Google, Instagram, TeacherTube, OpenTable, YouTube, and Twitter are just a few notable online platforms. Videos on these platforms give information and expectations of certain environments, and/or activities. Additionally, they teach a variety of “how-to’s.” These include putting on a Jeep Wrangler rooftop, making a vegan pie, or teaching your dog to skateboard. You can use these video platforms as an aide when teaching individuals with disabilities.
Working as a special education teacher in an elementary-age classroom, I was faced with many challenges. One of these challenges included teaching meaningful lessons that each student could access at their individual level of learning.
I used online video modeling to teach social skills and abstract topics such as personal preferences. To show competency in the skill, my students would demonstrate the skill with a peer or instructional assistant. These skills would only be considered mastered if the student demonstrated it across a variety of days/opportunities. To ensure generalization, individuals would practice these skills across multiple staff/ peers and settings.
Here are a few of my favorite videos to help with instruction!
Videos to Help With Teaching
For my early learners we watched videos such as opposites, to work on labeling similarities and difference.
Try using the video Belly Breathe. This video can help students practice taking deep breathes when they’re feeling stressed out, or unsure of what to do in a moment of frustration.
When practicing manners, I used Please and Thank You. Use this as a tool to support the students in teaching when to use manners and what words to say.
When preparing to enter the community, we would review this community helpers video. Pre-teaching who we were going to see when we entered the community allowed for ongoing conversations. This also was an errorless way for the students to know what community helper they were going to see.
I often used Do You Like? to guide the learners in forming their own opinions. This also aided in choice-making and identifying preferences.
More Than Just Teaching Materials
These videos were initially found to be used as teaching materials. Over time it became clear that they were much more than that. Some videos turned into preferred rewards that the students would ask to watch on their break time. A couple of students took these video examples as a way of communication and requested that their assignments be completed through video recording. There was growth in the classroom community, as each learner, no matter their level of performance, was able to access the message of these videos with their peers.
By Master Trainer Cassie Herman
There are several different types of preference assessment. In previous behavioral briefs, we reviewed a Free Operant Observation Preference Assessment and a Paired-Stimulus Preference Assessment. This Behavioral Brief will focus on Multiple-Stimulus Preference Assessment (MS).
There are two different types of Multiple-Stimulus Preference Assessments:
- Multiple-Stimulus with Replacement
- Multiple-Stimulus without Replacement (MSWO)
Both assessments will be discussed within this Behavioral Brief.
A Multiple-Stimulus without Replacement Preference Assessment is similar to a Paired-Stimulus. This is because they both identify high-preference, moderate-preference, and low-preferred items. The data is displayed in a hierarchy. This assessment can be completed in less time than both Pair-Stimulus and Free Operant Preference assessment.
The limitation of the Multiple-Stimulus assessment is that the individuals must have strong scanning repertoire due to an array of 5 to 7 items being presented (DeLeon & Iwata, 1996). If the individual does not have a strong scanning repertoire then the Free Operant, Single-Stimulus or a Paired-Stimulus should be conducted.
Teaser:
Identifying a high-preferred reinforcer is a crucial component in the creation of a behavior change program. Stay tuned for our 3rd installment on Stimulus Preference Assessments. In this behavioral brief we will be discussing Multiple-Stimulus Preference Assessments!
Visit our YouTube page to find more Behavioral Briefs: Making Reinforcement Effective and Debriefing with the Individual Following Behavioral Escalation.
You might also enjoy some of our behavioral blog posts: Performance Issues: “Can’t do” versus “Won’t do” and Escape Maintained Challenging Behavior.
By Master Trainer Sev Baron
Help! I don’t want to get sick but I just can’t stop touching my face.
Has some semblance of this thought crossed your mind lately? If so, you’re not alone. With everything going on in the world right now, some degree of hygiene hyper-vigilance is totally understandable.
To mitigate the spread of a virus like COVID-19, both the World Health Organization (WHO) and the Centers for Disease Control (CDC) recommend that we avoid touching our eyes, nose, and mouth (i.e., facial region) with unwashed hands. Sounds simple enough, right? Ummm… not quite!
Have you ever counted how many times your hands make contact with your face during the day? We do it a lot more often than we realize. In fact, there’s research out there that suggests humans touch their faces about 23 times an hour (on average). I’m not a math major but assuming you’re awake for 16 hours a day, 16 x 23 = a whole-lotta’ face touching! So, unless you’re washing your hands just as often as you’re touching your face, the risk for acquiring and/or spreading germs via this pathway is very real.

How to Stop Touching Your Face
Thankfully, the behavioral science community has come together and compiled a fairly cogent set of evidence-based recommendations to help minimize face touching. So, what can you start doing right now to minimize touching your face with your hands?
Increase Awareness
Increase your awareness of your own face touching – perhaps you don’t touch your face 23 times per hour. Maybe you touch your face 35 times per hour! Or more! Ahh! Whatever the number is, you want to get it as close to zero as possible. Some ways to accomplish this:
- Have a partner (e.g., friend, significant other, etc.) tell you when you’re touching your face.
- Document how often you touch your face (via paper + pen, digital notes, etc.).
- Use some type of external cue to remind you to refrain from touching your face like a particular perfume / cologne or specific bracelets.
Be Mindful
Be mindful that by reducing face touching and mitigating the spread of coronavirus, you are in fact helping others. How can you accomplish this level of mindfulness throughout your day?
- Remind yourself of the people whom you are trying to protect (e.g., significant other, children, elderly or immune-compromised family members / friends, coworkers, customers, etc.) by mitigating the spread of germs.
- Kindly remind others should you notice them touching their face.
Keep Your Hands Busy
Do other things with your hands; ideally, things that are mutually exclusive with touching your face. You can do these things proactively (i.e., to avoid touching your face in the first place) and/or reactively (i.e., as a result of recognizing that you just touched your face). The logic here is pretty simple – if your hands are busy doing something, they’re less likely to migrate to your facial area. Some examples of things to do with your hands include:
- Put hands in your pockets.
- Hold something in your hands (e.g., stress ball, fidget spinner, etc.).
- Make fists with your hands.
Change Postures
Change postures, if you find it difficult to stop touching your face given your current postural arrangement. The idea here is to augment your position such that touching your face is less conveniently accomplished. For example:
- Keep your elbows off the table.
- Sit in chairs without armrests.
- Sit in the middle of the couch.
Find Stress-Relief
Perhaps face touching is partially fueled by stress and, make no mistake, these are extra-stressful times. Regardless of whether you feel stress is a contributing factor to face touching, practicing relaxation techniques can be beneficial to your overall well-being. Some easy to implement and often effective relaxation techniques include:
- Focus on taking long, slow, deep breaths and relaxing any muscles that feel tense.
- Find a quiet place to sit and focus on the present moment rather than on the past or the future.
- Spend time in nature (whilst maintaining a safe distance from others).
Click here to watch a quick video on this topic. Also, the fine folks over at the Psychonomic Society have created this infographic for the public, which sums up their recommendations to reduce face touching. Click here for access to the infographic in multiple languages. They also have some handy-dandy recommendations to increase social-distancing, if you’re into that kind of thing. Hopefully, we can all help reduce the further spread of COVID-19 (and other communicable diseases) by putting these recommendations into practice and encouraging others to do so as well!
By Master Trainer Beth Harlan
Superheroes have dominated pop culture over the past few years. While we’re used to looking for them on screen, all we really need to do is look in the mirror. We all have superpowers in some way. In the era of Covid-19 it is imperative that behavior analysts and other related personnel use their skills to help us all unlock those superpowers by teaching parents how to use values-based behavior strategies.
Some ways to accomplish this were outlined in the article “From helpless to hero: Promoting values-based behavior and positive family interaction in the midst of Covid-19” by Szabo et al., 2020. Below, I’ve grouped the article’s recommendations of how professionals can help families and clients unleash their superpowers. I’ve broken it down into the categories of set-up, values, time, and activities.
Set-Up
Designate different rooms in the home for different activities. Indicate which room is for work, leisure, sleep, etc. You can do this through the use of colored cards, giving the room different names. Include children in the naming or color-coding process.
Additionally, you can create a daily schedule with a picture of the room where each activity will occur. There can be many benefits to having children and parents change rooms for different activities across the day. Doing so can help with some of the stress of being home every day.
Visual modeling of skills involves using pictures to demonstrate how you want someone else to complete a skill. Parents can take pictures of how to complete various tasks and post those images around their home.
Use of cues like colored cards to indicate when a room is, and is not, available for use. For example, say a parent is on the phone for a business call in the guest room. In this case, the guest room would have a red card visible. Or let’s say a parent is watching a movie in the guest room. For this instance, a green card would be visible in the guest room to show it is okay to enter.
Visual Schedules can be used to help provide structure to the day at home. Show parents how to set them up, how to include visuals and how to make sure that reinforcement and breaks are included in this schedule for everyone in the family.
Values
Verbal statements that make following rules, sharing, helping others, and making the best of a difficult situation heroic, could help increase children’s engagement in those skills. Teaching families to use these statements could also empower all members of the family to engage in these behaviors more often.
This could potentially even improve the overall morale of the family. Examples of these statements include stating things like, “…superheroes model being patient for their sisters and brothers: I love seeing you show your brother how to be so patient” (Szabo et al., 2020, p. 14).
Daily Visioning is a skill that involves teaching families to start their day by coming together as a group. They will then review a written statement of their family vision, or goals, and the family’s schedule for the day. This skill could be combined with the visual schedules that were addressed above.
Displaying rules visually involves teaching families to not only set rules, but also post those rules visually for all members of the family to refer to. Combine this with verbal statements that make following rules a heroic action. This encourages and reinforces the entire family for following the rules and reminding others to do so as well.
Value clarification involves teaching family members to identify each other’s values by drawing a coat of arms, that includes visual representations of their top four to six values.
Time
Beat the timer is a strategy that parents could be taught to use. The goal of this strategy would be to decrease the time it takes family members to complete various activities.

Families can also be taught to use timers to indicate how long an activity will occur. They can also be used to tell how much time is left before an activity will end. This use of timers is aimed at improving transition between activities.
Pausing when upset is a very important coping skill that practitioners could teach caregivers and clients to help families respond more effectively to stressors.
Activities
Tootles are an activity where the whole family is given cards, post-its, or a piece of paper. They are then told to record, and later share, when they catch their family member engaging in prosocial or heroic behavior.
Jumble Jar is a container full of sentence starters, topics, or statements. This can help provide structure to family conversations at meal times.
Life timeline is another activity families can do together. In this activity, you put out a line of tape on the floor. On the tape, you place pictures, drawings and life events in chronological order, then review/relive those events as a family.
PAX Good Behavior Game is a set of practices that parents can be taught to apply at home. Small alterations can be made when taking the game out of the classroom and into the home. All members of the family can be on teams. This could be a great way to provide more reinforcement for prosocial behavior at home.
Math mountain is another activity you could teach parents. It involves solving problems to climb the mountain and get safely down the other side. It also includes ways to get and give support when someone gives an incorrect answer.
Computer cleanup is a simple activity that caregivers can be taught to use. This activity involves setting up a structured schedule with timers. Once a number of minutes of work is completed, then that family member can have a number of minutes of computer time.
5-4-3-2-1 is a simple activity that families can used to stay in the moment. This activity can be done by stating a different number of things they can see, hear, touch, smell, and taste.
Conclusion
Above, I have described some ways to teach values-based behavior strategies that the article recommends behavior analysts and related professionals teach to parents. It is especially helpful for those with children with special needs, to teach prosocial skills at home. These skills will help caregivers, parents, and children unlock their personal superpowers. It is important to note that many of these skills can be combined. Any practitioner teaching these skills to families should individualize their instruction of the skills above to match their clients’ and families’ needs.
For more information, and to read the whole article, please click here.
Additional Resources
Check out other articles to help parents with kids at home: How to Work From Home With Kids: Learning, Leisure, and Love in the time of Coronavirus, 4 Tips for Keeping Your Kids Physically Active During the Stay-at-Home Period, and Escape Maintained Challenging Behavior.
QBS offers a webinar training program called Safety-Care for Families. It is a training program that allows organizations to train families working with behaviorally challenging individuals at home.
To sign up or learn more, please email info@qbs.com.
References:
By Master Trainer Fatima Zaidi
The federal government and CDC released guidelines to slow the spread of the novel coronavirus. As a result, millions of families will be home for quite some time, leaving parents struggling to find things to do with their kids while working from home. Juggling work and family is hard enough without COVID-19 around. Here are some general tips to keep in mind when you are planning your family time.
There is no academic emergency; home does not need to be a school
Most of us have never experienced anything like this. It’s important to acknowledge the crisis and talk about it with your children. It may be impractical to try to make home a school. If academic learning is difficult for your children, this may not be the time to focus on academics. Your children can still be productive by learning through play, helping around the house, and participating in family discussions. Think about the topics school doesn’t teach. Can you think of a fun way to teach this at home?

Offer screen time when you have important work to get done
If you are a parent working from home with kids, screen time may be a helpful tool to keep your children engaged so that you can get important work done. Be careful about how much screen time you offer: If screen time is available too often, children may become bored, sad, and frustrated (even when they keep asking for their screens).
To keep screen time effective, it’s important to only allow access during important work time or to help motivate your kids to help you around the house. Balance screen time with other leisure activities. Some children may not know how to interact with certain toys or leisure activities. It’s important to show them how to play new games and activities, learn to use things in an imaginative or unusual but fun way, or to show them the fun things you did when you were young. Chances are they may enjoy them too, and you can enjoy them together.
Build Rapport
Our modern world asks a lot from parents. Professional development and family development both require a lot of patience and attention. If you wanted to focus on one goal, consider the value of building rapport. Building rapport increases compliance, which mitigates risky behaviors in adolescents and adulthood, increases the quality of life, and builds secure attachment. If you can only spare 15 minutes, spend that time playing with your children. Let your children show you how they have fun. Don’t instruct, don’t ask hard questions. “Play is the opposite of work;” as Shonda Rhimes stated in her TED talk.
So, take a deep breath in, empathize, and embrace the experience. Take this time to communicate respect and promote dignity by avoiding power struggles, paring down instructions, offering more choices, giving descriptive praise, and taking an interest in their interests.
Check out some of our other blog posts to help handle your kids at home: Escape Maintained Challenging Behavior and How to Make Reinforcement Effective.
Everyone is probably tired of hearing “Wash your hands!” “Wash all the surfaces!” “Don’t leave your house!” Most of us are probably working hard to ensure we are cleaning everything we touch and sanitizing everything we can think to sanitize. But there’s always that one guy who scoffs and figures his hands are clean enough! That one person who says, “I cleaned that last month.” That’s always a bad look, but in these days of Coronavirus, it’s not just kind of gross, it’s dangerous.
How can Behavior Analysis Help Cleanliness Habits?
How can the field of behavior analysis help? Studies on hand-washing and general environmental cleanliness have been undertaken with encouraging results. One interesting study occurred in 2018 at a gym on a university campus. Obvious to anyone who has gone to the gym and watched a sweaty guy move on to the leg machine without wiping down the last machine he used, gyms can be optimal breeding grounds for all kinds of disturbing maladies. In their study, Ilexis Elba and Jonathan W. Ivy decided to try three different antecedent interventions to see if any might result in gym-goers showing more diligence in cleaning machines when they were finished using them.
Typical “Wipe down your machines after use” signs had been posted before research began. So, for the first condition, researchers added a verbal announcement over the loudspeaker of a woman saying, “Hey! Hey you! Someone wants to use that machine after you. Wipe down equipment after use.” To make the announcement more noticeable, the gym faded out the music before the announcement began and turned the music back on after the announcement ended.
In the second condition, the authors posted 6 signs around the target equipment, each with 2 graphic depictions of skin diseases that one could pick up in unsanitary conditions. In the third condition, the researchers kept the signs posted in addition to placing paper towels and sanitizing spray at each station.
Results of Study
Researchers found that the announcement didn’t really do much to change behavior. The signs resulted in an impressive increase in cleaning the equipment, but the increase didn’t necessarily last, decreasing after a period of time. The best, most lasting intervention appeared to be the accessibility of cleaning materials paired with the signs, which resulted in about a 53 percent increase in cleaning the machines after use.
Graph showing percentage of full and partial post-use cleaning of gym equipment across baseline, announcements, signs, and signs plus increased availability of cleaning materials.
Teaching Kids to Practice Cleanliness
Hopefully, with the recent additional threat to public health, adults are doing a decent job of maintaining cleanliness, but what about the kids? Not all kids have been taught how to best clean their hands (or if they have, they may not follow through). A study by Jess, Dozier, and Foley (2019) taught pre-school children how to wash their hands effectively. This study used video modeling, practice, verbal and visual feedback to teach and reinforce kids’ good handwashing behavior.
First, the authors showed a video that modeled the steps of handwashing, then they rehearsed handwashing with the children. They then taught a 20-second song about the correct steps set to the tune of “Frere Jacques.” Children were rewarded with verbal praise for following the correct steps for handwashing. In addition, researchers used a substance called “Glo-germ” which simulates germs commonly found on hands to measure whether the handwashing efforts made by the children actually resulted in cleaner hands.
Results of Study
At the beginning of the experiment, the authors gave each child a squirt of Glo-germ and asked them to lather it all over their hands. They then put the kids’ hands under a UV light and photographed them. After the kids washed their hands using the correct steps (from a hand-washing checklist), researchers had them put their hands under the UV light again and took photos. The study showed that when the children in the study used the correct hand-washing steps, it drastically reduced the illumination of “germs” (Glo-germ) on their hands to between 8-13% resulting in better overall cleanliness. (Illumination during baseline was at 91% and had decreased only to 68-77% before the kids were taught the hand-washing steps and taught the accompanying song.)
Graph showing the “germs” left on the hands of children before and after being taught how to properly use their hands.
The graphs to the left are the number of correct steps the children completed before and after training, and the graphs to the right depict the percentage of hands illuminated. “Germs” on the kids’ hands decreased dramatically as correct hand-washing steps increased.
Use Behavioral Analysis Skills To Encourage Cleanliness
It would seem that making it easier for staff to clean surfaces in group spaces, as well as posting eye-catching signs reminding everyone of the reasons for sanitizing might help increase cleanliness as we work collectively to fight the Coronavirus. Demonstrating hand washing to kids and making it fun and rewarding to follow each step teaches good behavior that can be used now and for years to come.
Stay safe (and wash your hands!), everyone!
References:
Elba, I. & Ivy, J. (2018). Increasing the post-use cleaning of gym equipment using prompts and increased access to cleaning materials. Behavior Analysis in Practice. 11(4) 390-394.
Jess, R.L., Dozier, C.L. & Foley, E.A. (2019). Effects of a handwashing intervention package on handwashing in preschool children. Behavioral Interventions. 34(4) 475-486.
All organizations will have to deal with performance problems at some point. It can be either one employee or an entire department. In order to respond effectively to these deficits, it’s important to understand the two major types of performance issues. These issues are “Can’t do” and “Won’t do”.
“Can’t Do” Issues
“Can’t do” performance issues exist when the employee is not able to perform the skill or task. This can happen for numerous reasons:
- Lack of
- Training
- Resources/materials
- Time
- Physical inability to perform a task
In order to solve “Can’t do” performance issues, one should focus on antecedent control. This means focusing on what you can modify before the behavior happens. This basically sets the stage for the employee to be successful. For “Can’t do” problems, providing additional training and resources can be effective interventions.
“Won’t Do” Issues
“Won’t do” performance issues occur when the employee has received the necessary training, has the needed resources, has been observed performing the task in the past, yet they are still not completing it frequently enough or at all. In this case, the employee knows how to complete the task but isn’t. It may be an easy route to assume they are lazy, unmotivated, or just don’t care. The issue with those routes is that they do not provide solutions, rather they raise more questions.

For “won’t do” problems, the focus must be shifted to consequences (not necessarily negative) for performance issues . This means that our intervention concentrates on what happens after the behavior occurs or doesn’t. In order to increase any good behaviors an employee exhibits, incentive programs should be used. Additionally, regular and individualized feedback sessions that highlight specific aspects of current and optimal performance is a great option in handling performance issues.
Regular and individualized feedback sessions, highlighting specific aspects of current and optimal performance is a great option in handling performance issues.
Discover the Root of the Problem
Prior to developing an intervention for a performance issue, it’s crucial to identify the root of the problem. A common organizational response to employees’ performance issues is to provide more training without identifying the reason, resulting in employees attending similar trainings that don’t resolve the problem at hand.
There are many other reasons, other than lack of skills, why an employee is not performing at a desired level. For instance, staff can attend numerous trainings on the importance of wearing gloves, but if these are provided, or if employees have to walk to the other side of the building to get gloves, the training will have little effect. When employees attend trainings for reasons other than skill acquisition or retention, it results in the company’s time and resources being wasted, as it doesn’t solve the performance issue at hand.
Learn more about how to keep your staff from exhibiting performance issues on our blog post discussing the importance of staff feedback.
Individuals may use challenging behavior to escape, delay, avoid a situation, task or instruction, or other non-preferred activity. When an individual escapes a situation by exhibiting challenging behavior, they will continue that behavior since it was effective in getting them the results they want.
Example: Caregiver Rachel asks individual Sam to clean up. Sam says “no!” and hits Rachel. Rachel says, “Sam – you need to take a break and calm down.”
In this example, Sam did not want to clean up and did not have to clean up after he hit Rachel. Since hitting got Sam the results he wanted, he will likely hit again next time he is asked to clean up.
De-escalation Strategies
A common myth is that using Safety Care de-escalation strategies might allow escape (“getting away with it”). This would unintentionally reinforce and increase challenging behavior.
Safety Care uses 3 de-escalation strategies: Help, Prompt, and Wait. These strategies are designed to help the individual engage in calmer, safer behavior while maintaining everyone’s safety. This does not force the individual to immediately comply with staff directives. Instead, Safety Care teaches communication, instructs likely behaviors, and withholds reinforcement from challenging behavior. While these may temporarily reinforce less severe or intense forms of the challenging behavior, it prevents the situation from escalating to more dangerous and unsafe behavior.
The chart above displays potential outcomes from the example with Sam.
- Rachel could have used Safety Care de-escalation strategies to prompt Sam to communicate that he needed a break. This would reinforce functional communication and teach Sam a way to escape cleaning up in a more appropriate way.
- If Rachel were to continue the instruction and physically force Sam to clean up, it is likely that the challenging behavior would become more intense and severe. As a result, Rachel may need to intervene using more restrictive strategies and Sam would still get out of cleaning up.
From both of these scenarios, Sam escapes cleaning up. In the first example, communication gets him a break. With the second example, more intense behavior gets him a break.
Additional Strategies to Manage Behavior
Geiger et al. (2010) provide additional recommendations when working with individuals who engage in challenging behavior maintained by escape:
- Provide choices of activities and tasks
- Ensure curriculum and tasks are an appropriate level and difficulty
- Start with few or no instructions and gradually increase
- Reinforce desirable behavior and withhold reinforcement from challenging behavior
- Avoid giving escape when the challenging behavior happens
- Every so often allow escape – just because!
“We can’t let them get away with it” may not be the safest or most practical option when dealing with challenging behavior. Safety Care recommends use of de-escalation strategies to effectively decrease and teach functional alternatives to challenging behavior.
For more information about Safety Care and de-escalation, please contact us at info@qbs.com.
The human service industry regularly encounters high levels of staff turnover, with some providers reporting turnover rates over 70% for direct care staff. When surveyed, HR leaders stated that burnout may account for more than fifty percent of workplace turnover each year.

Considered a workplace crisis, burnout may undermine the quality of care provided to the individuals served and lead to staff turnover which may result in the reallocation of resources away from the individuals served for recruitment and training purposes. As one state reported, constant recruitment and training can cause financial strain upwards of $24 million, annually. Organizations experiencing high rates of burnout may overload work responsibilities for current employees resulting in their subsequent burnout, creating a feedback loop that prevents the organization from fulfilling their overall mission.
Burnout-related turnover is a complex, systemic problem that is highly disruptive to organizational functioning. Preventing and managing burnout may contribute to an organization’s success and efficacy.
QBS is committed to providing our customers with quality behavioral solutions to complex behavioral challenges such as staff burnout. We think of burnout as a symptom of ill-equipped workplace environments and turnover as a result that prevents organizations from carrying out their mission. This is one of the reasons we train our Safety-Care™ Trainers to build resilience-related skills in their staff as they teach our competency-based curriculum. Additionally, we now offer Performance Management Competencies™ (PMC’s). This is a unique self-paced training course to improve new and front-line management performance which can function as a proactive measure for preventing burnout in direct-care staff.
In our series titled: Organizational Resilience, we have developed blog posts related to understanding burnout, identifying reinforcers, and creating a positive workplace culture in the context of the human services workplace environment. The purpose of these posts is to help organizational leaders consider various aspects of the environment that may be contributing to burnout. While there is no “one-size-fits-all” approach to handling burnout, there may be some helpful advice and perspectives that can guide organizations on how to view burnout.