The Growing Industry of Behavioral Health

Chris Miller had an entrepreneurial spirit; it was tying this with his desire to help people—as well as a fantastic team—that led to Trumpet Behavioral Health. “The crux of it was finding something that we could feel great about, improve the industry, and positively impact a lot of lives.”

Chris Miller had years of experience working for big-name investment companies such as Smith Barney, Draper Atlantic, and IMG. Although it was profitable, he knew corporate finance was not his calling, and he enrolled in business school at Stanford to pursue the next chapter of his life. Fortuitously, it was there where Miller would connect with his business partner, Lani Fritts, who introduced him to health care. “I was recruited by an old Stanford professor of mine to run a West Coast company called ResponseLink,” Miller says. “It was here that I found my calling in health-care services, where I focused on keeping seniors out of long-term care facilities and helping people every day.”

Backed by thirty years of research, Applied Behavior Analysis (ABA) is a scientific method used to understand how people’s actions and skills are affected by any physical or social influences in their environments. ABA helps children and adults with pervasive developmental disabilities, such as autism, achieve their highest level of functionality. It determines how learning takes place, and applies techniques, like systematic interventions, to reinforce positive behaviors.

ABA is approved by the US Surgeon General, the American Academy of Pediatrics, and the American Medical Association.

ABA encourages positive reinforcement for behaviors that improve skills and no reinforcement for behaviors that pose harm or prevent learning.

There are four types of ABA treatment: discrete trial training, early intensive behavioral intervention, pivotal response training, and verbal behavior intervention.

ABA improves communication, play, self-care, school, and employment, according to advocacy organization Autism Speaks.

ABA therapy accounts for 45% of therapies that develop long-lasting and observable results, according to the Surgeon General’s autism treatment report.

After finding what he wanted to do, it was time to track down a business partner. Miller presented the opportunity to search for the right business to Fritts, who at the time was serving as the vice president of strategy and business development for the Lockheed Martin Company, Savi Group. Fritts agreed, and in 2008, the pair began to lay out the mission of the company. Its roots would stem from the “do well by doing good” theory. Miller’s wife inspired him to steer the company’s mission towards helping those with Autism Spectrum Disorders (ASD). She worked as a behavioral analyst in the field of autism and had a small business that Miller supported.

Trumpet Behavioral Health (TBH) officially launched in the summer of 2009. TBH provides consultation, training, assessment, education plan development, and support services on behalf of families and schools for individuals with ASD and other developmental disabilities.

Despite Miller’s entrepreneur skills and business development background and Fritts’s corporate strategy and operations experience, the duo knew that they needed a high level of clinical expertise to guide the organization’s services. After a year of discussions, Miller and Fritts recruited Linda A. LeBlanc. As a licensed clinical psychologist, board-certified behavior analyst, and future fellow of the Association for Behavior Analysis International, LeBlanc provided the team with the expertise needed to become truly successful in the growing applied behavioral analysis (ABA) industry. LeBlanc left her academic position at Auburn University in 2012 and started with the TBH team as the executive director of clinical services and research. With more than twenty years of experience in applied behavior analysis, and a leader in the field, LeBlanc is building the company’s clinical team and its clinical standards platform.

With increasing diagnosis rates for ASD, finding the right team is one of the biggest challenges for the company. “When we first opened, the diagnosis rate for ASD was one in every 120 births, and now it is one in 68,” Miller says.

TBH currently has more than one hundred board-certified behavior analysts (BCBAs), which Miller says is one of the largest numbers of BCBAs in any behavioral health company in the United States. But even with impressive numbers, the company is trying to keep up with the growing demand for ABA treatment. “Unfortunately with the increasing rates we have wait lists for some of our divisions. Our initial growth strategy was to grow slowly and carefully, but we are trying furiously to meet that growing demand,” Miller says.

The company is expanding nationally, specifically eyeing states with insurance reform. ABA is a successful type of treatment, but also costly. Miller, Fritts, and LeBlanc are targeting states where insurance will help pay for the service. Texas, Arizona, and Illinois are targeted as locations for the next facilities. “We are trying to grow in adjacent geographies to where we already provide services,” Miller says. TBH locations are spread out in ten different states with more than thirty locations. Although Miller has his plate full, he is still thinking about long-term goals. “There is a huge, growing demand for these services internationally,” he says. But for now he is keeping his focus within the United States. “We are lucky to have an amazing team at TBH. Trumpet is only as good as the people who serve our clients, and ultimately the outcomes we
deliver,” Miller says.

His marketing strategy is through “word of mouth.” Miller says many of TBH’s new clients come through referrals from existing clients. Miller personally makes sure that the clients and their families are pleased with their clinical programming. He spends of good portion of his time traveling to observe those who are receiving therapy. “I love connecting with our team members as well as the family members we serve,” Miller says. When he isn’t on the road, he spends his time in the office strategizing about growth, operational efficiency, and working one on one with the company’s team members. Fritts can be found handling internal-focused strategies, clinical operations and managing investor relations. The duo breaks up the work load well. Even with the pressure to expand quickly, the company is succeeding through its clinical standard platform that makes sure the service is customized to the individual but includes a standardized platform for assessments, ethics, supervision, and training.

“What allows us to expand and differentiates ourselves from our competitors is the clinical standards platform we’ve worked hard to put in place, primarily led by Dr. LeBlanc’s amazing talents,” Miller says.