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with Heather Gilmore, MSW, LLMSW, BCBA

Client Choice: Use Client Preferences to Increase Satisfaction and Improve Outcomes

Using client preferences in applied behavior analysis is beneficial to the client’s satisfaction with treatment as well as to the possibility of the client experiencing positive outcomes from the treatment.

Gain Consent to Increase Client Satisfaction

It is important to gain consent for services which includes obtaining assent from a child if you work with youth. Youth are legally required to have a guardian or caregiver who offers consent for their services. However, the minor child can give assent to provide confirmation that they also agree with the services being provided.

Part of gaining assent or consent for ABA services often involves the client being on board with the treatment being provided. A client who is not satisfied with their services is likely to withdraw consent at some point if they provided consent (or assent) initially.

This is just one reason why you may consider using client preferences in treatment services to help clients become more satisfied with the services.

Preference to be an Active Participant in Their Treatment

Based on research, it seems that clients who receive medical services are becoming more likely to want to be an active participant in their services and treatment plans.

For instance, prior to the year 2000, only 50% of clients reported preferring to play an active role in their treatment decisions while, after the year 2000, 71% of clients reported wanting to play an active role in their treatment plans (Lindhiem, et. al., 2014).

Benefits of Client Choice

When clients are offered more choice in their treatment experience, they may experience any of the following benefits:

  • greater satisfaction with their services
  • greater probability they will complete the treatment
  • better compliance with the treatment plan
  • improved outcomes on the identified goals
  • more participation with treatment protocols
  • fewer cancellations or no shows of appointments
  • reduced symptoms
  • increased perception of personal quality of life

Offer Choices in a Variety of Ways

Offering clients choices doesn’t just have to be a one time event where you ask the client which of two or more treatment approaches they’d like to use.

For instance, this type of choice would be represented when you are completing an assessment and developing a treatment plan and you ask a client if they would rather use a more or less intensive toilet training protocol with their toddler.

This kind of choice is beneficial and recommended. However, you can also offer choices throughout intervention.

For instance, you can ask the parent of the toddler who is being toilet trained throughout intervention whether they would like to increase the amount of time the child has between planned sitting times for sitting on the toilet. You can also inquire with the child what activity they’d like to do after going potty.

There are many choice opportunities you can provide.

These choices can enhance the client and the parent’s satisfaction with treatment as well as increase the chances of positive outcomes for the client.


Lindhiem, O., Bennett, C. B., Trentacosta, C. J., & McLear, C. (2014). Client preferences affect treatment satisfaction, completion, and clinical outcome: a meta-analysis. Clinical psychology review, 34(6), 506–517. doi:10.1016/j.cpr.2014.06.002

Client Choice: Use Client Preferences to Increase Satisfaction and Improve Outcomes

Heather Gilmore, MSW, BCBA

Heather is a freelance writer, Board Certified Behavior Analyst (BCBA), and social worker. Heather takes interest in topics related to parenting, children, families, personal development, health and wellness, applied behavior analysis, as well as Autism, ADHD, Depression and Anxiety. Contact Heather if you would like to inquire about obtaining her freelance writing services. You can view more articles and resources from Heather at and email her at You can also advertise your autism services at one of Heather's websites: Heather is the developer of the "One-Year ABA Parent Training Curriculum."


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APA Reference
Gilmore, H. (2020). Client Choice: Use Client Preferences to Increase Satisfaction and Improve Outcomes. Psych Central. Retrieved on October 22, 2020, from