By Matt Harrington, BCBA · Behaviorist Book Club · Clinical decision guide
One of the most consequential decisions a behavior analyst makes is not just what intervention to use, but how to approach the clinical question in the first place. For bixpli presents: using the r.ai.s.e. platform to target your next clinic location in under a week, the difference between an evidence-based, individualized approach and a traditional, protocol-driven one can significantly impact outcomes.
This guide lays out the key factors side by side to support your clinical decision-making.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Time to first client | De Novo: Longer lead time — typically 6-12 months from site selection to first client, including leasing, buildout, licensing, staffing, and credentialing | Acquisition: Faster entry — existing clients, staff, and payor contracts in place, often allowing revenue on Day 1 post-close |
| Capital requirements | De Novo: Higher startup capital for leasehold improvements, equipment, and cash reserves to fund operations during ramp-up to break-even | Acquisition: Capital goes primarily to purchase price plus integration costs; ongoing capital needs may be lower if acquired practice is already operational |
| Clinical culture control | De Novo: Full control over clinical culture, hiring standards, program design, and staff training from day one | Acquisition: Inherits existing clinical culture, which may require significant remediation if the acquired practice has quality concerns or staff with entrenched habits |
| Staffing risk | De Novo: High staffing risk — must recruit and credential an entirely new team in the target market before accepting clients | Acquisition: Inherits existing staff, but key staff may leave post-acquisition, creating immediate clinical continuity risk for existing clients |
| Revenue trajectory | De Novo: Slower revenue ramp as intake grows from zero; requires adequate capital reserves or credit to fund operations during the build period | Acquisition: Faster revenue from existing client base; however, due diligence must verify revenue quality and sustainability post-transition |
| Strategic fit with R.AI.S.E. | De Novo: Directly aligned with R.AI.S.E. methodology — market analysis, site selection, operational readiness, and launch planning are all relevant | Acquisition: R.AI.S.E. market analysis informs target market identification, but acquisition due diligence adds additional layers including financial, legal, and operational review of the target practice |
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Use this framework when approaching bixpli presents: using the r.ai.s.e. platform to target your next clinic location in under a week in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
Bixpli Presents: Using the R.AI.S.E. Platform to Target Your Next Clinic Location in Under a Week — Lani Fritts · 1 BACB General CEUs · $0
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.