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How to Grow an ABA Organization Ethically: Lessons from Gradual Behavioral Health’s COO
What does it take to grow an ABA organization without sacrificing trust, quality, or clinical integrity?
In this episode of Tim Talks: Behavioral Health, Tim Zercher sits down with Meaghan Timko, Chief Operating Officer at Gradual Behavioral Health, to discuss the evolution of ABA, the increasing accountability facing the industry, and how ethical leadership can help you grow an ABA practice that lasts.
Meaghan shares her perspective on building trust with families, payers, and communities, leading with radical candor, and intentionally hiring the right people instead of scaling for the sake of growth. She also explains why organizations should focus on what makes them different rather than simply competing for visibility.
From ethical growth and team culture to leadership and the future of ABA, this conversation explores what it takes to build an organization designed to last.
Why ABA Organizations Must Earn Trust Beyond the Families They Serve
ABA has always been built on trust with families. As Meaghan Timko explains, that circle has expanded. With national media now paying close attention to the industry, ABA providers are accountable to payers, regulators, and the wider community as well, and anyone looking to grow an ABA practice today needs to earn trust in every direction.
Meaghan’s advice to clinicians is simple: “You do the trust things, then you show the trust things, and then the trust is built.” She believes the bigger learning curve belongs to the business side of ABA. Many investors and operators come from industries where no one outside the building sees how the work gets done. In behavioral health, families and communities are paying attention, and the people behind the organization can’t stay hidden.
For ABA providers, that means transparency has to show up everywhere, including how you describe your services, your team, and your approach online.
Radical Candor: The Leadership Principle That Holds ABA Teams Together
Across every role she’s held, from building companies to leading large organizations, Meaghan has relied on one principle: radical candor. She’s wary of euphemisms and “corporate word salad,” and of leaders who say one thing and do another. Polished language might help a team move faster in the short term, she says, but a lack of honesty eventually catches up with an organization.
That candor extends to how she mentors her team. Telling someone they’re doing a great job while ignoring their blind spots doesn’t help them grow. It only delays a harder conversation later. Meaghan notes that the toughest part of growing a team is working with people who resist that kind of accountability, which is why she keeps conversations plain and practical: “How do we do this better? Now let’s do it better.”
Why Standing Out Matters More Than Winning the Race for Google’s Top Spot
When Meaghan joined Gradual, she noticed that many ABA providers were chasing the same goal: get to the top of Google, bring in as many clients as possible, and hire to keep up. Her concern was that this becomes a spending race. If you spend $100,000 and a competitor spends $105,000, you lose.
Instead, Gradual focused on doing the right thing and communicating its values honestly. As Tim points out, every organization has something that makes it unique, and leading with that difference attracts families who are looking for exactly what you offer. Meaghan acknowledges this approach takes longer than buying visibility. But if you want to grow an ABA practice with staying power, she believes a one- to three-year view builds a more stable organization with the clients it’s best suited to serve, not just higher volume.
This is where brand positioning and long-term organic strategy work alongside paid campaigns, so ad spend supports your story rather than replacing it.
About Our Guest: Meaghan Timko
Meaghan Timko is Chief Operating Officer at Gradual Behavioral Health and a seasoned leader in ABA and neurodiversity services. With decades of experience working with families, individuals, and communities, she is passionate about ethical leadership, building strong teams, and creating meaningful, sustainable change.
Visit the Gradual Behavioral Health website to learn more about their mission.
Episode FAQ
What is brand positioning for behavioral health organizations?
Brand positioning is how your organization defines what makes it different and communicates that consistently to the people you serve. For ABA, addiction treatment, and mental health providers, strong positioning goes beyond listing services. It clearly expresses your values, your approach to care, and the kind of experience families and clients can expect, so the right people recognize you as the right fit.
Why should ABA providers focus on differentiation instead of just ranking first on Google?
When providers compete only for the top search spot, marketing can turn into a spending race that the biggest budget usually wins. As Gradual Behavioral Health COO Meaghan Timko explained on Tim Talks: Behavioral Health, focusing on what makes your organization different helps attract families who are looking for your specific approach. Visibility still matters, but differentiation gives people a reason to choose you once they find you.
How can behavioral health organizations build trust through their marketing?
Trust starts with transparency. Behavioral health organizations can build credibility by being honest about their services, introducing the real people on their team, explaining their approach in plain language, and avoiding promises about outcomes. With increased public attention on the industry, families, payers, and communities want to know who they’re working with, and your website and messaging should make that easy to see.
Is organic marketing worth it for behavioral health organizations compared to paid ads?
Both have a role. Paid advertising can generate visibility quickly, while organic strategies like SEO, content, and brand positioning tend to build momentum over time. In the episode, Meaghan Timko noted that a values-driven approach may take longer, but with a one- to three-year view it can help organizations attract the clients they’re best suited to serve, not just higher volume. The strongest strategies often combine the two so paid spend supports a clear brand story.
Episode Transcript
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Timothy Zercher 0:00
Megan, thank you so much for joining us. We really appreciate you taking time this morning.
Meaghan Timko 0:03
Yeah, thanks so much for having me. I’m glad to be here.
Timothy Zercher 0:06
Yeah, absolutely. So you’ve been in ABA since there were only a few thousand BCBAs. Looking back, what are the biggest challenges or changes really that you’ve witnessed in the industry before either better or worse over the time?
Meaghan Timko 0:22
I’ve been here, I’ve witnessed all the changes. So when people ask me this question, which is a lot lately, I can tell you that I have witnessed not only the evolution from what are we to we are behavior analysts, but now we are behavior analysts to we are business makers. And so while those seem like just two kind of big transitions, what I will tell you is that there was a lot of different faces for practitioners along the way. And now that we are both business owners or we have joined forces with somebody who is funding the business, we are we’re sort of like people who wear lots of different hats.
Timothy Zercher 0:59
Yeah. Yeah. And I think that’s sometimes a good thing, sometimes not a good thing. Because there’s there’s positives in it.
Meaghan Timko 1:04
So say it simply, yes.
Timothy Zercher 1:06
Yeah. So you’ve been outspoken about what you call the the reckoning facing AVA as an industry. What do you think ethical providers need to do today to ensure that the industry earns trust moving forward?
Meaghan Timko 1:21
That’s really interesting. I had a conversation this morning with some of my team about this. This is a business from the consumer side built on trust. And if you don’t have that trust, they will simply not want to work with you anymore. Now that we have to have that same relationship with payers and with the community at large because of articles in the Wall Street Journal and other Forbes, you know, all these people who have picked up on the commotion, we have to earn trust a different direction. So I say to my professional colleagues, you know how to do this. You do the trust things, then you show the trust things, and then the trust is built. I think more of the people who need to understand this message are the architects of the business side of this. And these are people who are not used to being held accountable to a consumer. They’re not used to being held accountable to a community of people who kind of don’t know what we do. And this is new for them. And so when you can go into a widget factory and nobody really knows what goes on behind closed doors, and you can walk out in your Patagonia vest and nobody’s the wiser, great. That doesn’t happen here. So here we are. How do we build that trust? It’s one day at a time.
Timothy Zercher 2:30
Absolutely. And it’s also a lot of individuals, frankly, that are not used to having any kind of public attention of any kind, whether it’s accountability or anything else. They’re scared of just being the spotlight at all.
Meaghan Timko 2:42
Yeah. These are people who now, when you build a company, the people who allow you to build those companies are saying, what’s your social security number? What’s your name? What’s your address? And so you can’t hide behind the veneer of an LLC anchored in Delaware. They want to know who you are because they’re not going to let these things happen anymore and just let them go. They’re going to find you. And sometimes that means really bad things like prison.
Timothy Zercher 3:07
Yeah, yeah, absolutely. Absolutely. So throughout your career, you’ve built, you built companies, you’ve advised families, and you’ve led very large organizations. What leadership principles have remained constant regardless of the role that you’ve held?
Meaghan Timko 3:22
I mean, I am, you know, I’ll say this like I am a believer in radical candor. I think that when people speak in euphemisms, I think that when you engage in lots of corporate word salad, I think when you try to do one thing and say another, that’s when you lose your ability to be a good leader. You may gain some fraction with making widgets faster or building a faster team because you sound cool and slick. But if you’re not honest with yourself and with the people around you, eventually you get found out. That’s happening right now in our field. But as a leader, I found that even though that’s a hard thing to do and adhere to on a daily basis, it always yields a good result in the end.
Timothy Zercher 4:04
Yeah, that makes complete sense. It makes complete sense. And that it builds that trust with the people you’re working with, right? Not just with the industry, not just with the consumers, but with the individuals that you’re working with when you have that radical candor.
Meaghan Timko 4:15
Yeah, because everybody loves a yes man until they’re a no man. But when people, for instance, in my role, I mentor a lot of people. And if I just tell them you’re doing a great job, you’re doing a great job, you’re doing a great job, and I don’t tell them when they need to check their blind spots, they’re eventually gonna hit a wall. And then they’re gonna be like, Why didn’t you tell me two, three, four, five, six times ago that I did something wrong? And then you’re the one that has to answer the question instead of the other way around.
Timothy Zercher 4:44
Absolutely. Absolutely. And what have you found, talking more about teams? What have you found is the hardest part of growing a team?
Meaghan Timko 4:52
When somebody doesn’t want that accountability, when somebody doesn’t want that candor, some people really actively shy away from it. And some people will do anything to not have it. And because they do like the corporate word and salad, I’m sure you’ve seen those videos on Instagram where there’s people walking around like bots saying things like verticals and silos and all the catchy little business phrases. And so the hardest part is when you have to just simply sit and talk with your team in a way that’s digestible for them, which may not be corporatees, which may be, hey guys, like how do we do this better? Now let’s do it better.
Timothy Zercher 5:30
Yeah, I love that. I love that. And since we’re our marketing agency that specializes in behavioral health marketing and advertising, what have you found works best right now for your team outside of word of mouth when it comes to client acquisition or talent acquisition, whichever you’d like to focus on?
Meaghan Timko 5:47
I mean everything that I just said. So I meet everybody that we hire. I make sure that they’re right for our team. So I am not a fan and nor do we put a body in a spot just because a spot is open. And so if there is somebody that’s a good fit for our team, we’ll bring them on. If somebody is not a good fit for our team, they will not be joining our team. And so convincing other people that have rapidly scaled in the last few years that this is a worthwhile solution to one a sliver of the problem right now is wild. Like I had somebody that we were interviewing to help us with talent retention and talent acquisition told me I was a control freak. And I just looked at this guy and I said, you know, maybe, but I know the quality of person, every single person that works on our team. And I’m not willing to sacrifice that hard stock.
Timothy Zercher 6:37
Yeah, I love that. I love that. I think that makes a lot of sense. And I think more people could learn from that. I think, especially right now, people are focused on scaling very quickly, and then you lose a lot of quality, not necessarily quality control, but you lose a lot of ability to build a team intentionally when you just hire quickly to hire.
Meaghan Timko 6:58
That’s a word I use a lot, is intentional. Like, are we doing this intentionally? Did we build this intentionally? Even if it accidentally happened, how can we intentionally move it forward? Because if the answer to any of those things is either a gray area or like, I don’t know, it’s gonna fall apart eventually, maybe not right away, but the wheels will come off.
Timothy Zercher 7:18
Yep, exactly. Exactly. So last kind of marketing question. What is one marketing tactic or strategy that either you and your team are considering for your organization or that you’re just watching really carefully in the marketplace right now?
Meaghan Timko 7:30
I have for like a year now, since I came on at gradual, I’ve been watching a lot of people and how they handle their marketing. And I think one of the strategies, especially, I don’t know that it’s happening as much anymore, but at least when I first joined on a year ago, it was like just get to the top of Google, like get to be the person that everybody clicks on and then bring everybody on and then hire everybody and then serve everybody. I was like, what is happening here? And I said, eventually you’re all competing for the same exact thing, and you’re just if you spend $100,000, if somebody else fails a hundred spends a hundred and five thousand dollars, you lose. And so why would we join that weird race? And you know, we took a much different approach than trying to be the first person that people clipped on Google. And I say that’ll happen organically, or maybe it won’t. I don’t know. But I’m I’m sure of one thing, which is we can get a lot of clients by doing the right thing and expressing our truth to people rather than paying for it.
Timothy Zercher 8:31
I love that. I love that. I love, I mean, you didn’t say it this way, but to me, I heard we need to focus on what makes us different, not just be in front of everybody, which I love. That’s what I that’s what I preach to my clients. So I I appreciate you joining the cause of talk about what’s different because just paying for that number one spot, it can be such a waste of budget when you could just focus on the thing that actually makes you different because everyone, every organization has something that’s truly different and unique about them. Because on that, the people who actually want that will come to you.
Meaghan Timko 9:00
Yes, I believe that. And so far it’s happened for us. So is it as fast as buying your your views in the market? Is it as fast as buying your rate of the top? Is it as fast as many other methods? No. But I do think in the long run, if you’re willing to look at a one, two, three year runway, you end up being better, having more clients, having the clients that you want rather than just having a volume.
Timothy Zercher 9:25
Yeah, which is which matters a lot more because it it makes a more stable business, not just larger.
Meaghan Timko 9:31
Yeah. Exactly.
Timothy Zercher 9:33
Yeah. Well, thank you so much. We really appreciate you coming on. We appreciate you taking time. I think you’ve shared some good insights that all of our listeners should learn a little bit from. So thank you.
Meaghan Timko 9:42
You’re welcome. Have a good one.
