What to Do When a Client Hits You During a Session: A Safety Guide for RBTs

Being hit during a session can leave you hurt or unsure what to do. Step back, get help, and follow the client's written safety and behavior plans. Your supervising BCBA decides how the intervention should change; you do not have to solve the incident alone.

Your next steps are to protect people from harm, follow the written plan, document what happened and tell your supervising BCBA. Ask for clinical direction when the plan is unclear or you cannot implement it safely. Do not infer why the client hit from the incident alone.

The RBT Ethics Code (2.0) addresses following supervision (2.02), training before unfamiliar interventions (2.04), and reporting risk of harm to a client (2.07). The Ethics Code for Behavior Analysts, section 2.19, addresses hazards to clients or staff. Ask your supervisor to review the plan and any training you need.

The steps below help you prepare, respond within your training, record the incident and discuss changes with your supervisor. General guidance cannot replace an individual crisis plan.

Practical Strategies You Can Use

1. Follow the communication and safety responses in the plan. Use the calm communication you have been trained to use, and get help if you are hurt or cannot keep people safe. Whether attention changes, a demand pauses or a session stops depends on safety needs and the written plan. Do not withhold help or continue a demand because a general guide says to avoid reinforcing hitting.

2. Ask for a clear written crisis plan. Your supervisor should explain what you are expected to do if someone is hit. Follow the written procedures you have been trained and authorized to use. Do not improvise a physical intervention. RBT Ethics Code 2.05 limits restrictive or punishment-based procedures to a documented plan after the supervisor verifies competence. Ask for clarification or training when a step is unfamiliar.

3. Create distance and get help when needed. Follow the safety plan for protecting yourself and the client, including getting assistance. Tell your supervisor if you cannot keep people safe. Follow the agency's emergency procedures and seek urgent help when someone is seriously hurt or in danger.

4. Document the incident once it is safe. Record what happened just before the hitting, what you observed and what happened afterward. Use observable details, such as the number of hits, rather than guessing the client's intention. ABC notes can help your BCBA decide what to assess or change; they do not establish behavioral function on their own. A comparison by Thompson and Iwata (2007) found that descriptive and functional analyses did not consistently agree. Use agency-approved records and protect confidential client information.

5. Report promptly and follow the injury procedures. Tell your supervisor what happened, what you did and what support you need. As practical guidance, report an incident the same day; follow any more urgent agency or emergency procedure first. This is guidance, not a quoted BACB same-day deadline. The RBT Test Content Outline (3rd ed.), E.1 and E.2, covers timely communication and seeking clinical direction. If you were injured, document that as well and follow your agency's injury reporting procedures.

If anyone is seriously hurt or in danger, call your local emergency number (911 in the US), then tell your supervisor. A bite that breaks the skin needs same-day medical evaluation. So does a head injury, or any injury you cannot judge. Human bite care and head injury guidance are available from MedlinePlus.

6. Discuss prevention with your BCBA. Share the patterns you observe around transitions, tasks or changes in access to preferred activities. Your BCBA may include visual supports, choices or task changes in the plan. Hume and colleagues (2021) identify antecedent-based interventions among evidence-based autism practices. That review does not establish that one response is best for this client. Implement the procedures your BCBA selects.

7. Follow the plan for replacement skills. If the plan teaches a request for a break, help or another activity, use the prompts and reinforcement schedule your BCBA has specified. Ask for clarification if the response is not working or you are unsure how to reinforce it. Do not create a new schedule or withhold assistance based on this guide.

8. Request training before using unfamiliar procedures. Tell your supervisor which steps you need to rehearse and ask for feedback on your implementation. RBT Ethics Code 2.04 addresses proper training before unfamiliar interventions. Ask for clinical direction when the plan is unclear or you cannot implement it safely.

What to Do This Week

Day 1: Review the client's behavior and safety plans with your supervisor. Ask what to do if someone is hit, when to get help, and which procedures you are trained and authorized to use. Clarify any missing or unclear instructions before relying on them.

Day 2: Review the latest incident record with your supervisor. Describe what happened, what you did and what followed. Use your agency's approved record and communication methods; protect the client's confidentiality.

Day 3: Share any patterns you notice in the recorded events. Ask your BCBA what those observations mean and whether further assessment is needed. A pattern in ABC notes does not establish the function by itself.

Day 4: Ask your supervisor to rehearse the plan's communication and safety responses with you. Practice with the client only as directed in the plan, using the specified prompts and reinforcement schedule.

Day 5: Check that the plan answers your practical questions: when to get help, whether a demand pauses, what to document and when to report. Ask for more training or a plan review if you still feel unable to implement it safely. Do not wait for a weekly check-in to report an urgent concern.