Motivation Is More Than A Buzzword: Lessons From a Behavior Analyst

You Can Lead a Horse to Water… But You Can’t Make it Drink

Recently at curaJOY we have been exploring the concept of “motivation” in our All Hands meetings. Our founder and CEO, Caitlyn Wang, brought up that it is often not enough to give people access to tools and resources and expect they will start a new behavior. Why is that? Where does motivation truly come from? How do we define motivation in the first place? This is a topic I have pondered many times in my career and specifically during my tenure as a department manager overseeing a large team of behavior technicians and behavior analysts. I noticed that behaviors as simple as writing a SOAP note that take less than 5 minutes were the ones I was most often chasing down staff to complete. We would spend leadership meetings agonizing over how to improve this behavior that was directly tied to a business metric of being able to bill sessions to insurance in a timely manner. It was a clear expectation that staff learned at onboarding, and it was communicated that they should be converting their sessions with SOAP notes at the very least by the end of each day. I tried explaining to the team again the importance of this behavior and the harmful outcomes that often hurt clients in the long run if we are not completing timely billing to insurance. I thought that perhaps it was just a misunderstanding and the team wasn’t clear on the expectations.

Tried and Tested (Unsuccessful) Strategies

We tried a laundry list of things that DIDN’T work: 

• Clarifying the expectations
• Training on strategies to optimize this workflow and make it easy to complete within a busy day
• Explaining the rationale for this behavior
• Entering staff members with perfect timely conversion into a drawing for a gift card
• Issuing reminder emails/texts/messages to convert session notes 
• Talking to individuals who were frequent offenders of late submissions
• Corrective action plans that would work temporarily and then the minute they were complete would often show regression

Evaluating Severity

In addition to these failed tactics, we faced a bigger dilemma: was this behavior important enough to warrant serious consequences, such as letting go of an employee? Was it serious enough to warrant not getting paid until this task was completed? I noticed we had three types of employees with regards to this behavior: the “all star” technicians who would convert on time, no questions asked, 100% of the time; the “occasionally forgetful” technicians who would convert on time mostly, but needed an occasional reminder; and the “frequent offenders” technicians who I would bet money on them having unconverted sessions at the end of the week. The frustrating part is that this behavior did not reflect how good they were at their jobs. It was not uncommon to have technicians who were amazing in direct client sessions, built strong rapport with families and coworkers, and yet just would not complete the small administrative duties of the job in a timely manner. 

Gamifying Motivation

One year as we approached the end of the year and the pressure to impact this business metric was rising, we tried a new tactic. Our clinic’s spirit week was approaching, and in a meeting with my BCBAs we discussed potential opportunities to incentivize this behavior. We decided to implement a version of the “Good Behavior Game”, an evidence-based behavior intervention, and valiantly offered up our dignity on a platter as the reward. The BCBAs (supervisors) made a video pitching this “challenge” to the behavior technicians: we would compete as teams, BCBAs versus behavior technicians, and whichever team won could choose costumes for the opposing team for spirit week. We made a large game board with a roadmap to victory and spaces for each of the days. Each team had a game piece that represented them. On any day that the behavior technicians had all of their notes converted before the following morning, they would move forward one space. On any day that they did NOT have all their notes converted, the BCBAs would move forward one space. You might be rolling your eyes at this concept or doubting its effectiveness, but never underestimate the power of group contingencies and the opportunity to gently humiliate your supervisors 😉 

Why Did This Work?

What was the outcome? The behavior technicians had a partial win, having progressed far enough to earn choosing costumes for half of the BCBAs. Hilarity ensued. They chose ridiculous costumes, and the BCBAs took it in stride. Was this a successful tactic overall? In my opinion, yes. It wasn’t perfect, but it made a notable impact both socially and for our metric of converted notes. So, why was this tactic effective? 

1. Group contingency – all behavior technicians had to participate in order for them to progress, which requires cooperation
2. Peer support – rather than top-down support, this intervention relied on peers to encourage each other which is often times more meaningful
3. Reward – although silly, it was something tangible and novel. It was an opportunity to connect with supervisors in an atypical way. Like I said, never underestimate the power of an opportunity to gently humiliate your supervisors 🙂 

You could also throw in that it was specific, measurable, achievable, relevant, and time-bound: the good ol’ SMART framework. 

The Moral of the Story Is…

So what does this mean in the bigger context of a conversation about motivation? First off, behavior is behavior. All behavior is learned, all behavior can be shaped, and all behavior is a product of environmental and contextual variables. We often think of behavior analysis as being a “therapy” tool for a very specific population, but in reality it is just the science of behavior and is applicable to nearly every industry and population. The key is to understand what those environmental and contextual variables are, and start implementing strategic tactics to support positive change. To bring it back to motivation, it boils down to this: if a behavior is not getting rewarded (either externally or because it is automatically rewarding for the individual), it will not continue or increase. Sometimes motivation must be creatively cultivated, and that is OK. If you find yourself asking the question “why are my staff not motivated to do this?” then chances are that behavior does not have an appropriate consequence or reward. Artificial reinforcement such as gift cards, social praise (company shout outs), prizes, or even time off, can be highly effective in establishing positive behaviors, and can be faded out over time. If you find yourself saying in response, “I shouldn’t need to give gift cards for my staff to do this behavior,” then perhaps it’s time to truly evaluate how important this behavior is to you and start by implementing the first set of strategies that don’t require a reward. If you have done that and still insist this is an important behavior, some positive reinforcement strategies are a good place to start. As always, take data and assess the impact. May you instill the gift of motivation to all those around you!