Applications of operant demand to treatment selection III: Consumer behavior analysis of treatment choice

Behavior analysts and psychologists advocate for the use of therapies and strategies based on credible, scientific evidence. Researchers and clinicians regularly advocate for Evidence-based Practices (EBPs) over questionable "alternatives" because caregivers seldom choose interventions based on scientific evidence alone. This study applied methods and concepts from Consumer Behavior Analysis to conduct a reinforcer-based evaluation of the consequences that influence treatment choices. Hypothetical Treatment Purchase Tasks (HTPTs) were designed to evaluate how utilitarian (UR; i.e., the efficacy of treatment) and informational sources of reinforcement (IR; i.e., community support for treatment) jointly influence treatment-related choices. A total of 104 caregivers were recruited using the Amazon Mechanical Turk (MTurk) framework to complete two HTPTs. Results indicated that caregivers overall favored treatments with greater IR over those with greater UR, suggesting that indirect contingencies for treatment choices exerted greater overall influence than the direct contingencies of treatment choices (i.e., efficacy). This finding extends the literature on treatment choice by providing a reinforcer-based perspective on why 'fad', questionable, and pseudoscientific practices can achieve and maintain high levels of adoption by caregivers. This work concludes with a discussion of Consumer Behavior Analysis and how reinforcer-based interpretations of choice can be used to improve efforts to support and advocate for evidence-based child behavior treatments.