Applications of operant demand to treatment selection I: Characterizing demand for evidence‐based practices
Parents buy fad treatments because they feel cheaper and easier than parent training, so lower the hassle price instead of adding more proof.
01Research in Context
What this study did
The team asked the caregivers why they pick treatments.
All parents said they wanted parent training.
Half still paid for fad diets, sensory brushes, or horse therapy.
The study used a demand curve, like a price test in a store.
Higher out-of-pocket cost lowered use of parent training more than it lowered use of fads.
What they found
Evidence alone does not sell parent training.
Caregivers treat fad care as a close substitute.
If parent training costs more time or money, they switch.
The curve shows you must lower the hassle price, not just show data.
How this fits with other research
Wolchik et al. (1982) already proved this point.
They gave parents lottery tickets when kids hit language goals.
Training use jumped.
The old paper showed the fix; Gilroy shows the market rule.
McGarty et al. (2018) repeated the trick.
Fifty cents a session lifted caregiver adherence and child print scores.
Again, tiny pay-offs beat big evidence sheets.
de Kuijper et al. (2014) looks like a contradiction.
Hanen parent training raised stress in already-depressed moms.
No wonder some parents flee to non-verbal fad care.
The three papers together say: make parent training cheaper, easier, and kinder, or families will keep shopping elsewhere.
Why it matters
Stop sending home long evidence packets.
Instead, cut the hassle price of your parent plan.
Offer flexible Zoom times, babysitting, or a small gift card.
Track uptake like a product manager, not a professor.
When attendance dips, tweak cost or kindness before you tweak the protocol.
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02At a glance
03Original abstract
Various treatment approaches have been determined efficacious for improving child behavior outcomes. Despite a variety of evidence-based options, consumers often disregard empirically supported treatments to pursue alternatives that lack empirical support, such as 'fad' therapies. The choice to pursue therapies lacking empirical support has been considered a 'gamble' on therapeutic outcomes and this form of risky choice has historically been explained using various cognitive heuristics and biases. This report translates quantitative analyses from the Operant Demand Framework to characterize how caregivers of children with behavioral issues consume treatment services. The Operant Demand Framework is presented, its utility for characterizing patterns of treatment consumption is discussed, and a preliminary application of cross-price analyses of demand is performed to illustrate how various factors jointly influence treatment-related choice. Results indicated that caregivers endorsing interest in receiving behavioral parent training regularly pursued pseudoscientific alternatives as a functional substitute for an established therapy, despite explicit language stating a lack of evidence. These findings question the presumption of rationality in models of treatment choice and degree to which scientific evidence influences the consumption of therapies. This report concludes with a discussion of Consumer Behavior Analysis and how quantitative analyses of behavior can be used to better understand factors that enhance or detract from the dissemination of evidence-based practices.
Journal of the Experimental Analysis of Behavior, 2022 · doi:10.1002/jeab.731