical routines, and designing interventions that respect the child’s communication. Assent is not an add-on. It is the starting point.

If you are a parent, you deserve care where you are not held hostage by a system. If you are a BCBA, you do not get to hide behind “that is what insurance requires” when a child’s dignity is on the line.

If you only take one thing from this post

Stop assuming ABA is interchangeable. Ask how decisions get made. Ask who is actually delivering treatment. Ask what happens when your child says “no” with their behavior. And if you see coercion, threats, or forced compliance packaged as “standard practice,” invite yourself to take it seriously. You have options, and you have a voice.