Applications of operant demand to treatment selection <scp>II</scp>: Covariance of evidence strength and treatment consumption
Caregivers will trade down to lower-proof treatments unless you spotlight strong evidence, so lead with the science.
01Research in Context
What this study did
Gilroy et al. (2022) asked caregivers to shop in a make-believe store. The store sold different versions of the same therapy. Some versions had strong science proof. Others had weak proof.
Caregivers picked what they would buy at different prices. The team used an operant demand curve to see how proof level changed shopping.
What they found
Caregivers treated every therapy version as a swap for the top-proof one. Yet stronger proof made them less willing to swap.
In plain words: hype helps, but data helps more.
How this fits with other research
Kim et al. (2025) show that choice itself is not always wanted; people pick less when options feel big or hard. Gilroy adds that proof strength is another lever that shifts choice.
Bottini et al. (2019) found that providers often ignore proof and trust gut feeling. Gilroy’s caregivers do the opposite; they still look at proof when cost is on the line.
Walmsley et al. (2019) gave us a four-step checklist to judge non-behavioral treatments. Gilroy turns that idea into numbers, showing how each step up in proof cuts swapping.
Why it matters
When you list treatments, don’t hide the proof. Say “This one has ten solid studies” right next to the price or time ask. The stronger the evidence you can state, the less likely families will drift to weaker, shinier options.
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02At a glance
03Original abstract
Evidence-based practices (EBPs) are a critical component of effective and ethical service delivery. Clinicians in the behavioral sciences regularly advocate for the use of therapies and interventions based on the strength and breadth of scientific evidence. However, caregiver choices related to specific behavior therapies are seldom based solely on the degree (or the presence) of scientific evidence. This study applied methods from the Operant Demand Framework to characterize caregiver choices when concurrently available behavior therapies varied in terms of unit price and levels of evidence. Four Hypothetical Treatment Purchase Tasks were designed to evaluate how relative differences in scientific evidence between behavior therapies influenced the demand for, and substitutability of, EBPs. Results from 106 caregivers recruited from the Amazon Mechanical Turk platform indicated that low-, moderate-, and high-evidence treatment choices all functioned as substitutes for a high-evidence (i.e., well-established) behavior therapy. A main effect was observed for the level of evidence, whereby the strength of evidence appeared to moderate the degree to which respective treatments functioned as substitutes. These results extend the literature on the factors associated with treatment choices, and specifically, highlight how differences in the degree of scientific evidence influence choice when deciding between behavior therapies. These results are discussed in the context of more effectively advocating for the use of EBPs with mainstream and lay audiences.
Journal of the Experimental Analysis of Behavior, 2022 · doi:10.1002/jeab.735