Clinician Spotlight: Dennis Fraser

Meet Dennis Fraser! Dennis is a BCBA (board-certified behavior analyst) who has been a part of HMEA since 2014, when he joined our team as a direct care staff member for our Employment Services program in Plainville.

Dennis is currently a Behavior Clinician for several of our Adult Services programs, including Day Habilitation, Employment Services, Shared Living, and some of our Residential programs. We spoke with him to learn more about his time at HMEA and his path to becoming a Behavioral Clinician.

Can you map out your career path from when you started at HMEA until now? 

When I came to HMEA, I had two years of college under my belt. I had attended the University of Rhode Island to take my general education courses. At the time, I tried taking some communications and film classes, but nothing was clicking, so I dropped out. Afterward, I worked in restaurants for a couple of years before being hired by HMEA.

My first role at HMEA was in the Employment Services program, working as a direct care staff member for the individuals in the Plainville Employment program. I really loved it, especially taking folks out for lawn care. During this time, one of the clinicians, Tracey, approached me and asked me if I was interested in joining the Clinical Services team. They seemed to like the work I was doing and wanted to give me an opportunity.

I entered the clinical department as a Clinical Support Specialist. My main role was making sure the behavior plans were being followed as written. The department head at the time, Bill, approached me and asked if I’d be interested in going back to college to complete my undergraduate degree. I went back to Rhode Island College and took some psychology classes, one to two at a time.

When I finished my degree, Bill came to me again and said, “How would you feel about getting your Master’s degree? They’re doing a presentation for Cambridge College in Boston – you should go and see what you think. You don’t have to make any commitments.”

I attended the presentation, and they talked about Cambridge College’s BCBA program. They talked about how it would work into my schedule and the opportunities it would provide. I walked out and was like, “I have to do this. This is such a great opportunity.” The other department members were so supportive and encouraging– I had to take it.

I completed my Master’s degree and have been a licensed BCBA for two years now. HMEA has been nothing but supportive throughout the entire process.

What are your current responsibilities?

As a behavior clinician, my main responsibility is writing Positive Behavior Support Plans that help our individuals reduce problem behaviors and develop positive skills to enhance their quality of life. I also train staff on how to execute each plan and work with support teams to make adjustments as needed. 

I started out in Day Services, but recently, I’ve been branching out into other programs, including our Shared Living program and group homes. As a result, I’ve been working with many different folks – direct care staff, shared living providers,  other clinicians, supervisors, families, group home managers, people at the state level, psychiatrists, etc. I love working with people who have so many different backgrounds and viewpoints. It definitely keeps me on my toes.

What are the challenges of your role?

Different service levels provide unique challenges. The issues you see in the day programs are different than what you might see in the residential programs. In Day Services, there are certain expectations for skill development and participation. You ask people to be involved in activities they might not normally do, which can create tension. It’s a constant balance of trying to encourage folks to be engaged and learn new things, while also respecting their needs for breaks and downtime. 

Residential can be more laid back, but there are still challenges. There is a thin line between promoting independence and freedom, but also keeping someone safe and healthy. What do you do when someone constantly wakes up in the middle of the night and eats a whole jar of peanut butter? Obviously, that isn’t a healthy habit, but you and I can do that any time we want. Why shouldn’t they be able to? A lot of my work in the homes is about developing strategies to promote good choices, and environmental modifications to avoid ongoing issues. 

Being a BCBA is typically associated with working with children using applied behavior analysis, but you work with adults. Was there something in particular that drew you to working with adults over children?

It was mostly a coincidence that I started working with adults, but I don’t see ever wanting to change that. Children and their families can access many resources and supports that adults don’t typically get. People tend to overlook the fact that those children become adults, and issues don’t magically go away. It’s really rewarding to work with a “forgotten” population that still needs our help.  

Also, I find the type of skills that we address with adults to be more interesting. In children’s ABA, they work on activities like distinguishing between letters, colors, animals, etc. It’s a lot of following scripts and doing flash cards. In adult services, the focus is on life skills and independence. I like teaching things that are functional, like crossing the street safely, making a simple snack, mowing a lawn, or handling stressful situations. The best way to teach those skills is to actually practice them in real life. Staff get really creative in their classes, and there are always a lot of fun projects going on.  

How has HMEA supported your professional development?

When I took my college classes, the tuition reimbursement HMEA provided for my studies was pretty good. More importantly, HMEA gave me a lot of flexibility, as long as I was getting my work done at school and at my job.

One thing HMEA does when you’re becoming a BCBA is provide you with a supervisor, which many places don’t do. You need 1500 clinical hours to sit for your BCBA exams, and you need a BCBA supervisor to sign off on those hours. Many people in my classes at school struggled with this and either had to pay someone privately or cycle through multiple supervisors. However, HMEA provided me with the same supervisor throughout the whole process. Additionally, some places have the same supervisor assigned to 10-15 people, but HMEA gives you 1:1 supervision. 

My supervisor, Tom, was AWESOME. He made sure I was driving the ship, but any time I needed to send him anything, he’d read it and get back to me ASAP. That was so invaluable – I don’t know if I could’ve earned my BCBA without him. 

After I got my BCBA, I automatically received more responsibilities, but also more trust. Tom’s still available as a resource – I send him stuff all the time. I also call Tracey day and night just to go over everything. It’s been a really nice mix of independent work and having support if I need help.

Looking back at your time at HMEA, what are you most proud of?

During the COVID-19 pandemic, we ran vaccine clinics. They were massive – I’m talking hundreds of people per day. We have a nursing department that coordinated the clinics, and they did an excellent job with the paperwork and making sure our clients received all the vaccinations they needed. On the day of the clinics, however, our team was responsible for the flow of logistics and making sure everyone had what they needed.

I must’ve done six or seven vaccine clinics over a year and a half. They take up an entire day and are usually a 12-hour process. The first one I did took place on Super Bowl Sunday in the middle of a snowstorm. It was at this weird point in the pandemic when everyone was still terrified of COVID and trying to figure things out. The vaccine was the first glimmer of hope that we were coming out of it. I was doing activities that weren’t in my job description, such as making sure the lines were moving along or making sure our individuals in wheelchairs got where they needed to be.

Seeing the relief of parents, guardians, house managers, and clients as they came in was so rewarding. Many of them were individuals I hadn’t seen in person since pre-COVID. We work with some people who are extremely immunocompromised or have severe respiratory issues. It meant the world to be able to give these houses a ray of hope after they went through so much grief. 

Those kinds of things happen all the time. I also do SOLVE (Strategies of Limiting Violent Episodes) training in the evenings, to show people how to de-escalate agitated individuals and keep everyone safe in an emergency situation. It’s outside of my job description, but it’s a great opportunity to meet people from all over the company and get more face time with them. There are all these little opportunities that I’m not sure other companies provide.

Why would you recommend working at HMEA?

In my department, there are a number of people who have been here for 15-20 years, even 25+ years. It’s not just my department, but other departments like staff, nursing, management, transportation, etc. People really like working here.  There are so many people at HMEA who started in entry-level positions and worked their way up. That opportunity’s here for everyone. 

Also, you’re dealing with people who have had some real challenges in their lives. We have some individuals who were previously institutionalized or have even been homeless. It’s amazing how something simple like taking them out in the community or just taking the time to sit and chat with them can improve their presentation. These are little things, but they go so far. It’s so great to have a job where you get to make those little differences every day.