To date, most investigations of treatment acceptability have utilized an analog methodology, with few studies examining the acceptability of treatments in naturalistic environments. The purpose of the present study was to examine both analog and naturalistic ratings of acceptability using the same group of parents. Participants were 40 parents whose children were seen in a behavior management clinic. Parents rated the acceptability of alternative treatments applied to caw descriptions and also rated the acceptability of treatments actually provided to them in the clinic for the management of their children's behavior difficulties. Naturalistic ratings were obtained in the clinic and at 1, 3, and 6 months following the clinic visit. Results indicated that analog treatments were distinguished on the basis of acceptability ratings. When the severity of behavior problems was considered, a positive relationship existed between analog and naturalistic acceptability ratings. A strong, positive relationship was found between treatment effectiveness and acceptability at each time point. In addition, a gradual increase was observed in the relationship between acceptability and compliance over time.