Rapid Conversion from Clinic to Telehealth Behavioral Services During the COVID-19 Pandemic
A big clinic flipped to telehealth overnight and served more clients while making more money.
01Research in Context
What this study did
Crockett et al. (2020) watched a large ABA clinic switch from in-person to telehealth in days. The team kept every data sheet and billing code the same, just on screens.
They tracked how many kids got hours, how much money came in, and whether staff still used graphs to guide choices.
What they found
After the switch, the clinic served more families, not fewer. Revenue and profit both rose while data-based decisions stayed in place.
No lay-offs happened. Staff kept collecting data and adjusting plans each session, just through video calls.
How this fits with other research
Shepley et al. (2021) ran a brief outpatient model and saw gains only when families stayed; drop-out hit 39%. Crockett’s clinic cut travel time, so more families could stick around.
Schreck et al. (2025) warn that BCBAs already carry too many cases. Telehealth, shown here, can add hours without adding drive time, easing the load instead of piling it on.
Souza et al. (2023) found telehealth BST trains parents well. Crockett proves the same tech can keep an entire clinic humming at full volume.
Why it matters
You can expand reach and protect revenue the Monday after an emergency. Keep your data sheets, graphing rules, and staff roles—just deliver them through a screen. Start with one case, measure fidelity, then scale up.
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02At a glance
03Original abstract
Survival often depends on behavior that can adapt to rapid changes in contingencies, which should be particularly well suited to a contingency-sensitive and data-based discipline such as applied behavior analysis (ABA). The speed and scale with which contingencies shifted in early March 2020 due to the effects of COVID-19 represent a textbook case for rapid adaptation with a direct impact on the survival of many types of enterprises. We describe here the impact, changes, and outcomes achieved by a large, multifaceted ABA clinical program that has (a) ongoing data that forecasted and tracked changes, (b) staff well practiced with data-based shifts in operations (behavior), and (c) up-to-date information (data) on policy and regulations. The results showed rapid shifts in client and staff behavior on a daily basis, shifts in services from in-person services to telehealth, and increases in volumes, revenue, and margins. We detail regulations and provide actionable steps that clinical organizations can take pertinent to this shift now and in the future. The challenges of the COVID-19 pandemic underscore the importance of maintaining robust coordination and communication across our field in order to address crises that affect our field.
Behavior Analysis in Practice, 2020 · doi:10.1007/s40617-020-00499-8