What I Learned Opening the First ABA Clinic in Our Rural Community

When my husband and I first packed up our life in Greenville to start ENC ABA in Morehead City, North Carolina, we had no idea what we were stepping into. We weren’t moving for a job or because we knew the area well. We moved because we felt deeply called to serve a community where no ABA clinic existed—and kids were going without services that could change their lives.

We opened our doors in January 2023 with just two clients and a small team. Within six months, we outgrew our building. We now serve 25–30 families with a staff of 30, including six BCBAs.

Looking back, I can say this: starting a clinic from the ground up in a rural community has been one of the hardest and most rewarding things I’ve ever done. If you’re considering doing the same, I hope our story helps.

Building a Team

ABA was brand new to our community, but the demand for ABA services was there from the beginning. It was the staffing that proved to be the real challenge.

Because ABA was brand new to our county, no one knew what it was. We weren’t just building a clinic; we were building awareness, which made hiring really difficult. We didn’t have a pool of trained staff, so we had to train from scratch.

But here’s the incredible part: the staff we do have are some of the most dedicated, big-hearted people I’ve ever met. They’re not here because it’s easy—they’re here because they believe in the mission and they love working with our clients.

Creating the Right Culture

We have five core values at ENC ABA: generosity, integrity, honor, connection, and respect. These aren’t just words on a wall—we live them. And we recognize our team when they do, too.

We use a system called Bonusly to assign points to staff when they demonstrate our values. Ten points are equivalent to $1.00, which can be cashed in for a variety of gift cards like Target, Starbucks, and Amazon.

• 10 points for demonstrating consistent positive behavior aligned with our values.

• 25 points means that they're going beyond the regular duties to support company values. (sharing resources, ideas, tools and materials, with colleagues to improve everybody's performance)

• 50 points for exceptional contributions to upholding company values. (leading or participating in company-wide initiatives, contribute to the well-being of teams clients organizing group activities, or volunteering at a company or community event)

We also recently began using Brellium to audit our session notes, and we plan to integrate those audit scores into our point system. If someone consistently scores high on chart documentation, they’ll be rewarded for that too. It’s all about reinforcing the behaviors we want to see more of.

Taking Care of Our People

This field is hard. Really hard. And we know the cost of living in a rural beach town is high. That’s why we offer guaranteed hours, 100% employer-paid health insurance for full-time staff, 13 paid holidays, and 10 days of PTO annually. We close for a full week at Christmas—paid—because if I’m spending that week with my family, I want our staff to be able to do the same.

We also host an annual “staff fun day”—one year it was an escape room, another year we had a wellness coach come in for yoga and smoothies. This year’s event will be a surprise for our staff!

The goal is simple: connection. Community. A reminder that we’re in this together.

Advice for New Clinic Owners

If you’re thinking about opening a clinic in a rural area, here’s my biggest advice:

1. Get in network with as many funders as possible. In a rural area, you won’t have the luxury of being selective.

2. Value people over profits. Retention is so important, and taking care of your team is what makes it all work.

3. Communicate with consistency and clarity. This has been our mantra this year because confusion leads to burnout, and burnout leads to turnover. (We use Google Workspace to keep our team connected, with separate chat channels for each client, a shared space for forms, and a staff-wide chat for announcements. And we hold monthly in-person meetings to reinforce what really matters.)

Looking Ahead

Our dream is to bring all our services under one roof. Right now, we’re split between two buildings, and I miss being physically present with the whole team. Long-term, we’d love to expand into a multi-specialty clinic with mental health, speech, OT, and diagnostic services all in one place. Because autism doesn’t just affect one child; it impacts the whole family.

We named our company ENC Family Services for a reason. ABA is just the beginning. Our mission is to serve families—completely and compassionately.

Every day is a learning experience, but I’m proud of what we’ve built. Our staff care deeply about the kids and the mission. Even on the hard days, they show up with heart. That’s what makes this work matter.

Interested in Joining Us?

We’re always looking for people who care deeply about kids and want to make a difference here in Carteret County. If you live in or near Morehead City and believe in the kind of work we’re doing, we’d love to hear from you. Reach out to info@encaba.com learn more about open roles at ENC ABA.