Thought Leaders 014 - Founder & President Jose Martinez-Diaz Part 2

Shauna Costello (00:01):
You're listening to operant innovations, a podcast by ABA technologies. Today we continue our talk with Dr. Jose Martinez Diaz, as we explore where he thinks the field is going and where he would like it to go. That's, that's quite a bit that you accomplished in that 19 year, time period. And just that again, the persistence of up against people firing you and finding your people and the people that had that behavioral perspective to be able to really make a difference and get your inroads there. So that's really fantastic to hear that and sort of that evolution and I guess sort of thinking about that perspective and you have been in the field for so many years and seeing how it's evolved over time and gone from being, um, in the psychology department to being more recognized as behavior analysis. So just wanted to start to transition and think about where do you see the future of behavior analysis going? You know, you've seen all this happened over the years. What do you think is going to be happening in the future?
Jose Martinez Diaz (01:00):
Oh my goodness. A crystal ball, I do not have, I know what I would like to see, but I also, at the same time, know what the contingencies are out there and the contingencies are against things happening in the way that I would like them to be. So it could be that we totally mess it up and we wind up not accomplishing what people like Jerry Shook, like JimJohnson, like Judy fable, and some other folks that had the vision to take this field separate from psychology and who fortunately have me as one of them, I, the word partner is so strong of a word, but I was one of the people involved in helping create something separate for behavior analyst. And of course, I haven't told you, uh, and maybe depending on how this gets said, and I can say that now. It's just the fact that the transition from where we were back in the sixties and seventies and eighties to what started to happen in the nineties. And then what happened in the 2000s so far versus what's happening in the future is very important, but here's the, there's a vision and what sort of people like myself and the other people I mentioned, saw, is what we wanted to happen versus what is happening, which is very different than, than what we hope would happen. I don't know. You can ask, maybe I lost track of the question here, because it's like, where do I want it to go, versus where do I see it going? Are two different questions. Ah,
Kelly Therrien (03:39):
I mean, maybe focus on where you want to go.
Alison King (03:41):
Is there one that you feel more comfortable?
Jose Martinez Diaz (03:44):
No, I, I would like to talk about both, but they're two different, two different things where I want it to go versus where I could go if things do not,
Alison King (03:57):
Maybe we back up into that. So maybe we start with sort of the vision for what you'd like to see. And then we've got another question about, um, what keeps you up at night or concerns. So maybe go with the vision.
Shauna Costello (04:09):
Yeah. What would you like to see?
Jose Martinez Diaz (04:11):
Okay. Oh my goodness.
Alison King (04:16):
Got just, I think we'll do like three more questions given our timing. Um, okay, so just picking up kind of where we were. So we just talked about your history and sort of how you came to, um, behavior analysis and your educational background. So next, just wanted to think about what would you like to see for the field of behavior analysis going into the future? Where would you like to see it go? What would you like to see for it?
Jose Martinez Diaz (04:42):
Well, that's, that's a big one because I've had a vision for decades about this and it, uh, essentially, uh, I was lucky enough to find other people who had similar visions, people like Jerry Shook, people like Jim Johnston, uh, also Judy fable, um, and, and so forth. And, uh, and, and, and we all wanted, first of all, to protect people from people who were not trained well enough to apply our very powerful procedures, um, because behavior analysis applied behavioral analysis and the old name behavior mod, uh, for years, what it was thought of is anybody can do this stuff. In fact, I'll digress a little bit just to tell you that when I, uh, late, later on in my life, I took a job as a director of a residential center, uh, for, um, uh, kids and teenagers through age, uh, through age 17, uh, the, the, uh, and there was a psych psychiatrist who said, Oh, so you're one of those behavior modifiers are, what, how, why do you need a Ph.D. on that?
Jose Martinez Diaz (06:34):
Why do you even need a degree it's the direct care staff, who does all that stuff. Anybody can do that. And unfortunately, and that we were turning over and doing training with people and, and it was like, anybody can know this, we're going to teach you how to do this. And then you're going to do it and, and, and spread it this way. And even in Florida. And what happened was that when, uh, uh, the state institutions got in trouble and whether the, and the department of justice recommended that they set regulations for behavior analysis and behavior modification, in the state of Florida and the, for the certification started initially the requirements to be, uh, uh, for the CBA as a certified behavior analyst, you have to have a high school diploma. You could have a Ph.D., you could have a master's, but a high school diploma and a 40-hour workshop and no supervised experience requirement.
Jose Martinez Diaz (07:59):
And then the state of Florida had to have certain people who are certified behavior analysts, overseeing programs. And even though there was also a district behavior analyst who was supposed to be somebody who really knew what they were doing, I was one of those at a point in time, and then via a review committee that also resolve things. We couldn't oversee everything. And the stuff that was happening by far, the CBAs that were poorly drained was awful. But then at the same time, people who are licensed professionals, even licensed psychologists, thought that this behavior mod stuff, they all knew it because it was the easy stuff. And they also were messing people up. So in California, I had this experience that that's what led me to do something different. What, when I was working at camera radio, I taught two of the individuals that I had worked with, I had went into group homes, the community, and they both died.
Jose Martinez Diaz (09:17):
And I found out how they died. And they died because a licensed psychologist with no behavior analysis, wrote behavior plans for them that reinforced all the problem behavior. We had worked so hard to replace with alternative behavior. We had taught them communication skills. We had taught them a lot of skills, and instead they reversed the contingencies. They did a reversal of the contingencies total, total reversal, not just a withdrawal had, they had withdrawn treatment that would have been better, but they reversed it. And, and all the problem behavior came back. And then one died while being placed in prone containment. They crushed his chest. And the other one died in a lockdown room of a seizure because he wasn't monitored. And the two deaths happen shortly. And I was sent in to the state and, uh, to the, uh, group homes, uh, the state took them over.
Jose Martinez Diaz (10:40):
And, uh, and temporarily and I was working for the state. So I got sent in to fix the mess. And I cried not only for the death of those two individuals, but to see what was happening with the other individuals who lived there, who I had worked with and who now had not only lost the skills that they had gained while working with us, but all their problems behavior had gone back. And they were, they were totally out of control. And it was a mess. And there were six group homes with six beds a piece 36 individuals whose lives were totally ruined. Well, two of them died and I knew we had to do something different. So when I came to Florida and I saw the certification stuff, I thought it was the answer. And then I found out what a was. And that's when I partnered with Jerry Shook and Michael Hemingway, and then Jim Johnston, and later on Judy Fable and so forth.
Jose Martinez Diaz (11:50):
And, uh, and the, vision that we had back to the vision was that we would set up standards for certification that made sure that people were well trained and that there would be a system for ensuring that people were disciplined if they were doing things wrong. But unfortunately, we knew that we had to start the bar low and gradually increase it. I can spend a lot of time talking about that, but the question stuff about the vision for the future. But it's important to mention that in any profession, if you start out with the bar where it's so high, that nobody can meet it, because for example, in other countries, now you have to have alternative pathways for them to reach certification, because they don't have enough university programs or any, and behavior analysis. They don't even, and they don't have any board-certified behavior analysts, or they might have one or two for the whole huge country.
Jose Martinez Diaz (13:11):
So you can't have the same standards, but our vision was that eventually people would have to get a masters in behavior analysis and programs that had the quality of the ones we know about are really good, uh, accredited programs eventually, uh, like Western Michigan, like West Virginia, like Kansas, like Southern Illinois, like university of Nevada Reno. And I can mention quite a few more, that's not the only ones. Uh, I'm just mentioning them because those have been around for a long time, Kansas. I think I said, they've been around for a long time, uh, and, uh, Florida tech, of course, but Florida tech is newer. Uh, we've been around like 21 years, but the other ones I've mentioned have been around from the sixties and early seventies. Uh, uh, yeah, they're, they've been around since I was around.
Jose Martinez Diaz (14:21):
Anyway, the, um, the, so anyway, to have that kind of quality in the training of behavioral analysts, because first of all, you have to have well-trained people and the standards for becoming board certified and for becoming licensed should be high enough that you guarantee that you're going to have somebody who is not a technician, is not a technologist, is not somebody who follows a cookbook approach, but who uses everything they know about the research and about the basic principles of behavior to always analyze the contingencies and, and, and work on programs, whether they're working within the videos with a diagnosis of autism, or working with an individual with a diagnosis of schizophrenia or working, uh, in schools with kids, with behavior problems, or at home with kids, with behavior problems or whatever, or in business and industry or whatever, but that they know what they're doing the way that unfortunately, I was trained, I am so happy that I was trained well by other people who somehow knew all this stuff much better than maybe I even know it now, they, they were masters at it.
Jose Martinez Diaz (16:02):
But the, the main thing is that training has to have the highest standards possible. And that eventually you can't just have somebody just take some courses here and then I'll do their practicum or whatever, or their supervisor experience anywhere. But like, for example, in clinical psychology, in order to become licensed, of course there were exceptions. Cause you could have an alternate pathway too, but we had to go around for one year, full time, 40 hours a week for a whole 12 months to go to an APA accredited internship, the American psychology association. Actually, I credit that internships. Well, we haven't gotten there yet, in behavior analysis, each university either approves their own practicum sites themselves. They're not an external body. So remember there was always contingencies and operation so that things don't always go well, I know I'm fully well. I've been around the block.
Jose Martinez Diaz (17:30):
And then people do their supervised experience outside of a university setting and they do it at their workplace and it's more like a job. And then they get supervised. And there's something to that too. I worked at a lot of places and I learned a lot of places that I worked, but the fact that I went through a formalized internship in which I was there, I couldn't get paid. Oh, and I have to do 2000 hours of, uh, university of practicum. First, I had to do 2000 hours and then I have to do a thousand hour APA approved internship. And then I had to do a 2000 hour post doc training to become licensed.
Jose Martinez Diaz (18:18):
And people complain about 1500 hours and they wanted to be their place of work and they want to get paid. And of course, people have to get paid. It's the realities of the world. I was lucky enough that at the time there were training grants by the national Institute of mental health. And so what I got was grants from the national Institute of mental health that made it possible for me to do an internship. So UCLA had grant money from an IMH and the grant allowed me to have living expenses. Then they, I was at a state hospital. They gave me a dorm room. I had to say, stay in the dorms while I was doing my internship. You know, I, I got fed, I got three square meals a day at the hospital. You know, it wasn't good food. It wasn't good housing, but I didn't have to have a job. I was there to learn.
Jose Martinez Diaz (19:33):
And this days people want to have their job and then make their money and have their nice cars and their nice apartments or houses. And, and then, then still get their training. But what happens is they get trained and whatever the place is doing. So they're doing this great trials. That's what they learn. Discrete trials, no free operant work there. Do you know that there's some behavioral analysts that come out and there'd be CBAs. And they had only done discrete trials and they don't even know what a free operant is. It's crazy. It's sad.
Jose Martinez Diaz (20:26):
It is amazing. But in my internship and in my practica, I had to do rotations to learn different skills. And there was a curriculum of all the skills that I have to learn. So I learned discrete trials. Hey, I learned it from people who had learned it from Lovaas. Lovaas came around. And so what we were doing, uh, he'd only came every three months, but he's still came around. And the people there had been trained directly by him at UCLA. My boss had been. Listen, it's like I, but then I, I learned other procedures, behavioral skills training before it was called behavioral skills training. I learned that's what they used at the clinical research unit for the study of schizophrenia to train the skills for the schizophrenics, shaping. How, how do I shape behavior? And that's a free operant procedure. That's not discrete trials. How many people don't know how to change behavior? And it's sad. So people need to learn the skills, but more than that, they need to learn to always look at the contingencies. And some people don't even know what a contingency is. They don't know the difference between a functional relation and a contingency. Cause I've asked in interviews, I interview people and asked them that question. What's the difference between a contingency and a functional relation and they don't know. And how can a BCBA not know that?
Jose Martinez Diaz (22:02):
So this stuff that is really a science and a technology, that's based on that science and people sometimes are just learning techniques. They're not even learning that technology based on the science. They're just learning a bunch of techniques. And that's where we need to make sure that that's not what happens instead. What happens is that people are well trained and then we have to set up contingencies so that people can continue to practice. Because what happens is there's drift and people not only do they drift in terms of what they've learned before, but sometimes they either failed to learn anything new or they don't learn it well enough to really be able to apply it. Application has a much higher level skill than it's called knowledge. I don't like the word knowledge. It's one of those cognitive words I hate. But if you look at Bloom's taxonomy in terms of training, that's what we are educators use in terms of training people.
Jose Martinez Diaz (23:31):
And there is all these things, and then you get to the higher level stuff and there's the three highest levels application. Then higher than that as an analytical analysis. And hey, as a behavior analyst, do you need to not only apply, but you need to analyze it and then sythesis these. And sythesis is to sythesize all that, you know, from the different things as, uh, so that then you can produce something and which you make things from different things that you have learned together to come up with something new and be innovative and, and, and be able to drive things that still makes sense, but they are innovations try new things, but then evaluate them carefully. But anyways, so I'm digressing a little bit here, but it's what we need is to have people that are well trained enough for all this. And we do need more PhDs, but we also need the most people in the field master's level people to be well trained.
Jose Martinez Diaz (24:54):
And you can be well-trained at the master's level. If you go to one of the excellent programs out there, uh, and, and, and, but then you really focus on that. And it's not something you just do on the side, uh, while the rest of your life is the main thing. Um, and this is just something you do on the side. It's like total immersion is what we would like. But unfortunately the, the contingencies out there. And the reality is that it's very difficult. Part of it is that education has not supported to the sense that it is, and people have to work and people can't afford school and people get into financial debt. And I was fortunate enough to have an IMH grants to support all this stuff. Plus I didn't mind being poor for a lot of years because I was so used to being poor
Shauna Costello (26:11):
And Jose, like, how do you think that, that, so I know a lot of, like, you brought up people working in the jobs as direct care staff right now as RBTs, if they get the credential, um, how do you think it impacts their supervision when they're kind of stuck in this RBT role?
Jose Martinez Diaz (26:32):
Right. Well, first of all, it's good to get the RBT and work as an RBT for a good period of time. Before you learn the higher level of skills, but once you are being trained to be a behavior analyst and you're getting supervised to be a BCABA and even more so a BCBA then what happens is that agencies have the, contingencies are that they can only bill for these people. If they are RBTs doing RBT work, they can't bill for doing behavioral analysis work and they, and the people want to get paid. And the company says, well, we can't pay you unless you do what we need to do, which is do billable hours. So the contingencies are such for both the agency and the person who's getting, trying to get trained. Sorry, that's the X files or something, or maybe
Jose Martinez Diaz (27:50):
That's right? Yep. Taht's a warning. No, that was
Shauna Costello (27:56):
Meeting coming up in 15 minutes. Yeah. That's what it is.
Jose Martinez Diaz (28:02):
That's funny. Yeah. They're contacting me that I have a meeting in 15 minutes. Yes. I have those alarm things because of not, I don't get to my meetings well, when I'm not, when you're not here and I don't want that. My silence wooo spaceship landed. At least I put a nice sound on it.
Shauna Costello (28:25):
So I think I'm hearing you say that the contingencies of how the system is set up right now might be affecting the quality BCBAs that we're getting.
Jose Martinez Diaz (28:40):
Definitely so. So what ideally would happen is that somehow the emphasis on billable hours needs to be shifted. And the way that it might work is that if the agency is making enough money out of the people, they need to just pay them for those hours. And it all depends. In some states, they might be billing $50 an hour for an RBT. I'm not as familiar with the rates of pay now, but I think if I read something that it varies from like 30 to 50 or something, but how much are they paying those people an hour? Oh, they really want these to go. Yeah. Well maybe, well, maybe what we can look as we need to restart this again. Cause it got messed up, but I think we have something usable for today.
Shauna Costello (29:58):
You heard it straight from his mouth. We will be hearing from Dr. Jose Martinez Diaz even more, but that doesn't mean we don't have other thought leaders for you in the upcoming months. We will be talking with dr. Tom Freeman, Dr. Henry Roane, Dr. Kyle, Miguel, and even more. And as always, if you have any feedback or suggestions, please contact us at operantinnovations@abatechnologies.com.