Episode 38: No Man's Land-The Myth of Ascent: Why Choice is Just a Contingency

Episode 38: No Man's Land-The Myth of Ascent: Why Choice is Just a Contingency

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.

Episode 37: Who the Hell is This? Solving the Access to Care Bottleneck with Amol Deshpande from Frontera Health

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 [www.fronterahealth.com]

Episode 36: Who The Hell Is That with Dr Lou Sandler-Dosing Disruption & Why 40 Hours is the Gummy Bear of ABA

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.

Episode 35: Prove It: The Policy Shift That’s Forcing ABA to Grow Up

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 [https://webservices.ncleg.gov/ViewBillDocument/2025/7815/0/H696-PCCS10584-LUXR-3]

Episode 34: Beyond the Clinic Walls with Dr. Nick Green-Breaking the Iron Ceiling With Data, Discipline, and the Science of Moving

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.