Practitioner Development

Behavioral activation for depression in older adults: theoretical and practical considerations.

Polenick et al. (2013) · The Behavior analyst 2013
★ The Verdict

Behavioral activation is ready for behavior analysts to use with seniors, and past ABA mobility studies show it can work.

✓ Read this if BCBAs working with depressed adults 65+ in nursing homes or day programs.
✗ Skip if Clinicians who only serve young children or non-depression cases.

01Research in Context

01

What this study did

Allyn et al. (2013) wrote a narrative review. They looked at how behavioral activation can treat depression in adults 65 and older.

The paper pulls together theory and gives practice tips for behavior analysts who want to enter this area.

02

What they found

The review says behavioral activation is a good fit for late-life depression. It lines up with basic ABA ideas.

The authors call for more single-case and group studies done by behavior analysts.

03

How this fits with other research

Burgio et al. (1986) already showed ABA works with nursing-home residents. Their prompt-and-praise package doubled walking distance in eight older adults. This real trial extends the review’s call to action.

Bennett et al. (1973) activated very withdrawn adults using the Premack principle. Like behavioral activation, they targeted low activity, but their sample was younger and psychiatric. The method is similar: start small, reinforce movement.

Kamana et al. (2024) scaled staff training in adult IDD homes. Their success with BST plus on-the-job feedback shows behavior analysts can run large adult programs. It answers the review’s plea for expanded service delivery.

04

Why it matters

You can start a behavioral activation program tomorrow with your older clients. Pick one valued activity, schedule it daily, and track mood. The review gives the map, and studies like D et al. prove ABA works in senior care.

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→ Action — try this Monday

Ask your senior client to list one pleasant activity, then schedule and track it daily for mood change.

02At a glance

Intervention
not applicable
Design
narrative review
Population
other
Finding
not reported

03Original abstract

Late-life depression (LLD) is a major public health concern that can have devastating effects on older individuals and their families. Behavioral theories predict that decreases in response-contingent positive reinforcement and increases in negatively reinforced avoidance behaviors, often accompanied by aversive life events, result in the selection and maintenance of depression. Based on these theories, behavioral activation treatments for depression are designed to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement. We discuss the applicability of behavioral models for LLD, and we briefly review current behavioral activation interventions for LLD with an emphasis on implications for future behavior-analytic research. Behavioral activation has been demonstrated to be effective in reducing depression and increasing healthy behavior in older adults. Potential challenges and considerations for future research are discussed. We suggest that applied behavior analysts and clinical behavior analysts are particularly well suited to improve and expand on the knowledge base and practical application of behavioral activation interventions with this population.

The Behavior analyst, 2013 · doi:10.1007/BF03392291