By: Zoe Lucock, Ph.D., BCBA-D
Note: This is a personal opinion piece
Behavioural gerontologists research and practice in an incredibly small and niche field, one that has historically been around for many decades, but has not seen the growth as behavioural work with other populations. In the USA, behavioural services for children with autism are close to reaching a saturation point. Soon, there will be sufficient numbers of certified behaviour analysts to fill the roles available, but the number of new practitioners qualifying each year will continue to grow. As this happens, we are likely to see an increasing number of behaviour analysts looking to other populations to whom they can offer their services. Outside of the USA with it’s specific insurance style model of health and social care, behaviour analysts are often in a different position. There is no standard funding for behavioural services, and we are at more liberty to work with the populations we are passionate about; the response effort to working with people/children with autism is only slightly lower than working with other populations because there is limited funding or established infrastructure for behaviour analysts to work with either. Most of us grow up with much-adored grandparents and begin to see signs of ageing in our parents as we progress through adulthood. As adults, we develop a passion for older adults as an underserved, undervalued population; a population of which we all hope to one day become part of. In short, people are discovering behavioural gerontology, and understandably, they want in. Applied behaviour analysis, as I am sure we can all agree, is a phenomenal science that, when applied appropriately, can be life-changing for clients of any age, diagnosis, health status, or background. It is not limited, and should not be limited, to work with children with autism and adults with disabilities.
The case for protection
The role of behavioural gerontologists who are currently working (research or practice) with older adults is a cautious one. Older adults, particularly those who may benefit most from our services (such as those with a major neurocognitive disorder, health issues or who are isolated) are at higher risk of mistreatment. It is incredibly important, therefore, that we work to protect our client group from poor quality services coming from a behavioural background. If a behaviour analyst moves directly from working with other populations to working with older adults without significant training or supervision, not only is this a direct violation of the BACB ethics code, but it opens up our client group to a new threat. Not only that, but it will likely leave our sub-field in disrepute. We are all aware of the controversial nature of ABA for people with autism and the many claims of abuse; some of which is of course, based in misinformation and misunderstanding, but others which I have no doubt is based in truth. We have a duty of care to our own subspecialty to learn from the mistakes made with other populations, and ensure that this does not happen in older adult services. We, of course, do not wish to jeopardise the very precious and precarious connections and routes in that have been made by the pioneers in behavioural gerontology across the world.
The case against protectionism
The problem arises, however, that due to our desire and duty to protect older adults from poor practice, it is very easy for us to slip into protectionism and gatekeeping. Behavioural gerontology is a difficult field to break into at the best of times; there are so few practitioners available to supervise, so few graduate programmes that even mention behavioural gerontology let alone teach it, and there is no clear route or structure to follow to become trained in this area. It is my personal view that whether we like it or not, more people will attempt to enter the field of behavioural gerontology and work with older adults. We have the choice to try to limit their ability to join by not offering training and supervision, simply allowing them to get on with it and separate ourselves from their work (which long term is likely to damage the reputation of behavioural gerontologists full stop and cause harm to our client group). Or, we embrace these newcomers and do our best to guide, support, and train them wherever possible. Currently, there are not masses of money to be made in this area, and the response effort is higher, so those that do want to get involved are generally motivated by a passion for older adult care. If we shape their behaviour in line with our values and ensure competency, we can ensure that the workforce grows in the direction of being professional, competent and compassionate.
It is my personal view that there is a balance to be struck between protection and protectionism, and one that is not always easy given most behavioural gerontologists are already stretched thin and how few of us there are in relation to the numbers wanting to join. I hope, however, that together we can provide and collaborative space and direct people that reach out to the BG SIG, resources, training, and supervision to get them started on their journey to do it the right way the first time. I believe that the best way to protect older adults who come into contact with our services is to keep checking ourselves for protectionism and support our field to grow with competent behaviour analysts.
You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!