Incentive and Inducements in Psychotherapy Research

The issue of offering incentives or inducements to potential research participants is addressed specifically in Standard 8.06 of the APA Ethics Code.  This standard states:

(a) Psychologists make reasonable efforts to avoid offering excessive or inappropriate financial or other inducements for research participation when such inducements are likely to coerce participation.

(b) When offering professional services as an inducement for research participation, psychologists clarify the nature of the services, as well as the risks, obligations, and limitations. (See also Standard 6.05 Barter With Clients/Patients). (p. 1070)

Thus, this practice may be engaged in, but it must be done so with appropriate forethought and caution.  The first part of this standard is consistent with the previous discussion of informed consent, which we must ensure is given voluntarily.  If the inducements are such that there is a coercive effect, then this is inappropriate and violates the APA Ethics Code.  For example, let’s say I am doing a study with human participants that holds many risks, requires a significant time commitment, and may be of little value to the participants.  To solicit participants I stand outside of a Methadone Clinic in an inner-city setting and offer patients there $500 for their participation in the study. This could be seen as preying on their vulnerabilities and taking advantage of their circumstances.  All use of inducements must occur without coercion.  Further, all research protocols to include the recruitment of participants should be reviewed and approved by an Institutional Review Board (IRB) prior to initiating any of these activities.

As you mention, some researchers offer participants various services in return for their participation in the research study.  Examples may include a physical exam, nutritional counseling, psychotherapy, and the like.  Consistent with the part (b) of Standard 8.06 all this must be addressed fully in the informed consent.  Further, the offer of such services as an inducement for participation in the study must be consistent with part (a) of this standard as discussed above.  If psychotherapy or other treatment services are being offered in return for participation in the study it is important that all other relevant standards of the APA Ethics Code be followed to include informed consent, competence, avoiding harm, and multiple relationships. Each must be carefully considered prior to engaging in these practices.  The use of colleagues for consultation and the use of an IRB in all research planning are extremely helpful and important as well.

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Jeffrey E. Barnett, Psy.D., ABPP

Jeffrey E. Barnett, Psy.D., ABPP is a Professor in the Department of Psychology at Loyola University Maryland and a licensed psychologist who is board certified by the American Board of Professional Psychology in Clinical Psychology and in Clinical Child and Adolescent Psychology. Additionally, he is a Distinguished Practitioner in Psychology of the National Academies of Practice. Among his many professional activities, Dr. Barnett is a past chair of the ethics committees of the American Psychological Association, the American Board of Professional Psychology, and the Maryland Psychological Association. He previously served on the Maryland Board of Examiners of Psychologists and has been a consultant to licensing boards across a range of health professions. His numerous publications and presentations focus on ethics, legal, and professional practice issues in psychology. Dr. Barnett is a recipient of the APA’s outstanding ethics educator award.