By Matt Harrington, BCBA · Behaviorist Book Club · April 2026 · 12 min read

DoBetter 2024: Reflective Practice, Intrinsic Motivation, and Connected Relationships in ABA

Overview & Clinical Significance

The DoBetter 2024 Bundle brings together five interconnected presentations that collectively challenge behavior analysts to examine their own practice through a lens of self-reflection, relationship-building, and strengths-based thinking. Rather than focusing on specific clinical techniques in isolation, this bundle addresses the foundational dispositions and interpersonal skills that determine whether technical competence translates into meaningful client outcomes.

The concept of radically assessing the behavior of the implementer represents a significant shift in clinical focus. Behavior analysts are trained to analyze the behavior of their clients with precision, identifying antecedents, consequences, and motivating operations that maintain or suppress target behaviors. Yet the behavior of the clinician, the person designing and implementing interventions, is rarely subjected to the same level of analysis. The clinician's own rule-governed behavior, their assumptions about what constitutes progress, their emotional responses to challenging cases, and their habitual patterns of interaction all influence the therapeutic process in ways that may be invisible without deliberate self-examination.

Rule-governed behavior is particularly relevant to clinical practice because behavior analysts operate within complex verbal environments that include professional training, organizational policies, clinical guidelines, and personal beliefs about how therapy should look. These rules can be helpful when they guide evidence-based practice, but they can also be counterproductive when they persist despite contradictory evidence from the client's data. A clinician who follows the rule that structured discrete trial training is always the best approach for skill acquisition may persist with this format even when the data show that a naturalistic teaching arrangement produces faster learning for a particular client. Understanding one's own rule-governed behavior is the first step toward becoming a more responsive and effective clinician.

The pursuit of intrinsic motivation in play represents another clinically significant theme. Many ABA programs treat play as a vehicle for embedding learning targets rather than as a valuable activity in its own right. When play becomes instrumentalized, with every play interaction structured around teaching objectives, the learner may lose access to the naturally reinforcing properties of play itself. Creative approaches to pursuing intrinsic motivation recognize that play has value independent of its use as a teaching tool, and that helping learners develop genuine play skills contributes to their quality of life, social relationships, and self-regulation.

The emphasis on connected relationships in service delivery reflects growing recognition that the therapeutic relationship itself is a critical variable in ABA outcomes. The quality of the relationship between the clinician and the client, between the clinician and the family, and between the clinical team members all influence treatment engagement, implementation fidelity, and the sustainability of outcomes. Connected relationships are not a soft skill peripheral to behavior-analytic practice. They are the medium through which effective behavior change occurs.

Background & Context

The DoBetter movement within behavior analysis emerged from a broader reckoning within the field about the values and practices that define ABA service delivery. This reckoning has been driven by multiple forces, including feedback from autistic self-advocates about their experiences in ABA, research on the long-term outcomes of behavioral intervention, and growing awareness within the profession that technical competence alone does not guarantee ethical or effective practice.

The analysis of implementer behavior draws on the behavioral concept of rule-governed behavior, which distinguishes between behavior that is directly shaped by environmental contingencies and behavior that is controlled by verbal rules. In clinical practice, rule-governed behavior manifests as the tendency to follow established protocols, adhere to theoretical positions, and respond to clients based on verbal formulations rather than direct observation. While rule-following is often adaptive, particularly when the rules are based on solid evidence and the clinician lacks direct experience with a novel situation, it can also create inflexibility when rules conflict with the data emerging from a specific case.

The concept of intrinsic motivation has a complex relationship with behavior analysis. Traditional behavior-analytic accounts describe all motivation in terms of establishing operations and reinforcement contingencies, without reference to internal motivational states. However, the practical distinction between activities that are maintained by natural consequences inherent in the activity itself and activities that are maintained only by contrived external reinforcement is clinically meaningful. A child who plays with blocks because the tactile and visual stimulation of building is reinforcing is engaging in a fundamentally different behavioral pattern than a child who plays with blocks only because token reinforcement follows block play. The former represents genuine engagement maintained by natural contingencies, while the latter represents contingency-managed compliance that is unlikely to maintain when the tokens are removed.

The relationship between reframing disability and clinical practice reflects a paradigm shift in how behavior analysts understand their clients. The medical model of disability, which frames disability as a deficit within the individual to be remediated, has historically aligned with ABA's emphasis on skill building and behavior reduction. The social model and the strengths-based model offer alternative frameworks that recognize the contributions of environmental barriers and individual differences rather than locating the problem exclusively within the person. Embracing strengths means identifying what the learner does well, what they are interested in, and how their unique characteristics can be leveraged to promote success rather than viewing every difference as a deficit to be corrected.

The theme of building instructional programs that work represents the practical synthesis of these conceptual shifts. When clinicians analyze their own behavior, pursue intrinsic motivation, build connected relationships, and embrace strengths, the result should be instructional programs that are more effective, more engaging, and more sustainable than programs designed without these considerations. The technical aspects of program design, including task analysis, prompt hierarchies, reinforcement schedules, and data-based decision-making, are enhanced rather than replaced by this broader perspective.

Clinical Implications

The clinical implications of the DoBetter framework span the full range of behavior-analytic practice, from initial assessment through ongoing service delivery and program evaluation. Each theme in the bundle translates into specific practice changes that behavior analysts can implement immediately.

Self-analysis of implementer behavior begins with systematic observation of one's own clinical patterns. This might involve video recording sessions and reviewing them not for client behavior but for clinician behavior, noting patterns such as the frequency and type of prompts used, the ratio of demands to reinforcement opportunities, the clinician's tone and affect during sessions, and the clinician's response to client errors, frustration, and assent withdrawal. This self-observation often reveals discrepancies between what clinicians believe they are doing and what they are actually doing. A clinician who believes they provide frequent reinforcement may discover through video review that their reinforcement rate has drifted downward over time. A clinician who believes they respond to client distress with sensitivity may discover that they habitually redirect to the next trial without acknowledging the client's emotional state.

Identifying rule-governed behavior in clinical practice requires examining the rules that guide decision-making and evaluating whether those rules are supported by the current client's data. Common clinical rules include beliefs about how many trials constitute adequate practice, assumptions about which prompting strategies are most effective, expectations about the pace of skill acquisition, and beliefs about the necessity of particular program components. Each of these rules should be treated as a hypothesis that can be tested against the client's data rather than as an immutable principle.

Pursuing intrinsic motivation in play programming requires a fundamental reassessment of how play is targeted in ABA programs. Rather than embedding discrete targets into play interactions, clinicians should begin by identifying what forms of play are naturally reinforcing for the learner and creating opportunities for the learner to access those forms of play without instructional demands. As play skills develop and the learner demonstrates sustained engagement, the clinician can gradually introduce social play partners, novel materials, and expanded play themes. The key is that the learner's interest drives the play interaction rather than the clinician's programming agenda.

Building connected relationships requires clinicians to invest time in rapport-building activities that do not have clinical objectives attached to them. This might mean spending the first few minutes of each session in unstructured interaction, following the client's lead, and demonstrating genuine interest in the client's preferences and experiences. For families, connected relationships involve regular communication that goes beyond clinical updates to include checking in on family wellbeing, acknowledging the challenges of parenting a child with complex needs, and creating space for families to express concerns and preferences without judgment.

Reframing disability through a strengths-based lens has direct implications for goal selection and program design. Rather than developing goals exclusively around deficit areas, clinicians should identify client strengths and design programs that leverage those strengths. A learner who has strong visual-spatial skills might benefit from visual learning formats, visual schedules, and activities that capitalize on their spatial abilities. A learner who has intense interests in specific topics might benefit from using those interests as contextual variables that increase engagement across learning targets.

Building instructional programs that work requires integrating all of these elements into a cohesive program design methodology. Effective programs are characterized by clear operational definitions of target skills, individualized teaching procedures matched to the learner's strengths and preferences, data collection systems that capture meaningful progress indicators, decision rules that guide program modification based on data, and ongoing self-evaluation by the clinician to ensure that the program is being implemented as designed and that the design remains appropriate for the learner's current needs.

Ethical Considerations

The ethical dimensions of the DoBetter framework address both the explicit requirements of the BACB Ethics Code (2022) and the broader ethical orientation that distinguishes competent technical practice from genuinely excellent clinical care.

Code 1.10 (Awareness of Personal Biases and Challenges) is directly relevant to the self-analysis of implementer behavior. This code requires behavior analysts to be aware of how their personal biases, challenges, and limitations might affect their professional work. Systematic self-observation of clinical behavior is one of the most concrete ways to fulfill this requirement. When clinicians discover through self-analysis that they respond differently to clients based on characteristics such as the severity of challenging behavior, the client's communicative ability, or the family's engagement with services, they have identified biases that require attention and correction.

Code 2.01 (Providing Effective Treatment) connects to the theme of building programs that actually work. This code requires not just that behavior analysts implement evidence-based procedures but that they monitor outcomes and modify interventions when data indicate that the current approach is not producing adequate progress. The DoBetter framework enhances compliance with this code by encouraging clinicians to look beyond technique to the broader conditions that determine whether techniques translate into meaningful outcomes. A technically correct discrete trial procedure implemented by a clinician who has not established a connected relationship with the learner may produce lower learning rates than a less structured approach delivered in the context of strong rapport.

Code 2.14 (Selecting, Designing, and Implementing Behavior-Change Interventions) requires that interventions be selected based on the best available evidence and tailored to the individual. The strengths-based approach advocated in the DoBetter framework enhances the individualization of intervention design. When clinicians identify and leverage client strengths, they create interventions that are uniquely suited to the individual rather than applying standardized protocols that may not account for the learner's unique profile.

Code 2.09 (Involving Clients and Stakeholders) requires meaningful involvement of clients and families in treatment planning. The emphasis on connected relationships creates the conditions under which this involvement becomes genuine rather than pro forma. Families who feel connected to and respected by the clinical team are more likely to share their priorities, voice their concerns, and actively participate in the treatment planning process. When the therapeutic relationship is strong, the information exchanged during treatment planning is more honest, more complete, and more useful for designing programs that align with family values and goals.

Code 3.10 (Awareness of Impact on Supervised Individuals) extends the self-analysis framework to supervisory relationships. Supervisors who examine their own rule-governed behavior may discover that they are imposing programming preferences on supervisees that reflect habit rather than evidence. Supervisors who build connected relationships with their supervisees create supervisory contexts in which honest discussion of clinical challenges is possible. The DoBetter framework applied to supervision produces supervisors who are more self-aware, more responsive to supervisee needs, and more effective in developing the next generation of reflective practitioners.

The ethical imperative to embrace strengths and reframe disability connects to Code 2.01 and its emphasis on client dignity. When behavior analysts frame their clients primarily through the lens of deficits and challenging behavior, they inadvertently communicate a devaluing narrative about the client's worth and potential. A strengths-based approach communicates respect, optimism, and a genuine belief that the client has valuable characteristics that deserve recognition and support.

Assessment & Decision-Making

The DoBetter framework requires behavior analysts to assess not only client behavior but also their own clinical behavior and the quality of the therapeutic relationships they have established. This expanded assessment scope supports better decision-making by providing a more complete picture of the variables that influence treatment outcomes.

Self-assessment of implementer behavior can be structured using a behavioral skills approach. The clinician identifies specific target behaviors for self-improvement, establishes baseline measures through video review or peer observation, sets improvement goals, implements self-management strategies, and monitors progress over time. Common targets for self-assessment include reinforcement rate during sessions, prompt dependency patterns, response to client errors and frustration, fidelity to planned session activities, and the balance between clinician-directed and client-directed activities.

A rule-governed behavior audit helps clinicians identify the verbal rules that control their clinical decisions. The process involves listing the clinical decisions made during a typical week, identifying the reasoning behind each decision, evaluating whether the reasoning is based on current client data or on generalized rules from training, and testing whether the rules produce the expected outcomes for specific clients. For example, a clinician who always begins sessions with structured work before free play might evaluate whether this sequence is supported by the client's data or whether reversing the order might produce better engagement and learning outcomes.

Relationship quality assessment involves evaluating the strength and nature of therapeutic relationships across the clinical team. This can be assessed through family satisfaction surveys that include questions about communication quality, respect, and partnership. Client engagement measures such as spontaneous approach behavior toward the clinician, positive affect during sessions, and resistance to session termination provide behavioral indicators of relationship quality. Team dynamics can be assessed through observation of team meetings, analysis of communication patterns, and feedback from team members about their sense of connection and collaboration.

Strengths-based assessment requires expanding the intake and ongoing assessment process to include systematic identification of client strengths, preferences, and interests. Rather than focusing exclusively on skill deficits and challenging behavior, the assessment should document what the learner does well, what activities and topics interest them, what sensory experiences they seek out, what social interactions they enjoy, and what environments they function best in. These strengths then inform goal selection and intervention design, ensuring that programs build on existing competencies rather than starting exclusively from deficit.

The decision-making process for program design should integrate data from all four assessment domains. Client behavior data inform what skills need to be taught and what challenging behaviors need to be addressed. Implementer behavior data inform how the clinician needs to adjust their own behavior to improve outcomes. Relationship data inform the interpersonal context in which treatment occurs. Strengths data inform how to leverage the client's existing competencies to support new learning.

Decision rules should include criteria for when to evaluate and adjust implementer behavior, not just client programming. If a client is not making expected progress and treatment fidelity data show adequate implementation of the prescribed procedures, the next step should include self-analysis of implementer behavior to identify qualitative factors such as rapport, reinforcement quality, and session pacing that may be affecting outcomes.

What This Means for Your Practice

The DoBetter framework invites you to become a more self-aware, relationship-centered, and strengths-focused practitioner. This does not require abandoning your behavioral training. It requires expanding it to include yourself as a subject of analysis and your relationships as a medium of intervention.

Begin with one concrete self-analysis practice. Record one session per week and review it with a focus on your own behavior rather than the client's. Count your reinforcement deliveries, note your response to client errors, observe your affect and energy level, and evaluate whether your session matched your plan. Share your observations with a trusted colleague and invite their perspective. This practice alone will produce insights that transform your clinical effectiveness.

Examine your play programming for the presence of genuine play versus instrumentalized play. If every play interaction is structured around discrete targets, experiment with periods of unstructured, learner-directed play and observe what happens to the learner's engagement and affect. You may discover that reducing instructional density during play increases the learner's overall willingness to engage in learning activities.

Invest in relationship-building with families. Schedule periodic check-ins that are not attached to clinical updates or progress reports. Ask families about their priorities, their stressors, and their hopes for their child. Listen without immediately translating their responses into clinical objectives. This investment in connection pays dividends in treatment engagement, implementation fidelity, and family satisfaction.

Conduct a strengths inventory for each client on your caseload. Identify at least five strengths for each learner and evaluate whether your current programming leverages any of them. If your programs are built entirely around deficit areas, look for opportunities to incorporate client strengths as teaching contexts, reinforcement sources, or social connection points.