By Matt Harrington, BCBA · Behaviorist Book Club · Research-backed answers for behavior analysts
The most significant challenges fell into two categories. Client-level challenges included increased challenging behavior driven by disrupted routines, lost access to reinforcers that normally maintained appropriate behavior, heightened anxiety responses to environmental change, and regression in skills that had been maintained by regular community and social activities. The establishing operations created by social isolation, schedule disruption, and the loss of positive reinforcement sources significantly elevated behavioral vulnerabilities for residents with pre-existing behavioral challenges. Organizational challenges included severe staffing disruptions, the need to modify behavior intervention plans and skill programs for environments that now looked completely different, maintaining supervisory oversight with limited in-person access, and managing the emotional and psychological impact on both residents and staff simultaneously.
Maintaining fidelity under staffing disruption requires that behavior plan knowledge be distributed across more staff members than typically implement the plan under normal conditions. Crisis-period strategies include simplifying existing behavior plans to their highest-priority elements — identifying the two or three most critical response protocols and focusing training and oversight on those — and developing one-page implementation guides with visual decision trees that allow backup staff to implement core procedures without the depth of training that primary staff have. Emergency BST sessions of 20-30 minutes can bring backup staff to a functional implementation level for the most critical behaviors. Accept that fidelity will be lower than usual during crisis periods, document the staffing disruptions in your data records, and prioritize safety-critical behaviors over skill acquisition during acute disruptions.
The first step is behavioral assessment to identify the functional variables driving the increase. Challenging behavior that increases during crisis events is typically a predictable behavioral response to altered antecedent conditions and motivating operations — not a sign that existing interventions are no longer working or that escalation is required. The analysis should ask: which specific antecedents associated with the increase in challenging behavior have changed? Which positive reinforcers have been removed or reduced? What new aversive stimuli have been introduced? The answers point toward antecedent modification strategies — engineering the environment to restore as many maintaining conditions as possible — and reinforcement supplementation strategies that compensate for lost reinforcer access. More restrictive interventions should be the last resort, not the first response to behavioral deterioration during crisis conditions.
Skill acquisition programs should be reviewed against the current environmental reality and modified to reflect what can actually be implemented given current staffing, physical space, and resource constraints. Programs that require community settings should be adapted to available indoor alternatives where possible, or placed on temporary maintenance schedules if adaptation is not feasible. Safety and functional independence skills — those most relevant to the current crisis context — should be prioritized over generalization and expansion of skills that depend on normal environmental access. Maintain data collection on at least a reduced schedule so that skill regression can be detected and addressed rather than discovered after extended delays. When normal operations resume, conduct a full assessment of skill regression across all active programs and rebuild maintenance schedules accordingly.
Research and practitioner reports from the pandemic period identify several organizational adaptations that supported service continuity. Technology-mediated family contact — video calling, family training via telehealth — maintained family engagement when visitation was not possible and helped families provide behavioral support remotely. Cross-training of staff across multiple residents before the crisis hit significantly reduced vulnerability to staffing disruptions, because organizations with broadly competent staff were better positioned to redeploy personnel when specific teams were depleted. Written crisis protocols that specified decision criteria for service modifications allowed leaders to make faster, more consistent decisions under pressure. And proactive staff support — acknowledging the difficulty of the situation, providing psychological support resources, and making explicit efforts to reduce unnecessary demands on staff — helped sustain staff performance under conditions that would otherwise have accelerated burnout.
Telehealth and video supervision provide a viable alternative to in-person supervision for many supervisory functions: case consultation, data review, protocol review, and supervision of written work can all be conducted effectively via video platforms. Functions that depend on direct clinical observation — fidelity assessment, behavioral skills training with rehearsal — are more challenging at a distance but can be approximated through video recording of sessions reviewed asynchronously. When in-person supervision is entirely unavailable, prioritize the supervisory functions most critical for client safety: direct oversight of crisis response procedures, review of safety plans, and monitoring of behavioral data for concerning trends. Document all supervisory contacts, including mode of delivery, so that the modified supervision record reflects the reality of crisis-period operations.
A behavior-analytic crisis preparedness plan operates at three levels. At the client level, it includes documented contingency plans for each resident's two or three most critical behavioral support conditions, specifying functional alternatives for each. At the program level, it includes prioritized lists of the skills and behaviors that are most critical to maintain during disruptions, with specific guidance on how standard programs should be modified in different crisis scenarios. At the organizational level, it includes staffing thresholds that trigger different service modification protocols, communication procedures for families and guardians, supervisory backup chains, and data collection minimum standards that apply during disruptions. The plan should be reviewed annually under normal conditions and tested against specific crisis scenarios to identify gaps before an actual crisis requires it.
Communication with families and guardians during crisis events should be proactive, specific, and frequent. Families have a right to know how their family member's care is being affected, what specific changes have been made to behavioral programs, and what the organization is doing to maintain quality under difficult conditions. The most effective communication specifies concrete behavioral information: 'John has shown increased attempts to elope from his room in the past week, which we believe is related to not being able to access his usual outdoor activities. We are implementing three indoor activity alternatives and want to discuss with you whether there are activities from home that might help.' This behavioral specificity is more useful and more reassuring than general statements about maintaining quality and commitment to care.
BCBAs in residential settings have an obligation under Code 2.19 to report serious problems in service delivery through appropriate channels, even when those problems result from external crisis conditions rather than organizational failure. When service quality has deteriorated below a safe or clinically acceptable threshold, the BCBA must document the deterioration, communicate it to organizational leadership, and advocate for the resources and structural changes needed to restore quality. Code 1.05 requires action when aware of practices likely to harm clients. In crisis contexts, this obligation requires honesty about what behavioral services are actually being delivered versus what is specified in clients' plans, and it requires advocacy for the minimum resources needed to maintain clinical safety even when organizational pressure pushes in the direction of minimizing the problem.
Post-crisis evaluation should examine three questions. First, what happened to client behavioral outcomes during the crisis period: which clients experienced significant behavioral deterioration, which maintained stability, and which showed unexpected resilience? The answers provide information about which behavioral support conditions are most critical and which clients are most vulnerable to disruption. Second, which organizational adaptations worked and which created new problems: where did pre-existing systems hold up, where did they fail, and which improvised solutions produced better outcomes than expected? Third, what structural changes should be made to organizational systems based on crisis-period experience: which crisis protocols should be formalized, which cross-training gaps should be addressed, which family communication procedures should be standardized? This evaluation converts crisis experience into organizational learning that reduces vulnerability to future disruptions.
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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.