Rad N Bad Podcast

Here’s the dirty little open secret in applied behavior analysis right now: the pendulum swung so hard away from discrete trial training that clinicians are terrified to even look at a flashcard. Everyone ran screaming from the tabletop because God forbid you look like an old-school compliance robot. And where did we land? In a land of milk, honey, and vibes known as "Natural Environment Teaching"—except half the time, it isn't teaching at all. It’s an ideological surrender. We took entry-level technicians, gave them 40 hours of sleep-inducing online modules, threw them onto a foam mat, and told them: "Just follow the child's lead, bro." Now insurance companies and families are cutting checks for $75 to $100 an hour for intensive, medically necessary behavioral intervention, while a tech sits crisscross applesauce staring into the middle distance while a kid watches wheels spin on an iPad. That’s not trauma-informed clinical mastery. That’s the world’s most aggressively overbilled babysitting gig. On this episode of Rad N Bad , Sean Yocum and Mike Carrero march straight into No Man’s Land to call out the clinical neglect hiding behind progressive buzzwords. In this episode, we unpack: Real NET vs. Passive Proximity: Why legitimate incidental teaching is elite, dynamic behavioral science that demands active environmental sabotage—not sitting on your hands waiting for an establishing operation to fall from the sky. The 85% Trial-Density Collapse: How trading structured repetition for casual play robs learners of up to 60,000 learning opportunities a year. The Token Board Illusion: Why arbitrary five-star boards are rarely functioning as generalized conditioned reinforcers, but rather as visual countdown timers to escape the clinician. Assent Washing: The dangerous line between respecting human autonomy and using "compassionate care" as an excuse to avoid hard instructional friction and guarantee lifelong dependency. The Measurement Dumpster Fire: Why fast-moving sessions lead to 4:55 PM creative writing on session notes, and how cold probes, first-trial data, and Standard Celeration Charts save empirical integrity. The Synthesis: Why you earn the floor at the desk and prove the desk on the floor.

Somewhere along the way, applied behavior analysis took an intensely personal clinical question— what does this unique child and family actually need right now? —and turned it into an algebra problem. Higher support needs? Add hours. More assessment goals? Add hours. Comprehensive treatment? Hand over 30 to 40 hours of your week. We spend our entire careers training parents, schools, and technicians not to explain behavior with circular labels. We tell them to find the environmental variables, analyze motivating operations, and identify reinforcement contingencies. Yet, when someone asks why an autistic child needs 30 hours of ABA, our answer basically amounts to: "Because they're in the 30-hour tier." That isn’t a functional analysis. That’s circular reasoning with a CPT billing code slapped onto it. On this episode of Rad N Bad , Sean Yocum and Mike Carrero stop ducking the hardest, most guarded debate in the behavioral health industry. We trace the history of high-dosage ABA from Lovaas in 1987 to the landmark 2024 JAMA Pediatrics meta-analysis, run a ruthless systems-level contingency analysis on fee-for-service reimbursement, and challenge every clinician in the field to take The Zero-Dollar Test . In this episode, Sean and Mike break down: Where Did 40 Hours Actually Come From? Deconstructing the 1987 UCLA Young Autism Project, replication attempts by Smith and Eikeseth, the 2001 National Research Council report, and why our field mistook a broad treatment package for a single active ingredient. The 2024 Sandbank Meta-Analysis: What 144 studies and over 9,000 children published in JAMA Pediatrics actually tell us about the lack of a universal linear dose-response curve. Volume vs. Intensity (The Baseball Practice Metaphor): Why hours only measure elapsed time on a clock—and why 15 hours of dense, high-integrity, parent-embedded teaching can be far more behaviorally "intensive" than 35 hours of passive technician time. Follow the Money (Contingency Analysis): How traditional fee-for-service reimbursement actively punishes clinical titration, rewards dependence, and turns a BCBA who successfully makes therapy unnecessary into an operational nightmare. The Caregiver Gap: Why 30 hours of therapy only touches 18% of a child’s week, and why under-reimbursing parent coaching keeps families trapped in professional dependency. The Zero-Dollar Test: If your organization’s revenue was completely disconnected from the volume of direct billable hours delivered, would your treatment recommendations look the same tomorrow morning?

There is a brutal reality nobody warns you about when you sit for your BCBA exam: within 18 months of launching an independent practice, you aren't analyzing behavior graphs. You're staring at generic QuickBooks spreadsheets at midnight, explaining CPT codes to an accountant who doesn't know ABA, and watching payroll approach while commercial payers sit on your claims for 90 days. The dirty secret of our industry right now isn't that clinical models are failing—it's that independent, clinician-owned operators are getting choked out by cash flow. On this episode of Rad N Bad , Sean Yocum and Mike Carrero sit down with Ethan Schwarzbach , co-founder of Flychain , to cut directly into the financial engine of ABA. We pull back the curtain on how predatory private equity actually took over the space (hint: it wasn't superior clinical care) and how independent clinics can build modern financial infrastructure to stay open, stay ethical, and compete. In this episode, we break down: The Fixed-Payroll vs. Variable-Reimbursement Trap: Why paying staff on a strict bi-weekly schedule while waiting on unpredictable 60-to-90-day payer cycles creates an operational crisis. The Myth of Private Equity Clinical Superiority: Why corporate roll-ups dominate through capital reserves, data infrastructure, and secret contracted rate bargaining—not clinical outcomes. True Unit Economics: Calculating the fully burdened cost of an RBT hour (taxes, benefits, non-billable drive time, supervision allocation) vs. raw hourly pay. The Quota Trap: Why pushing clinicians to maximum billable capacity masks broken margins and accelerates burnout, turnover, and clinic failure. Leveling the Playing Field: How machine-readable payer rate transparency and CFO benchmark tooling give independent owners the leverage to negotiate higher reimbursement rates. Visit Flychain at https://www.flychain.us/

For decades, the applied behavior analysis sector in autism has treated the broader healthcare ecosystem like an aversive stimulus. We built a fortress out of rigid jargon, locked the gates, and convinced ourselves that clinical isolation equals purity. Here’s the unfiltered truth: our stubborn refusal to practice basic selective accommodation and collaborate across disciplines is putting our own field on a fast track to being faded out permanently. On this episode of Rad N Bad , Sean Yocum and Mike Carrero sit down with physician executive, health system leader, and author Dr. Steven Merahn, MD ( Care Evolution ) to hear what the rest of the medical world actually says about behavior analysis behind closed doors. In this episode, we unpack: Autism is Neurodevelopmental, Not Behavioral: Why treating autism strictly through a reductionist behavioral lens violates the medical principle of Rational Therapeutics . Hours Are Not Dosage: Why prescribing arbitrary 30-to-40-hour weekly clinic minimums fails pharmacokinetic principles and alienates pediatricians and health plans. Why Our Assessments Are Inherently Ableist: How comparing autistic children against normative peer curves or criterion sequences creates deficit-based traps rather than functional trajectories. The 5 Rules of Earning Professional Equity: Why behavior analysts must leave their echo chamber, attend adjacent medical conferences, read journals like JAMA Pediatrics , and stop denigrating allied disciplines. The "Default Mode Network" & Inner Life: Understanding the neuroscience of attention, why joint attention doesn't require forced eye contact, and why developmental relationship-based models (DRBI) must be respected. Professional Humility: Moving past professional supremacism to recognize that ABA is a powerful tool in the healthcare toolbox—not the entire toolbox. Find Dr Steve on Linkedin here: https://www.linkedin.com/in/stevenmerahn/

We love to say we value lived experience. We talk constantly about assent, compassionate care, social validity, and person-centered treatment. We’ve gotten really good at saying all the right words. But are we actually listening? When someone tells our field, "ABA helped me," we lean in. But when someone says, "ABA hurt me," or "ABA failed my family," we immediately jump into defense attorney mode: What kind of ABA was it? When did it happen? That’s not real ABA. On this inaugural episode of our new series, The Other Side of the Table, Sean Yocum and Mike Carrero stop explaining and start listening. We sit down with Kim Lambert, a single mother from North Carolina recently interviewed in the New York Times Article about ABA and whose son, spent years inside the ABA system. Kim pulls no punches as she shares the raw reality of navigating our field: The "Trust the Process" Trap: Why telling exhausted parents to "trust the process" often just means "hand over your judgment and stop asking questions." Graphs vs. Real Life: Why mastering "touch the blue square" at a clinic desk means nothing when a child still can't eat, sleep, use the bathroom, or leave the house without a 4-hour meltdown. The Fear of Telling the Truth: Why parents hide severe behaviors from BCBAs because they're terrified of being judged, blamed, or reported. From 30 Hours of "Babysitting" to True Independence: How moving away from cookie-cutter clinic quotas and into functional, parent-involved accountability completely transformed Rhett's future from institutional talk to sleepaway camp and public school.

Filing an ethics complaint against us would require actually citing the ethics code—and honestly, we’d appreciate the peer review. On this episode of Rad N Bad , Sean Yocum and Mike Carrero sit down with ethics heavy-hitters Dr. Jon Bailey (founder of the ABA Ethics Hotline) and Zachary Stevens (co-authors alongside Dr. Mary Burch of The Ethical Behavior Analyst ) for an unfiltered examination of modern behavioral healthcare. We move past checklist compliance and memorize-the-code ethics to ask the hard questions: What happens when ethical practice collides with corporate private equity and billable hour quotas? Why are we teaching supervisees like they’re taking driver’s ed instead of preparing them for the clinical highway? And why is the true goal of ABA not great therapy, but making therapy completely unnecessary? Key Discussion Points: Driver’s Ed Ethics vs. Ethical Judgment: Why memorizing the BACB ethics code doesn’t prepare clinicians for real-world clinical pressure. The Conflict of Interest Trap: How tying compensation to billable quotas, 25-to-40-hour minimums, and "drive-by supervision" undermines client care. Outcome-Based vs. Dosage-Based Models: Why the field must shift from billing hours to measuring functional, real-world skill acquisition. The Supervision Reality: Moving beyond checking off 2,000 fieldwork hours to modeling how to handle denials, mistakes, and true client advocacy. The Mirror Moment: Why behavior analysts must embrace feedback, kick out private equity exploitation, and never lose sight of the human being across the table. You can pick up a copy of the Ethical Behavior Analyst right here! https://www.routledge.com/The-Ethical-Behavior-Analyst/Stevens-Bailey-Burch/p/book/9781032988849?gad_source=1&gad_campaignid=23976946742&gbraid=0AAAAACWuhHWAw1T6SJ5lQNVEYoky-9B4T&gclid=CjwKCAjwtKrUBhAhEiwAr77Zol_NkaYtUw4k7TMT4rxYZUP2YiRttF1P7SXqJ_LyNZ6yf2Y28qkO7BoCzsAQAvD_BwE

Why is our field so terrified of its own critics? When people critique Applied Behavior Analysis, the knee-jerk reaction across clinics, message boards, and leadership panels is almost always defense: "They just misunderstand the science," "They're talking about old ABA," or "That's not real ABA." On this episode of Rad N Bad , Mike Carrero and Sean Yocum sit down with B.F. Middleton ( Oh Behave! Podcast / The Bearded Behaviorist) to stop playing defense attorney for our discipline and start applying behavior analysis to our own institutional practices. Instead of dismissing the Anti-ABA movement as irrational or misinformed, we analyze it for what it actually is: textbook Skinnerian counter-control. Anti-ABA Opposition as Environmental Data: Why public critique isn't an attack to be shut down—it’s critical environmental feedback signaling where our controlling practices have become coercive. The "Today's ABA" Trap: Why rebranding our methods as "compassionate" or "trauma-informed" fails if we don't alter the underlying corporate contingencies (billables, compliance, authorization metrics) driving clinician behavior. Albert Bandura & Moral Disengagement: How clinicians use verbal mechanisms—like comparing current practice to historical aversives—to insulate themselves from legitimate feedback about client distress. Rights Holders vs. Stakeholders: Re-centering Montrose Wolf's concept of Social Validity around client autonomy, assent, and human rights rather than insurance compliance or parent convenience. Beyond the Echo Chamber: How behavior analysis can transition from defending a static identity to creating a self-correcting science that continuously responds to neurodivergent self-advocates. Where to find BF Middleton: https://www.linkedin.com/in/beardedbehaviorist/

There is no shortage of organizations in autism—we have associations, credentialing bodies, coalitions, and advocacy groups. Yet, the field remains completely fragmented. Behavior analysts talk to behavior analysts, speech therapists talk to speech therapists, and physicians talk to physicians. While clinicians protect their turf, insurance companies write policy, legislators write laws, and private equity reshapes service delivery. In this episode of Rad N Bad , Sean Yocum and Mike Carrero sit down with Dr. Robin McLeod , founding CEO of the National Society of Autism Professionals (NSAP) , to address the missing element in autism care: cross-disciplinary leadership and standardized accountability. Dr. McLeod breaks down NSAP’s massive mission to unite clinical healthcare, education, policy, research, technology, and advocacy around meaningful, lifelong outcomes for autistic individuals and their families. Key Topics Covered in This Episode: The Fragmented Field: Why operating in professional silos leaves clinicians reactive to payer policies instead of driving care standards. The Two Engines of NSAP: How the Standards Engine (building a cross-disciplinary competency framework) powers the Influence Engine (advocating with payers and legislators). "Hover Before You Land": Dr. McLeod’s framework for cross-disciplinary perspective-taking and facilitating productive, respectful disagreement among experts. Compliance vs. Outcomes: Why an audit-proof treatment plan and high session attendance do not automatically equal clinically significant change. Value-Based Care & Reinforcement: How shifting away from volume-based hourly billing incentivizes true generalization, caregiver competence, and functional independence across the lifespan. If you are ready to stop performing leadership and help build an industry standard that holds providers and payers accountable, this episode is a must-listen. Learn More & Join NSAP: NSAP.org

Most BCBAs are taught that high-integrity care requires a toddler sitting in a clinic 40 hours a week, locked into a screen, and managed by burned-out middle management. Melissa Kozak is here to prove that model completely wrong. As the founder of Kozak Consulting and Going Independent , Melissa has conducted over 1,300 direct caregiver sessions with an astounding 1% cancellation rate . The secret? She ditched the corporate assembly line, threw out the blanket hour prescriptions, and built a pure, caregiver-led practice that prioritizes human connection, Behavior Skills Training (BST), and soft skills over billable unit metrics. In this episode, Sean Yocum and Mike Carrero sit down with Melissa to tackle the uncomfortable truths holding the ABA field back: The Soft-Skills Deficit: Why so many clinicians struggle to talk to parents without hiding behind an iPad or a checklist—and how to build genuine, rapport-first relationships. The Caregiver-Led Blueprint: How targeting real-life family priorities (like a 3-second photo or a mealtime routine) leads to lower cancellations and faster, sustainable progress. Ditching the 40-Hour Prescription: Why massive, blanket hour authorizations are often driving burnout and revenue—not actual clinical necessity. Tech That Works for You: How tools like HiRasmus can be leveraged to streamline clinical workflows without losing the human element. Taking Control of Your Science: How burnt-out BCBAs can step off the corporate hamster wheel, cut out the middleman, and launch their own high-impact, independent practices. If you are ready to stop checking corporate boxes and start engineering real-world outcomes, hit play.

The BCBA credential has never been more valuable. So why do so many new clinicians feel completely unprepared? Sean Yocum and Mike Carrero welcome Dr. Han-Leong Goh for an unapologetic conversation about the systems shaping modern behavior analysis. From graduate education and supervision to insurance reform, billable hours, leadership, and mentorship, they examine how good intentions created incentives that don't always produce great clinicians. The conversation isn't about blaming universities, employers, or behavior analysts. It's about asking whether the profession has accidentally built a system that rewards the wrong behaviors—and what it would take to rebuild it.

The multi-billion-dollar corporate takeover of autism services has officially reached its breaking point. Over the last decade, we have watched private equity firms dump massive capital into the industry, swallowing up small community providers and mass-producing cookie-cutter clinic networks. Somewhere along the line, trade associations and self-appointed accreditation programs stepped behind closed doors and declared themselves the official voice of our science. But nobody asked the practitioners on the ground for a vote. In this explosive episode of Rad N Bad , Sean and Mike strip away the corporate marketing jargon to answer a simple, glaring question: Who the hell is actually driving this field? Joining the studio are Kirsten Hall and Aaron Gold , founders of the ABA Accountability Project , an organization dedicating itself to tracking power, governance, and transparency inside Applied Behavior Analysis. Together, they drop the ultimate "Umpire Analogy"—dissecting the massive conflict of interest where the same entities creating clinical standards are financially tied to the monopolies inspecting them, all while lobbying insurance payers to make those very inspections mandatory. They take a hard, behavior-analytic lens to the dangerous reality of corporate lobbying groups fighting against mandatory frontline RBT credentials under the guise of "improving access to care." This isn't a simple personal vendetta; it's a structural evaluation of an industry that treats kids like products and clinical decision-making like an asset portfolio. If you are an independent provider, a clinician drowning under corporate caseload targets, or a parent fighting for quality over volume, this episode is a blueprint for grassroots reform. Buckle up. Strong sciences don't fear questions—they invite them.

The Titanic has officially struck the iceberg, and the music is starting to stop behind closed doors. Following the explosive New York Times investigation exposing fraud, seven-minute nap billings, and hyper-inflated center-based hours across the autism therapy sector, the industry is entering its ultimate "prove it" era. But how did a pure, data-driven behavioral science transform into an industrialized, multi-billion-dollar corporate machine virtually overnight? In this massive, unfiltered, two-and-a-half-hour episode of Rad N Bad , Sean and Mike strip away the corporate marketing language, the toxic positivity, and the social media binaries to perform a brutal behavioral analysis of the contingencies that broke the field. Joining the conversation is an industry icon, Dr. Lou Sandler , who brings 45 years of clinical history from the trenches of Kennedy Krieger to pull back the curtain on what went wrong. Together, the guys dissect the concept of "Medical School Envy"—the dangerous structural delusion that behavior analysis can function as a standalone, isolated medical discipline rather than an integrated, instructional resource. Dr. Lou drops a nuclear take on why Discrete Trial Training (DTT) needs to die, exposes the total lack of clinical oversight in the mass-produced BCBA pipeline, and calls out the absolute corporate absurdity of offering financial bonuses to supervisors for hitting billing percentage targets. This isn't an attack on clinicians, and it's not a blind defense of a broken system. It’s a raw, battle-tested manifesto detailing how we pivot away from a service maintenance dependency model and go "back to the future" by prioritizing homes over centers, treating the family structure as the ultimate clinical environment, and measuring success solely by our ability to work ourselves out of a job. Buckle up. The filters are completely off, the labels are being torn down, and it's time to get radical.

Are we using clinical structure to build real-world independence, or are we just using it as an excuse for corporate and intellectual laziness? This week, Sean and Mike step right into the crossfire of the industry’s loudest, most polarizing argument to map out the definitive middle ground on Discrete Trial Training (DTT). Depending on who you ask on social media, DTT is either the only way to successfully teach complex skills or it’s the absolute poster child for everything wrong with modern, compliance-driven therapy. Both sides are completely right about the execution failures, but they are completely wrong about the science. Sean and Mike strip away the corporate marketing crap, toxic positivity, and traditionalist dogma to expose the reality of engineering behavior that actually leaves the clinical room. They break down: The Illusion of the Table: Why high acquisition numbers on a tablet can be a clinical lie if the behavior doesn't survive when the theatrical props, cards, and contrived rewards go away. The Workflow Over Science Trap: Tearing down why clinics stay stubbornly codependent on tabletop drills—not because the science demands it, but because it’s cheap to train, easy to score, and simple to audit for insurance funders. The True Middle Ground: How to ruthlessly apply intense structural repetition to build prerequisite skills in isolation, while simultaneously programming for prompt fading and Natural Environment Teaching (NET) from day one. The Generalization Mandate: Why if you cannot describe exactly how a target response transfers across new settings, novel materials, and organic contingencies, you are fundamentally not done designing the clinical program. Stop hiding behind rigid procedural brands or superficial, positive-only marketing labels to avoid the messy, complex work of real-world generalization. DTT should serve as a powerful clinical ladder—but a ladder is meant to be climbed off of, not lived on. Tune in, audit your current setups, and help us reclaim the true spirit of radical behaviorism. Stay bold. Stay contrarian. Stay Rad N Bad.

Most people in the tech space claim they understand the frontline trenches. They haven’t. This week, Sean and Mike pull back the curtain on the corporate contingencies crippling clinical quality, and they are joined by someone who has lived a literal clinical Odyssey: Dr. Erin Moran, Director of Clinical Innovation at Hi-Rasmus. Dr. Moran didn’t just climb a corporate tech ladder. She has been thrown into a room with 38 six-year-olds in a Thai port city with zero support. She has backpacked into the freezing winter of Eastern Kazakhstan with nothing but shorts and a tank top to build parent-led behavior programs from scratch, getting her passport stamped in a dark back alley just to help moms who were told their children's autism was their fault. She has sat on the highly critical academic stages of London as the only BCBA in the room, defending the core science against massive systemic stigma. Sean, Mike, and Erin strip away the marketing fluff and toxic positivity to expose the systemic failures of modern, commercialized operations, including: The Rebrand Trap: Why the anti-ABA movement isn't attacking our scientific principles, but rather a rigid, high-hour commercialized therapy model that operates like a corporate religion. The 40-Hour Checkbox Crisis: Tearing down the passive, uninspiring video training models that are producing catastrophic 18% RBT exam pass rates across major national providers, and why real Behavior Skills Training (BST) cannot be scaled through a computer screen. The Circus Trick of Dependency: Why an intervention that only works when a clinician is standing in the room is a total failure, and how Erin used pure science to train Kazakhstani mothers to become the university professors training the next generation of therapists. Engineering Software with Science: How Erin is taking her global, boots-on-the-ground experience to design data systems that eliminate administrative headaches, supercharge supervisor feedback loops, and give BCBAs their time back to focus on the work that actually matters. Stop hiding behind empty corporate buzzwords and traditionalist dogma. If your therapy requires rigid compliance and endless paperwork, your environmental engineering is broken. The science doesn’t choose a side—it analyzes contingencies. Tune in to hear how a global perspective is rewriting the status quo of standard industry technology. Stay bold. Stay contrarian. Stay Rad N Bad. https://www.linkedin.com/in/emoran1/

In this episode of the No Man’s Land series, Sean and Mike tackle the 'forbidden E-word' of ABA: Extinction. While cancel culture and critics often paint extinction as cold or outdated, the guys pull the curtain back to show that it’s not a trend—it’s a law of behavior. Whether you call it 'planned ignoring' or 'compassionate support,' if you change a reinforcement contingency, you’re implementing extinction. Sean and Mike dive into the messy reality of extinction bursts, the 'vending machine' analogy of human behavior, and the controversial rise of 'Kind Extinction.' They argue that the science hasn't changed; our clinical skill just finally caught up. Stop avoiding the uncomfortable and start understanding the mechanics of how learning actually happens when the 'house rules' change.

Is "assent" the future of ethical ABA, or is it a clinical retreat into "fragile tolerance"? In this installment of the No Man’s Land series, Sean Yocum and Mike Carrero step directly into one of the most emotionally charged debates in behavioral health. While the field currently treats assent as an ethical evolution, Sean and Mike strip away the marketing and the buzzwords to look at the raw mechanics underneath. From a radical behaviorist perspective, does "assent" even exist? Or is it simply a hypothetical construct—a label we’ve placed on behavior that is actually being shaped by environmental contingencies? Sean and Mike dive deep into: The Reality Gap: Are we preparing learners for a world that requires persistence and resilience, or are we engineering "safe spaces" that fail to translate to the real world? Buzzwords vs. Science: Why "Trauma-Informed Care" and "Assent-Based Care" are often just rebrands for what should have been good behavioral design all along. The Middle Ground: Moving past the extremes of forced compliance and unlimited refusal to focus on shaping, reinforcement schedules, and functional communication. The Radical Lens: Reframing refusal not as a philosophical choice, but as critical data that tells us exactly where our behavioral design is failing. Stop asking if your learner "assents" and start asking what your environment is reinforcing. It’s time to move beyond the "feel-good" terminology and get back to the science of shaping independence.

The ABA industry has an access problem, and throwing generic corporate software at it isn't fixing a damn thing. In this episode of Rad N Bad , Sean and Mike sit down with Amol Deshpande, the founder of Frontera Health, a Silicon Valley veteran who is injecting radical disruption into the behavioral health tech space. Driven by his personal experience as a parent of an autistic son who achieved a life-changing outcome through high-quality early intervention, Amol isn't here to build another corporate tool. He’s here to dismantle the bottlenecks keeping families stuck on waitlists for months just to get a label. We strip away the marketing crap and dive deep into what it actually takes to scale access to quality care without burning clinicians into the ground. We talk about utilizing advanced, clinician-built AI to obliterate the administrative nightmare of report writing, and why billing platforms do absolutely nothing to change what happens in a child's home on a Tuesday night. Amol pulls no filters as we tackle the toxic tech trends plaguing the sector—specifically software providers who attempt to build a business "moat" by hoarding clinical data and blocking integrations. We unpack the line between clinical augmentation and replacement, why parent-mediated therapy models are the next major frontier, and how passive data collection through video could revolutionize accountability and RBT supervision. Stop letting corporate billing convenience dictate your clinical priorities. It’s time to use technology to eliminate the noise so we can get back to what actually matters: human connection, clinical depth, and radical behavior change. www.fronterahealth.com

In this "Who the Hell is That?" episode, Sean and Mike welcome Dr. Lou Sandler , a 45-year veteran of the field who isn't afraid to take a sledgehammer to the industry’s "sacred cows." The trio dives deep into the "40-hour work week" obsession, the private equity takeover of behavioral health, and why we’ve traded clinical precision for billable presence. From the "seismograph" data of failing center-based programs to the "pink dumbbell" of low-intensity dosing, this conversation is an unapologetic call to return to the human side of human behavior.

ABA is under pressure—and a lot of it is deserved. In this episode of Rad N Bad , Sean and Mike break down the real impact of North Carolina’s recent Medicaid policy changes and what they signal for the future of the field. This isn’t speculation. This is a direct response to rising costs, federal audits, and growing questions about how ABA services are delivered and justified. For years, the industry has been highly effective at getting services authorized—but far less consistent at proving meaningful, real-world outcomes. Now, states are starting to ask better questions: Why this many hours? What is actually changing outside the session? Can caregivers implement the intervention independently? Where is the plan to fade services? North Carolina didn’t eliminate ABA. They challenged it. And in doing so, they introduced a new reality: Telehealth is being restricted Supervision is being defined and enforced Parent training is no longer optional High-intensity services must be justified—monthly Exceptions for rural and underserved areas must be proven, not assumed This episode goes beyond the policy language and gets into what it actually means for providers, BCBAs, and organizations trying to navigate the shift. Sean and Mike also call out the uncomfortable truth: At some point, hours became the product. Instead of focusing on independence, generalization, and caregiver competency, parts of the field leaned into volume—and now the system is correcting it. But this isn’t just criticism. They break down what a defensible, outcome-driven model actually looks like, including: Lower direct hours with higher impact Parent-Mediated Intervention (PMI) Caregivers as the primary agents of change Measuring outcomes through adaptive functioning and real-world performance Building models that lead to titration and discharge—not dependency The takeaway is simple: This isn’t the end of ABA. It’s a filter. And the field is being asked one question: Does what you do actually create independence? Because the future of ABA won’t be defined by how many hours are provided… It will be defined by what changes because of them. Here is the policy if you would like to read it: https://webservices.ncleg.gov/ViewBillDocument/2025/7815/0/H696-PCCS10584-LUXR-3

In this episode, Mike Carrero sits down with Dr. Nick Green , a behavior analyst who traded the clinic for the gym. As the founder of BehaviorFit , Dr. Green is on a mission to prove that ABA isn't just for autism—it's the secret weapon for human performance. They dissect the "Autism Industrial Complex," explore why only 20% of adults worldwide meet physical activity guidelines, and reveal why your "lack of motivation" is actually an environmental design flaw. Whether you're a "reconditioning athlete" chasing former glory or a professional trying to find time for a treadmill, this conversation reframes fitness as a sustainable behavioral contingency.