Token Economy Approaches for Psychiatric Patients

Abstract

Although the token economy is among the most well-validated and effective behavioral treatments for schizophrenia and other serious psychiatric disorders, its use in clinical and research settings has declined from a peak in the early 1970s. Reasons for this decrease in use include staff resistance, reduced length of inpatient admissions, greater emphasis on community based treatments, economic constraints, and legal and ethical challenges. Nevertheless, a small but enthusiastic group of proponents still conducts token economy research and treatment. Important topics pertaining to the token economy remain to be addressed, including specifying its remediative components, developing strategies to promote generalization and maintenance of treatment gains, and creating better methods to identify patients who would most benefit from participating in these programs.