Our Story

CBH started with a gap we couldn't stop seeing. Before there was Cairn Behavioral Health, there were more than two decades of classrooms, school hallways, behavior plans, difficult days, small victories, and relationships with students and families.

CBH founders Gretchen Smith Vazquez and Erin (EJ) Cox each spent more than 20 years working in education, much of that time supporting students with significant emotional and behavioral needs. We worked with children who were bright, funny, creative, capable — and struggling. Some had autism, but many did not. Their diagnoses and histories varied, but they had something in common: their behavioral and emotional needs were interfering with their ability to be successful at school, at home, with peers, and in their communities.

Both of us also had opportunities to teach outside of the United States. The languages, cultures, and school systems were different, but we saw something remarkably familiar: behavior still served a purpose. Children still needed to feel safe and understood. Relationships still mattered. And the science of learning and behavior could be applied across very different environments while respecting the individual, family, and culture in front of us. Those experiences shaped the clinicians — and people — we have become.

The Gap We Kept Seeing

Over the years, we watched families search for help for children with significant behavioral needs and discover that they didn't always fit neatly into the services available to them. Some didn't have an autism diagnosis. Others had combinations of ADHD, anxiety, trauma, developmental differences, emotional regulation difficulties, prenatal substance exposure, or other behavioral health needs. Some had behaviors that made it difficult to participate successfully in programs designed for their peers. Their families knew they needed help. We knew the science of Applied Behavior Analysis could help.

At its core, ABA gives us a way to look beyond what a child is doing and work to understand why the behavior is happening — what the child may be communicating, avoiding, seeking, or trying to navigate. Once we better understand the function a behavior serves, we can teach safer, more effective, and more socially meaningful ways for the child to meet that same need To us, that has always been one of the most powerful parts of ABA:

Behavior isn't simply something to stop. It's something to understand.

And when we understand it, we have a much better starting point for teaching meaningful skills. But we also saw another gap. A child might learn a skill successfully in a highly controlled one-to-one environment and still struggle to use it in a classroom full of peers, during a frustrating assignment, when the schedule unexpectedly changes, or when another child says something they don't like. Knowing a skill and being able to use that skill in real life aren't always the same thing. CBH was born in that space.

Bridging the Gap

We wanted to create an ABA program informed by what we had learned from decades of working in schools while remaining distinctly a clinical treatment environment. CBH is not a school. But our environment intentionally creates opportunities for clients to practice the kinds of skills they need in school, at home, and in their communities. That might mean participating in a group, transitioning when you aren't quite ready, handling a change in plans, asking for help, navigating conflict with a peer, coping with frustration, or regulating when life doesn't go according to plan.

We don't want a child to be successful only because we've removed every situation that is difficult for them. We want to support them while they learn what to do when those situations happen. Because ultimately, we want the skill to work when life gets messy. The goal isn't for a child to become really good at being at CBH. The goal is for what they learn here to help them experience greater success everywhere else. That's the gap we're trying to bridge.

Why "Cairn"?

A cairn is a stack of stones built along a trail — each one unique, shaped over time, and created one stone at a time. That image felt right for what we wanted to build. We believe every child and family is on their own journey. Our job isn't to walk the path for them or decide where it should lead. Instead, we have the privilege of adding a stone to their cairn along the way. Sometimes that stone is a new skill. Sometimes it's understanding why a behavior is happening, navigating a difficult moment, building a relationship, or discovering, "I can do this."

And we aren't the only ones adding stones. Families, teachers, therapists, RBTs, friends, and others may each contribute something different. Every cairn is unique because every person's journey is unique — and what someone needs along the way may change over time. Progress is built much the same way: one experience, one relationship, one skill, one stone at a time. We don't expect to be someone's entire journey. We are simply honored to be part of it.

From an Idea to a Team

CBH may have started with the two of us, but it certainly isn't just the two of us anymore. Bringing this vision to life has meant surrounding ourselves with people who bring knowledge, perspectives, and skills we could never provide alone. We've had the privilege of working alongside incredible RBTs, behavior analysts, speech-language pathologists, occupational therapists, physical therapists, mental health professionals, educators, families, and community providers who share a desire to see children succeed.

Behavior doesn't exist in a vacuum, and neither should behavioral healthcare. A communication challenge may benefit from the expertise of a speech-language pathologist. Sensory or motor needs may call for OT or PT. Mental health needs may extend beyond the appropriate scope of ABA. Teachers see things we can't see inside our clinic. And families bring an expertise about their child that no professional degree can replace. We don't believe CBH needs to be everything to every child. We believe children do better when the people supporting them are willing to work together.

Where We're Going

We aren't trying to build the biggest ABA company. We are trying to build one we're proud of. We want to be exceptionally good at what we do here in our community - while continuing to create opportunities for children who haven't always had easy access to them. Because therapy is only part of a child's life. Kids should also get to belong. They should get to discover that they love painting. Build an elaborate LEGO creation with another kid. Learn to shoot a basketball. Join a club. Make a friend. Try something new. Be part of a team. For some of the children we serve, those ordinary childhood experiences haven't always been easy to access. Behavioral or emotional needs may make traditional camps, clubs, sports, or after-school programs difficult. Families may have experienced being asked to leave a program, or may simply wonder, Will there be someone there who understands my child if things get hard?

As CBH grows, we hope to create more places where the answer can be yes. We envision after-school clubs and school-break skills camps built around things kids actually enjoy — art, basketball, LEGO building, games, movement, creative projects, and more — where communication, flexibility, teamwork, coping, and social skills can be practiced naturally along the way.

Because not everything meaningful has to happen sitting across a table from a therapist.

CBH is still young. We are still learning, building, and refining what this company can become. Whatever comes next will be built alongside our team, our families, our community partners, and the children who continue to teach us what meaningful progress actually looks like. But the reason we started hasn't changed. There were children falling into the gap between the support they needed and the support available to them.

We built Cairn Behavioral Health to help bridge that gap and guide every path with purpose and care along the way.