As therapists, we are also business owners, and our clients are not just people seeking change but also consumers, so understanding some basic marketing strategies can be useful. The decoy effect is a cognitive bias that is used in marketing to encourage people to make a specific choice out of all the options they are presented with.
Making consumer choices can be hard: there are so many variations on even the simplest of purchases, especially therapy where there are likely to be quite a few options in your area - in terms of both therapists and types of therapy. The general aim of the decoy effect is to provide a product option which you know in advance people are unlikely to choose, because it compares badly with the other options they have. The effect works best when people have already narrowed down their choices to two options, the target (the one you want them to take) and the competitor (the most likely other option). By introducing a third, decoy, choice, they are nudged towards the target.
How decoy effect works.
A decoy could be used either to encourage people to choose your services over other people's, or to choose one of your products over others. For simplicity, I’m going to stick with that second option as an example because more of the factors are under your direct control. [1]
Let’s say you have two payment options in your practice. You will all have your own pricing structure, of course, but let’s use some random numbers to make things easy. In this example, your clients can pay £100 at each session, or £450 in advance for a block of six sessions.
Clearly, the block of six sessions is better value, working out at only £75 for each appointment. However, clients are not just evaluating their choices on price, but also on the convenience (or otherwise) of paying out a larger sum immediately and committing to multiple sessions. You're finding that not many clients are opting for the package and you’d like more people to do so.
Instead of reducing the cost of the six-session option, you introduce a third choice - four sessions for £380. True, it doesn't require as much commitment as six sessions, but it’s clearly not much of a deal. It has all the inconvenience of paying out in advance alongside a negligible reduction in price (£95), so very few clients are likely to choose it.
However, the four-session package is such a bad buy that the six-session package instantly looks like a much better prospect. You still have to pay out in advance but it’s only slightly higher in cost and such a comparative bargain that more people will find it worthwhile.
The decoy effect is generally very effective. In one study (on choosing between online and hard copy newspaper subscriptions) 68% chose the cheapest option when given a straight choice, and only 16% did so after a decoy was used to encourage them to choose a more expensive subscription. [2] It’s called ‘nudging’ and similar results have been found in experiments done with other products.[3]
Is the decoy effect ethical?
The decoy effect does use factors that are outside most people’s conscious awareness when making their decisions. However, it is widely considered an ethical way to market because you are still offering the client a choice, and not impacting on their free will. In our example, if paying in advance would be problematic for the client, or they don’t want to commit to more than one session at a time, they can still stick with the pay as you go option.
You are encouraging a different choice, of course, but the same could be said for most marketing techniques. Many people report finding it easier to make the decision when a decoy is involved because there is a clear justification (value) for doing so. In simpler terms, they feel happy because they got a good deal.
Decoy strategies in therapy
There is very little research on using this effect in areas that could be considered therapeutic, although I have found a couple.
Stoffel et al (2019) used the decoy effect to increase the uptake of colorectal screening. [4] The idea was to encourage those electing not to have a screening at all to choose a specific hospital. Uptake went from 39% to 54% or 37% to 59% depending on the level of information given about the target hospital and how much better the hospital was perceived to be over the decoy.
On the other hand, Rogers et al (2020) looked at how the decoy effect influenced smokers’ choices of how many counselling sessions to attend when quitting. [5] The counsellors' guidelines showed that four or more sessions were most effective, but their clients were reluctant to commit to so many even though they were free. Smokers in the control group were offered a choice of two or five sessions, and those in the experimental group were offered two, five or seven sessions (with five being the target choice and seven being the decoy). Unfortunately, this didn’t show any significant effect on smokers’ choices. The experimenters suggested one reason for this might be that smokers’ choices were based on a single factor (time commitment) rather than two competing factors as in other decoy effect studies.
That being the case, you can do a little informal research of your own, since you can introduce more than one variable for comparison. You could certainly use our example above to encourage clients to sign up for a specific number of sessions in advance, or review your smokers’ programme, for example.
Like the counsellors referred to above, we know that a single session of hypnosis for quitting smoking is, on average, not as effective as multiple sessions. [6] Despite this, the ‘one session’ approach is often favoured by clients who want to quit. By offering packages that nudge clients towards the statistically more effective option you can perhaps increase your success rates and help more people to become smoke-free for good.
Or you may be able to come up with decoy theory-inspired ways to encourage clients to complete the support tasks you set them between sessions (offering them a choice between target, competitor, and decoy activities), or to practice the techniques you teach them. In theory, the decoy effect could also be used in ‘forced choice’ questions to increase the likelihood of the client selecting a specific option, though I appreciate many of you might consider that too leading or directive.
If you do try this out, please let me know. Email me or post your example in the comments below. I would love to know how it works for you.
Attributions
Title image: Missvain, CC BY 4.0, via Wikimedia Commons, cropped and text added.
Notes and references
[1] my example is based on an informal experiment done with popcorn at a cinema, where the two factors under consideration by purchasers were portion size and price. The introduction of a relatively expensive ‘medium’ portion caused significantly more people to purchase the large option than when there was only a choice between large and small. https://thedecisionlab.com/biases/decoy-effect/
[2] https://www.youtube.com/watch?v=xOhb4LwAaJk Pricing the Economist
[3] https://theconversation.com/the-decoy-effect-how-you-are-influenced-to-choose-without-really-knowing-it-111259#
[4] Stoffel ST, Yang J, Vlaev I, von Wagner C (2019) Correction: Testing the decoy effect to increase interest in colorectal cancer screening. PLOS ONE 14(7): e0219811. https://doi.org/10.1371/journal.pone.0219811
[5] Rogers, E.S., Vargas, E.A. & Voigt, E. Exploring the decoy effect to guide tobacco treatment choice: a randomized experiment. BMC Res Notes 13, 3 (2020). https://doi.org/10.1186/s13104-019-4873-0
[6] Taylor and Dingle (1994) cited in http://www.empoweredchoices.com/pdf/Compare%20The%20Success%20Rates%20Of%20The%20Top%208%20Stop%20Smoking%20Methods.pdf
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion and Their Worlds, Your Words and a co-writer of the Hypnotherapy Handbook, all of which are available from Amazon.
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