Counseling And Behavior Analysis (with Dr. Katie Saint, BCBA)

Counseling and Behavior Analysis (with Dr. Katie Saint, BCBA)

Dr. Katie Saint is a dually certified licensed behavior analyst and licensed professional counselor. She joins Erika to discuss the intersection of counseling and behavior analysis to serve adolescents, adults, and families with her unique lens. If you have an adolescent struggling with behavioral and mental health challenges, listen in as Katie discusses when to see a dually certified professional and the benefits of counselors having a behavior analytic background.

Related Read: What Does A Child Behavioral Specialist Do?

Interview Highlights:

  • Katie Saint is a dually certified licensed behavior analyst and licensed professional counselor. She shares about how these fields intermingle and work together to provide holistic care for clients who are struggling with behavioral and mental health challenges. [1:02]
  • Katie has her PhD in behavior analysis and provides individual and couples counseling to adolescents and adults. [1:19]
  • Katie has written college courses and speaks internationally on topics related to mental health and behavior analysis. She has published three books related to mental health and one assessment related to people’s ability to live a fulfilling adult life. [1:27]
  • Katie also has been published in several magazines. She works with individuals experiencing relational problems, transitioning through divorce, working through ADHD, PTSD, anxiety, depression, grieving the loss of a loved one and other life stressors. [1:46]
  • Katie focuses on helping clients recognize and build on their own strengths to meet their personal goals. She does this by using a variety of therapeutic techniques including a combination of behavior analysis, Acceptance and Commitment Therapy (ACT) and psychoanalytic tools. [2:01]
  • The main difference between a behavior analyst and a clinical counselor is that a behavior analyst typically focuses on behaviors and things that are observable and measurable. For mental health counseling, they would focus more on emotions, depression, anxiety and trauma that are not readily observable [3:22]
  • For example, sometimes a barrier with depression may be that a client has low levels of dopamine, which means that their motivation is really low. Getting them to engage in some of the behaviors that would be beneficial to get their depression to improve requires some behavior analytic techniques [4:55]
  • Katie does individual sessions, family sessions, and parent training. [6:57]
  • If a child is diagnosed with multiple diagnoses, seeing someone who is both a BCBA and counselor would be really beneficial. If someone has autism or behavior challenges and no additional diagnoses, most BCBAs would be suitable [9:02]

“I love what ABA brings to counseling. I think every diagnosis benefits from that behavioral component.” — Katie Saint

  • It’s hard for people to ask for help sometimes. Katie sees many families who have been struggling for a while and now it has gotten to an unmanageable point. [10:30]

“When we explore clients’ values and help them see and be more aware of what it is they care about and why they’re so upset about certain things, they are way less defensive.” — Katie Saint

  • In addition to Katie’s private practice where she does counseling, she also works for an autism company and does parent training for them as well [17:22]
  • The best advice that Katie received was from a counselor who said, “I hear these heartbreaking stories every day, but I feel really good that I’m part of what’s healing people.” [19:23]

Horrible things have happened in the world, but now I get to be part of the solution.” — Katie Saint

  • Katie has a book she wrote called Autism and Depression. It can be read by the person with depression themselves or a parent can go through it with their adolescent child. [20:44]
  • Katie has a new book coming out in late 2021. It’s called ABA Terms Applied to Your Life. It goes through all the Behavior Analytic terms in the Cooper book, which is like the BCBA Bible. [22:54]

“We are living and breathing ABA every day.” — Katie Saint

Guest Bio:

Katie Saint has her PhD in behavior analysis from the Chicago School of Professional Psychology and graduated from Lakeland College with a Master’s Degree in counseling. Katie obtained her behavior analytic degree from Florida Institute of Technology. Katie is dual certified as a Licensed Professional Counselor and a Board Certified Behavior Analyst. She provides individual, and couples counseling to adolescents and adults.

Katie has written college courses and speaks internationally on topics related to mental health and behavior analysis. Katie has published three books related to mental health and one assessment related to people’s ability to live a fulfilling adult life. Katie has been published in several magazines. Katie utilizes a variety of therapeutic techniques including the combination of behavior analysis, Acceptance and Commitment Therapy (ACT) and psychoanalytic tools.

Katie works with clients who struggle with relational problems, transitioning through divorce, working through ADHD, PTSD, anxiety and depression, grieving the loss of a loved one, and other life stressors. Katie focuses on helping clients recognize and build on their own strengths to meet their personal goals.

Photo Of Katie Saint

“I hear these heartbreaking stories every day, but I feel really good that I’m part of what’s healing those people.”

— Katie Saint

Resources from this episode:

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We’re trying out transcribing our podcasts using a software program. Please forgive any typos as the bot isn’t correct 100% of the time.

Read the Transcript:

Erika Ng

Welcome to Behavioral Health Collective podcast. A community of behavior analysts who are passionate about sharing our science by connecting families to information that promotes meaningful behavior change. We are a community of practitioners who seek to empower parents by sharing effective behavioral strategies and evidence-based practices from the perspective of behavior science while also advocating for better access to behavioral health services for a wide variety of families.

Hi there. I’m Erika Ng, the founder of the Behavioral Health Collective. Thank you so much for joining me today. So, at the Behavioral Health Collective, we talk a lot about behavior analysis and sometimes you might wonder how it fits in with other professions and other fields. Maybe you’re debating right now whether to seek out a counselor or a BCBA to help you with your child’s behavior, but not exactly sure where to turn or what decision to make.

Have you ever wondered maybe what the differences? Were there overlaps or how the field of counseling and behavior science can work together? Well, look no further, because today we have Dr. Katie Saint joining us from Wisconsin. She’s a dually certified licensed behavior analyst and licensed professional counselor who will share with us more about how these fields intermingle and work together to provide holistic care for clients who are struggling with behavioral and mental health challenges.

Katie has her PhD in behavior analysis and provides individual and couple counseling to adolescents and adults, so she serves 16 and up. Katie has written in college courses, speaks internationally on topics related to mental health and behavior analysis. Katie has published three books related to mental health and one assessment related to people’s ability to live a fulfilling adult life.

These are linked in the show notes, so I’ll make sure they’re all there. She also mentioned some books later on. Katie also has been published in some or several magazines. She works with relational problems, transitioning through divorce. Working through ADHD, PTSD, anxiety, depression, grieving the loss of a loved one and other life stressors.

Katie focuses on helping clients recognize and build on their own strengths to meet their personal goals. She does this by using a variety of therapeutic techniques including the combination of behavioral acceptance and commitment therapy and psychoanalytic tools. So, let’s listen in to Katie who has this amazing, unique dual licensure and get her perspective on both of these fields and how they work and work together. 

Hi there, Katie. How are you doing? 

Related Read: ABA Practice Management Software For Enterprise Practices

Katie Saint

Hi. I’m good. Thanks for having me. 

Erika Ng

Thank you so much for being here. I’m so excited to chat with you about your amazing dual certification here as a counselor and behavior analyst. And yeah, I just want to start by saying, I love your social media presence and just how you really make behavior analysis accessible.

The science of behavior accessible to people by educating them with the language that you use and just how you break it down and really infuse that mental health component. So yeah, looking forward to chatting with you. Thank you for being here. 

Katie Saint

Awesome. Well, thank you so much. I’m excited for it. Yeah.

Erika Ng

Yeah. I mean, it’s not common. I think for BCBAs to have the clinical counseling as well. So, you are in a really unique position. Could you maybe start off, and I just wonder if you know, listeners might be wondering what are the main differences between a behavior analyst and a clinical counselor? And what do those two services look like? 

Katie Saint

Sure. Absolutely. So, a behavior analyst is typically going to just focus on behaviors and things that are observable and measurable. So, ABA is most known for treatment for autism, and that’s where most of the funding sources go for ABA. But for mental health counseling, that focuses more on emotions and depression, anxiety, those kinds of things, trauma.

I typically, someone’s going to go to a counselor for those sorts of reasons. And sometimes people don’t know if they have a child with behavior problems and things like that. That they could go to a behavior analyst, but a lot of times when people have young kids with behavior problems without an autism diagnosis, they might go to a mental health counselor for that as well.

Erika Ng

Yeah, that’s certainly the case in our province, that if there is no diagnosis then straight to the counselor. And, you know, I think you can get both situations there of someone coming into a counselor and the counselor may not be able to meet all the behavioral needs or someone showing up to BCBA and not be able to address all the mental health needs.

So, yeah. It’s exciting to hear your perspective. So, in terms of counseling behavior analytics services and then being a bit different, now you do both. So what does that look like in your services, I suppose? 

Katie Saint

Absolutely. Yeah. So, I love having both because I feel like it better equips me on both sides of what I’m trying to treat.

So sometimes a barrier with depression, for example. Clients have low levels of dopamine. So that means like their motivation is going to be really low. So getting them to engage in some of the behaviors that they need to do in order to get their depression to improve requires some behavior analytic techniques of working on.

Okay, if your motivation is low, how can we change your environment to increase that motivation? You know, how can we reinforce those behaviors that are going to help you overcome your depression? You know, so each session kind of uses a little bit of both where we’re tapping into those emotions.

We’re looking at those internal events and kind of thinking about like, okay, what are your thought processes around this? And then using those behavior analytic techniques to get those behaviors established and maintained and all that kind of stuff, so. 

Erika Ng

That’s great. And I like how you describe behavior just as something someone needs to learn.

Cause I think sometimes we’ve, you know, society hears the word behavior and they think of negative behaviors, but like behavior is anything that we do. And so it’s establishing these new positive behaviors for this client with depression or whatnot. So yeah, I like how you frame that there. So, what do your services look like?

Do you do telehealth you do in person? Is it a combination? Do you meet with individuals or sometimes families? Cause I know you mentioned you serve 16 and up. So if you have teenagers, like, are their families involved? What does that look like? 

Katie Saint

Yeah. Yeah. So I do a variety of things. So, I did not do a telehealth until COVID started.

But last March insurance companies started approving to do video chat sessions with clients. And for some clients that’s been really great, for other clients that’s a barrier and it seemed to make counseling a little bit less effective. It was harder for some of those claims to open up. But I do individual sessions and I do family sessions and I do parent training.

So for example, one client I have has autism and an additional diagnosis of ODD. And so a lot of her behavioral issues we need parent involvement. We need training on how they’re going to respond to her behaviors and all of that kind of stuff. So most of her sessions are her and her parents meeting with me.

We create plans, we practice strategies, and then they go home and they implement those things. And then they come back in two weeks or whatever. And we talk about it again. So that’s one thing that I do. I also run some groups. So, I do a healthy relationships group and some emotional regulation groups.

And so in all of those groups, the clients reflect on their values and they pick goals and then they make their own data sheets and they also contact each other throughout the week to hold each other accountable and encourage each other. So those groups are kind of fun and they work on social skills and stuff like that too. So, yeah. 

Related Read: ABA Data Collection Software For Small Practices

Erika Ng

That sounds really all-encompassing. A group, like so many benefits there to be teaching the self-management, tapping into their values using probably some of that Acceptance and Commitment Therapy. And then also the social skills component. Like that sounds like such a nice environment.

 I’m sure especially for adolescents to have those social connections. That’s really cool. And are those, have those been virtual then as well?

Katie Saint

Some of those are virtual, some of them are in person. So, it just kind of depends. 

Erika Ng

Yeah. Okay. So a mix. So for a family or an individual, could you expand a little bit upon when someone might need to seek a BCBA or counselor, versus someone who is trained in both? Just if a family is dealing with, you know, what kind of issues would they be dealing with if they’re going to and who should they seek?

Katie Saint

Sure, sure. So I think if a child is dual diagnosed with multiple things, seeing someone who has both if you have severe behavior problems and mental health diagnosis is I think it would be really beneficial to have someone with both qualifications. But if somebody has autism or behavior problems and no additional diagnosis, any BCBA typically is gonna work with that awesome. 

You know, so as far as mental health only, you know, if the client is struggling with depression or, you know, anxiety sometimes, I don’t know. I guess I’m really biased in that. Like I love what ABA brings to counseling. So, you know, I just think every diagnosis benefits from that behavioral component.

So I guess that’s kind of hard for me to answer, but both are gonna be beneficial, you know, either way. So… 

Erika Ng

So if someone is coming to you, I guess I’m curious about what kinds of situations do families find themselves in? Like at what point are they coming to you? Like, are they in already in kind of crisis mode or do you treat families that are coming in kind of proactively?

Katie Saint

I feel a little bit of both and really like, it’s hard for people to ask for help sometimes. And so I think I see more of the family has been struggling for a while and now it got to an unmanageable point. And so they’re like, okay, we have to do something about this, you know? So that’s the bulk of the clients I get.

But the clients who come to me proactively where they’re like, Hey, I’m just starting to worry about this. You know, this client I got this past week, the mom set up counseling because her son just made one, like offhanded comment about killing himself. And she’s like, it just made me nervous. He said he didn’t mean it, but even just making a comment like that made me nervous.

So, I just wanted him to meet with you a couple of times, you know? And that was great because then he’s not as severe into this, like really bad like behavior patterns and like things that are really ingrained and reinforced for a long time. You know, so you get quicker results if you intervene sooner. 

Erika Ng

Right. That makes sense. And I’m curious, just kind of going off that, thinking about adolescents, I’m sure all the time you get parents that call you for services, but maybe the teen themselves is not super willing to go to counseling. Do you have any, you know, strategies or tips or tricks for parents if they’re kind of in that situation where they’re worried might not be a good situation at home to kind of get some of that buy-in from the young person?

Katie Saint

Yeah, absolutely. That actually did just happen with that client I was just describing where, like, he didn’t think he needed counseling, so he thought it was like dumb. Like, why am I here? So I love using ACT therapy for situations like that, because ACT is all about like, what are your values? So like, with that kid, I talked to him about, in my case. So that day where you talked about hurting yourself, like you must have been pretty miserable. You must have been pretty upset. I’m like, what I specialize in is helping that kind of painful feeling go away, you know. I can help you work through that and not feel that way and have a more satisfying life.

If your life could be like better and, you know, when you could be happier, like, wouldn’t that be cool? And, you know, like he’s kind of started to lower his defense mechanisms then and started talking more, so.  

Erika Ng

Yeah. So ACT with like that values-oriented piece. Yeah. That can really change motivation, that’s for sure.

And do you find that your young people are pretty receptive to, you know, talking about their values and accepting some of the activities that are activated even in group and stuff? 

Katie Saint

Yeah. Yeah. So a lot of my younger clients, you can’t just ask them like, Hey, what do you value? Like they don’t know how to answer that.

So some of it is like helping them learn what their values are. And a lot of times their pain speaks to what they value. Like you wouldn’t be upset about that if you didn’t value it. So let’s figure out how to build behaviors around that so you actually can have access to that thing that it is causing you pain right now because you don’t have it, you know?

So I find that when we explore clients’ values and help them see and be more aware of what it is they care about and why they’re so upset about certain things, they’re way less defensive. We have way more buy-in and they see like why therapy is about them and about making them happier ultimately. So… 

Erika Ng

Hmm. That’s awesome. So do you think you could share a couple success stories of situations where there was maybe some challenging behavior and some mental health issues? So you really were drawing and kind of both of your skillsets there with that some good outcomes. 

Katie Saint

Yeah. Yeah, absolutely. I had a client who was, had an autism diagnosis and he started cutting himself and he learned that like, it worked really good.

His mom is single and she’s a great mom, but she works a lot to pay the bills. And so she isn’t very available and he’s just like craves her attention. And so he learned that when I caught myself, mom cancels work. Spends the day with me, you know, like that was so powerful to him and she was being a good mom, you know?

So it stinks that that reinforced such a dangerous problem behavior. But he’s struggled with depression and things like that because he missed his mom. And so there was just all these layers that were not just like a behavior problem, you know. It was more complicated than that. So we had to do some family planning together on like, okay, these are the things we can’t change.

Like you need a roof over your head, you need food to eat. Some mom has to work, you know. So some of that we can’t change, but here’s where we can proactively plan some one-on-one time. And here’s some coping mechanisms, how we’re going to work through some of those really tough emotions and here’s some communication skills where we practice like.

How do I just ask for quality time versus letting it build up and, you know, then eventually leading to these severe problem behaviors. So, that kid was hospitalized before he started treatment multiple times, because of self harm. And so, now it’s been well over a year since he’s heard himself and his relationship with his mom is so much better.

So when he’s not struggling with depression anymore. So that’s a fun story that, you know, it makes me feel good and happy for them. Yeah. 

Erika Ng

That’s so beautiful. And I think that’s such a great, that is such a great example of understanding it from a behavioral perspective, but really getting down to the, into the depression and stuff as well, but having a holistic approach.

That’s amazing. I’m curious about when you work with parents as well, do you ever, or with young people, but do you ever work directly with a parent or are you always with the adolescent and the parent together? 

Katie Saint

Yeah. So this is another good example of using both. So in addition to my private practice where I do counseling, I also work for an Autism, maybe eight company, and do parent training for that too.

And so today I just met with two parents and I meet with them, well, they’re a married couple and I meet with them like every two to three weeks or so. And the entire conversation today was about mom’s mental health. She’s not following through with behavior plans and she’s really reinforcing some pretty serious problem behaviors.

And she talked about in session today, how she gets so depressed and that like depletes her energy level, her motivation. And so that’s why she’s not following through. So we made an entire mental health plan for mom on how to treat her depression in order to, you know, equip her better to follow the behavior plan.

Erika Ng

That is amazing. That’s really cool that you have that flexibility to be able to support the parent because you know, it’s so true. If she’s not able to carry through then there’s no moving ahead. And so, supporting her is really supporting the child as well. So… 

Katie Saint: Yeah. And in this situation, the mom didn’t need more parent education on like right way to respond. Like, she knew. She knew what she was supposed to do. So… 

Erika Ng

Yeah, it’s really just taking care of her really, you know, or like finding what she needs for support. That’s incredible. Very cool. I guess another good reason to have that mental health training along with the behavior component. Very cool. 

So before we wrap up, I just had a couple other questions for you. So just a few quick questions with some, potentially some advice or some tips. So what is the best advice you’ve received before? 

Katie Saint

You know what? This has stuck with me ever since this person told me. I did an internship at a sexual abuse center and I asked the counselor, I’m like, how do you not get burned out?

Like, how does this not just like crush you? And she talked about how, like, she’s like, I’ve always known that like horrible, horrible things have happened in the world, but now I get to be part of the solution. And so she’s like, I hear these heartbreaking stories every day, but I feel really good that I’m part of what’s healing those people.

And so that has just really stuck with me and has helped me like cope when I hear some of these, like, really heartbreaking situations that are just super traumatic and so, yeah. 

Related Podcast: Trauma-Informed Behavioral Health Services

Erika Ng

Yeah, that’s definitely helpful. And both are practitioners and maybe parents too, you know, when they’re in those tough situations, you know, kind of reorienting to, I’m going to be part of, I want to be part of the solution here. That’s great advice. 

How about an internet resource of some sort. Is there a website or a webinar you’ve done or anything that you’d like to recommend to families? 

Katie Saint

Sure. Yeah. I have a couple of webinars that if you go to revitalizecounselingservices.com, you can access them. I also have a book I wrote Autism and Depression. And that’s meant for the, it can be read by the person themselves or a parent can go through it with their child. So that’s meant to be like super user-friendly. 

My ACT training, I have a webinar that you can purchase and just watch in your own time. That teaches some of those emotional regulation skills and different things like that to help with mental health stuff too. So yeah, revitalizecounselingservices.com is where you can find all those resources. 

Erika Ng

Awesome. And I will definitely link that in our show notes. Would that last one, the ACT training also be applicable to parents? Like it’s designed for? Okay. 

Katie Saint

So it’s designed for therapist, but the principles apply as well to parents. So it’d be super easy to translate it. Yeah. 

Erika Ng

Okay, great. And I guess my last question is going to be, is there a book that you’d recommend? I guess you mentioned your one about Autism and depression, which sounds so useful if that’s something that an individual can do or a parent and an individual. Are there any other books that you wanted to mention that could be helpful for both that mental health and behavioral component?

Katie Saint

Sure. There’s a ton of ACT workbooks that if you just search ACT for adolescents or ACT for anxiety. And there’s some really, really good books that just walk you through how to treat that. And so that’s something parents could do with kids, you know, and help them through that mental health stuff in a behavior analytic consistent way. So… 

Erika Ng

Okay. And specifically, I guess workbook would be the key thing there. So it’s for the client, geared towards the client, the young person. Awesome. 

Katie Saint

Yes. So if I would go to Amazon and just type in ACT workbook for adolescents or something like that.

Erika Ng

Awesome. Great. Well, thank you so much, Katie. Is there anything else you’d like to mention to listeners about anything new coming up for you?

I will certainly link your social media account in the notes as well. Is there anything else you wanted to mention? 

Katie Saint

Absolutely. Yeah. Thank you. I have a book coming out really soon. It’s called ABA Terms Applied to Your Life. And so it goes through all the ABA terms in the Cooper book, which is like the BCBA Bible.

Erika Ng

Right. 

Katie Saint

And so it has their technical definition that’s like super jargon-y. And then it has a relatable example that’s just everyday language and then like goofy visuals and stuff like that. So you can see like how ABA applies to everyday life, you know. There’s so, like ABA is so well known for like just Autism.

Part of the reason I wanted to write that book was to help people see, like we are living and breathing ABA every day. And so this is kind of how it impacts you. 

Erika Ng

Yeah. Awesome. Wow. That is so exciting. Congratulations on that imminent publishing. How soon is it coming out? Like, is there a link that I could post about that?

Katie Saint

Not yet, they haven’t given us the official date yet. So I’m guessing that will be out in six months? 

Erika Ng

Okay. Awesome. Very exciting. Well, congratulations. Cool. Well, thank you so much, Katie. It’s been a pleasure speaking with you. I really appreciate you sharing your insights in this really unique area that you’re in.

And I think those are some really great examples and hopefully, I could definitely see some of those anecdotes resonating with listeners, especially that you serve adolescent clients and where that intersection of mental health comes in. So, thank you so much. I really appreciate it.

Katie Saint

Yeah, you bet. Thank you. 

Erika Ng

Thanks. Have a good evening.

Erika Ng

The comments and views expressed in this podcast do not constitute or replace contractual behavior, analytic consultation, or professional advice. Views expressed are solely the perspective of the speaker and do not represent the views or position of their colleagues, employer, or other associates.

Please seek out a behavior analyst with BACB website if you would like to receive further behavior consultation. Until next time. Take care.

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