Modeling Treatment-Related Decision-Making Using Applied Behavioral Economics: Caregiver Perspectives in Temporally-Extended Behavioral Treatments

Shawn P. Gilroy, Brent A. Kaplan

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Evidence-based behavioral therapies for children with disruptive and challenging behavior rarely yield immediate improvements in behavior. For caregivers participating in behavioral therapies, the benefits from these efforts are seldom visible until after substantial time commitments. Delays associated with relief from challenging behavior (i.e., improved behavior) can influence how caregivers decide to respond to instances of problem behavior, and in turn, their continued commitment (i.e., integrity, adherence) to treatments that require long-term implementation to produce improvements in child behavior. This study applied delay discounting methods to evaluate how delays affected caregiver preferences related to options for managing their child’s behavior. Specifically, methods were designed to evaluate the degree to which caregiver preferences for a more efficacious, recommended approach was affected by delays (i.e., numbers of weeks in treatment). That is, methods evaluated at which point caregivers opted to disregard the optimal, delayed strategy and instead elected to pursue suboptimal, immediate strategies. Results indicated that caregivers regularly discounted the value of the more efficacious treatment, electing to pursue suboptimal approaches when delays associated with the optimal approach grew larger. Caregivers demonstrated similar patterns of suboptimal choice across both clinical (i.e., intervention) and non-clinical (i.e., monetary) types of decisions. These findings are consistent with research that has highlighted temporal preferences as an individual factor that may be relevant to caregiver adherence to long-term evidence-based treatments and encourage the incorporation of behavioral economic methods to better understand caregiver decision-making.

Original languageEnglish
Pages (from-to)607-618
Number of pages12
JournalJournal of Abnormal Child Psychology
Volume48
Issue number5
DOIs
StatePublished - May 1 2020

Bibliographical note

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Behavioral economics
  • Caregiver decision-making
  • Delay discounting
  • Treatment adherence

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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