Behavior therapy and the elderly: a conceptual and ethical analysis

This article examines several dimensions of the conceptual framework of the behavioral approach to the treatment of the elderly's problems in living that require emphasis. These dimensions are: 1) Within the behavioral approach behavior is viewed as not being a function of discontinuous, developmental stages each with a unique set of psychological processes; chronological age therefore is considered not to be a causal variable in psychological development, but rather a pure index of only certain physical events; 2) The level of analysis of the behavioral approach to the problems of the elderly is that of molar behavior, and therefore explanations which appeal to other levels of observation, described in different terms and measured in different dimensions, are not considered to be part of this approach; 3) The molar behavior of the elderly is viewed as a function of the contingencies of reinforcement, and behavior that is labeled abnormal is viewed as not quantitatively nor qualitatively different in its development and maintenance from other learned behavior; and 4) Behavior therapy, like all therapies, is a value-laden enterprise in which ends as well as means can be explicated and critically examined. Behavior therapy, in which the involvement of the elderly in the determination of treatment goals is maximized and in which the ability of the elderly to influence and design their environments is enhanced, is advocated.