Tim Talks: Behavioral Health
Tim Talks: Behavioral Health is a fast-paced podcast featuring candid, 10-minute conversations with leaders across the behavioral health field.
Hosted by Timothy Zercher, CEO of A-Train Marketing, each episode dives into what’s actually working in marketing, practice growth, and leadership — with a sharp focus on ethics, sustainability, and smart strategy.
Designed for behavioral health providers, practice owners, and executive leaders, Tim Talks delivers real insight from real operators shaping the future of care.
Short talks. Big insights. Smarter growth.
New episodes weekly.
Tim Talks: Behavioral Health
Rachael Cain, M.S., BCBA, LBA - Regional Clinical Director, Autism Center of Excellence
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What does it take to build a clinic culture that people actually want to be part of?
In this episode of Tim Talks: Behavioral Health, Tim Zercher sits down with Rachael Cain, M.S., BCBA, LBA, Regional Clinical Director at Autism Center of Excellence, to discuss leadership, culture, and the challenges of scaling ABA organizations without losing what makes them special.
Rachael shares how understanding individual passions can keep clinicians engaged, why creating fun and joy at work matters just as much as clinical excellence, and how leaders can make new team members feel like they belong from day one.
They also explore one of the biggest challenges facing ABA providers today: BCBA burnout and retention. Rachael discusses creative approaches to recruitment, apprenticeship models for new BCBAs, and why personalized benefits may be the future of clinician retention.
Topics covered include:
- Building a culture that keeps clinicians engaged
- Maintaining team identity while scaling
- Supporting and retaining new BCBAs
- Creative employee benefits that actually matter
- Community partnerships as a growth strategy for ABA organizations
If you're leading a behavioral health organization or growing an ABA practice, this conversation is packed with practical insights you can apply immediately.
Well, Rachel, thank you so much for joining us. We really appreciate you taking time today.
Rachael CainOf course. Thanks for having me.
Timothy ZercherAbsolutely. So you started working with individuals with disabilities while still in high school, I think. I think I read that somewhere in your profile. What was it about that experience that made you realize that this was the field that you wanted to dedicate your career to?
Rachael CainHonestly, it was just the kids themselves. They were just so uh different from each other. But then also the way that you had to teach them and the way that you interacted with them, you had to get creative. And I don't know. It was just the interactions with them mostly more than anything. And it just was so rewarding, a little bit different than what I was experiencing otherwise. Of course, I was very young, so I didn't have a ton of experience back then. But I loved working with kids. I always wanted to do something that meant something. So learning that early on definitely helped with guiding what my next steps looked like. And working with the kids, honestly, to this day is still one of the best parts of my job.
Timothy ZercherI love that. It makes perfect sense. You've led clinics, operations, clinical teams across multiple different organizations in different states. What have you learned about creating a culture that keeps clinicians engaged and excited about their work like you are?
Rachael CainIt's going across each individual person's strengths. So really pay attention. I really get to know my team, all of the different people on the team, getting to know why they're in the field. In fact, that's one of the first questions that I ask in an interview process of why did you end up here? ABA is a different type of field. Most people trip and fall into it. And those stories really help me align with what got them into the field, what is their passion, and how do I use that to be able to help continue that passion moving forward? How do I have them feel supported and still have that fire? Because it's easy to lose day over day. But if you have that skill set and you have that passion, that's really truly what makes the difference. And then just like the individual things. If somebody really loves Pokemon, how do I integrate Pokemon into their day-to-day? Do I hide a little like Pokemon on their desk? Do I find a way to see if there's like a program that we can do that centered around like that sort of a theme? Just like how I do with the kids. It's everybody's an individual person. How do we bring that individuality into the team?
Timothy ZercherI like that. It goes to ABA, isn't just for kids. We can all be helped along with positive reinforcement in the right places in the right ways. So you often talk about balancing clinical excellence with fun, just like you were talking about, and creating that supportive environment. How do you maintain high work standards while still making sure teams don't lose the joy and lose the fun in the work?
Rachael CainI've set really solid expectations and then I communicate those expectations across the board. But at the same time, I take into account like feedback. And that's always something that my team is hearing from me is okay, so here's this thing that we're going to be doing. Here are the expectations that are going to be set. Now you tell me. Are there different pain points that aren't going to work for whatever reason? Do we not have the resources available? Do we not have the training that's been completed yet? So it's a communication. It's not just, here's what it is, now do it. It's here's what it is. Now you tell me how we can do it. And if we can't do it, let's work together and see how we can make it work. And the more creative their responses are, the better fun and joy and passion that comes into it. And I don't ever like working in a silo. I'm really bad at it. I love being part of a team. I love hearing the idea because I can't think of everything. And like recently, Dungeons and Dragons was something that came up as a way to structure a social skills program. I don't know how to play Dungeons and Dragons, but I know someone who does. So let's bring it in. And if that's gonna help our kids clinically, then let's do it.
Timothy ZercherThat's awesome. I love that. Dungeons and Dragons, I think, makes a lot of sense in ABS. I can tell you how can work.
Rachael CainIt's the role playing and the socialization. It's a whole thing. I'm really excited about it, but we're not talking about that right now. We'll talk about other things.
Timothy ZercherYeah, that should have made a whole question about Dungeons and Dragons for sure. On a different question, though, that might be more applicable to other people. What have you found is the hardest part of growing an organization or a team?
Rachael CainI guess ironically, it's maintaining the culture as you scale. Having a smaller group, it's a little bit easier to maintain a certain type of culture. But what's really difficult is having a tight-knit group, having a really good culture with the crew that you have, and then bringing new people into that. Not only would those people sometimes feel ostracized because they're not part of the OG crew or that they're just not able to fit in the same way because people have all these inside jokes with each other and there's all of these memories that people are bringing up. It's making sure that new people feel welcome and not only just in the way of like it's a new job, it's a new setting, but to also bring in themselves and their joy and their passions. So it's hard to find people that can integrate into the already set group of people. And how do we continue to maintain that without it affecting the services that we provide at the end of the day?
Timothy ZercherAbsolutely. Yeah. Definitely not an easy task, no matter how large the team, honestly, because even if it's a small team and new person still feel like the odd one out.
Rachael CainYeah. I actually grew up as a military brat. My dad was in the Air Force. So I very clearly understand what it's like to be the new person in a group of people that know each other very well. So I bring that experience that I've had to be able to communicate to the current teams, like this is how you make someone feel welcome. You give them these opportunities to be a part of whatever the groups are, you invite them out to lunch. We have different times during the day where the staff, like the RBTs, are able to take breaks. Why don't you invite that person to come with you? Or for the BCBAs, how do we set up their desk? Find out the things that they like, give them what their favorite color is, find a keyboard that's in that color, those sort of things to just show, hey, you're welcome here. When you're comfortable, then we can interact and have all of the fun memories and all of that until the next one comes.
Timothy ZercherAnd then we do Yeah, I love that. I think that makes a lot of sense. Shifting tax a little bit, since we are a marketing agency that specializes in this space, we always have to ask some more marketing type questions. The first one is for your organization, outside of word of mouth, what works best when it comes to acquiring new clients?
Rachael CainI would say uh collaboration is probably the biggest marketing tactic that we use outside of the usual like putting out ads and things like that. It's being able to collaborate with a variety of different providers. So interacting with psychologists, going into dental places, dentists, preschools, doing lunch and learns, those sort of things, and introducing ourselves. ABA is definitely a lot more well known than it was in the past, but there's a lot of misconception around it. And I think meeting the people who are doing the jobs and doing the different things definitely helps quite a bit and being able to have those conversations. So collaborating with as many people as possible. I always invite people, anybody who's met me, I guess hyper recently, where like I've had them come by. I'm like, come by, come see. This is what we have these things. I want you to walk around, I want you to see the kids, I want you to see the BCBAs. It's different than talking about it. And I have like full trust that once you come and see it, you'll be able to feel the difference. It's hard to explain unless you're there. One thing that we've been talking a lot about is BCBA recruitment. How do we talk to newer BCBAs or those that haven't had their certification for too long or didn't have the support? How do we kind of help them feel better about transitioning into the space? The thing about becoming a BCBA is the day you pass your exam, that the expectation is there. Full caseload, full everything, hit the ground running. If you didn't get that support in your hours, which is the main point of the hours, sometimes in often case, it's very overwhelming. We actually lose quite a few people in the first year of becoming a BCBA to the field in general. Like they completely phase out of ABA because they're just overwhelmed by what the expectations are. So we have an apprenticeship program that we're working on of what a slow fade would look like, not coming into a full caseload, but just giving more of that type of opportunity. And then aside from that, it's just being creative with what type of benefits are available. We have the regular medical dental, 401k, vision, the whole nine. But what else can we provide that's just a little bit more out there? An audible subscription, a gym membership, covering like even drop-ins for the pottery class, or covering dinner for you and your spouse at a restaurant in town if you're new to the area, those sort of things. I want to try to get as creative as possible rather than the one size fits all sort of solution.
Timothy ZercherYeah, that makes sense. One size fits all doesn't work for recruitment because people are not one size fits all. That's just the rare that makes perfect sense. Well, thank you so much, Rachel. I really appreciate you taking time out of your day. I know the life in the clinic is always busy, so we appreciate it.
Rachael CainYeah, definitely busy. Never boring.
Timothy ZercherNever boring. Well, thanks so much.
Rachael CainOf course, thank you.