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Results for “Token Economy”

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PubMed1991

Strategies that overcome barriers to token economies in community programs for severe mentally ill adults.

The token economy has been found to be an effective strategy for treatment of severe mentally ill inpatients. However, several barriers have prevented facile transfer of token economy strategies from inpatient settings to community programs; these barriers include outpatient access to competing reinforcers, supplemental income that help outpatients to purchase these reinforcers, weakening of the efficacy of response costs, limited hours of the day in which day treatment contingencies apply, and interference of contingency contracts by family or friends. These barriers can be obviated by avoiding response cost contingencies, providing reinforcers cheaply, and including other systems in the development and implementation of token contingencies.

Adaptation, Psychological↗
PubMed1990

Motivating adolescents to reduce their fines in a token economy.

Adolescents on a 16-bed token economy ward of a state hospital were subjected to four interventions in a seven-phase experiment to reduce the number of fines they received each day. Phase I was a four-week baseline period. Phases II and III were four- and five-week periods, respectively, in which residents were awarded tickets for a weekly $10 lottery each day they were at or below a changing criterion of daily fines. In Phase IV, residents received coupons, exchangeable for money, for days with zero fines. Phase V was a return to baseline. Phase VI was a one-week period in which daily lotteries for $1 were held, with the criterion for receiving a ticket being zero fines on the previous day. Phase VII was a one-week return to baseline. No significant differences in average fines per day, number of residents meeting criteria, or mean number of zero-fine days per week were found across phases. Results are discussed in terms of amount and immediacy of reinforcement, other opportunities to gain money, possible rebelliousness of the residents against the increased aversiveness of fines, and implications for further research.

Adolescent↗
PubMedDate not supplied

[A token economy experiment in young schizophrenic patients].

The paradigm of operant behaviour (Skinner) systematically applied to a group constitutes the theoretical basis of token-economy programs. Such a system consists in relating a certain behaviour to a consequence known to the patient. The efficiency of a token-economy has already been demonstrated for various populations: delinquants, schooolboys, chronic psychiatric patients. This pilot-study reports on our experience in applying in token-economy program in a group of young schizophrenics, most of them being hebefrenics: concepts and difficulties in realisation, hierarchical structure of the system, and results obtained.

Adolescent↗
PubMed1976

Effects of price manipulations on consumer behavior in sheltered workshop token economy.

The consumer behavior of institutionalized retarded clients in a sheltered workshop token economy were evaluated by changing prices in the workshop store. In the first experiment we found that clients displayed elasticity of demand in that raising the prices of frequently purchased goods reduced the frequency and amount spent on more expendable items. Results from the second experiment showed that this change in spending pattern was not due to the relative modal unit price of item classes. The regulation of demand for consumer goods is a potentially useful way to maintain economic balance and effectiveness of a token economy.

Adolescent↗
PubMed1977

Symptom changes in chronic schizophrenic patients on a token economy: a controlled experiment.

An 18-month controlled experiment was conducted into the effects of a token economy programme on the ward behaviour and symptoms of chronic schizophrenic patients. An experimental group received tokens dependent upon appropriate behaviour, while a matched control group on the same ward received every aspect of the ward programme similarly except that tokens were not dependent upon their behaviour. Regular assessment showed that both groups improved substantially in social withdrawal. Over twelve months of treatment the experimental group improved no more than the control group. There were no symptomatic changes. The conclusions were that token economy is a treatment affecting withdrawl and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.

Chronic Disease↗
PubMed1983

The use of token economy to reduce illicit drug use among methadone maintenance clients.

The effects of a token economy in modifying the illicit polydrug use of 97 methadone maintenance clients was investigated over a period of two and a half years. Subjects' drug-free urinalysis reports were reinforced with points which could be redeemed to obtain methadone. Each subject's daily dose level varied with the point balance. A multiple baseline analysis showed that when methadone acquisition was in part made contingent upon drug-free urinalyses, illicit drug use declined rapidly. After six months, the token economy group's urines were 14% positive for illicit drugs compared to 39% in the traditional treatment group. As time in treatment increased, illicit drug use further declined. These results suggest a more effective and practical strategy for the treatment of polydrug abusing methadone maintenance clients than has previously been available.

Adult↗
PubMed1979

Multiple-baseline analysis of a token economy for psychiatric inpatients.

Twelve behaviors selected for reinforcement among 16 chronic psychiatric inpatients were divided into four classes: (a) personal hygiene, (b) personal management, (c) ward work, and (d) social skills. A token economy program was introduced for each class in a sequential, cumulative, multiple-baseline format. Corrections were included for methodological deficiencies frequently enountered in past studies. Treatment variables were systematically monitored, and target behavior rates, levels of global individual functioning, general ward behavior, and off-ward behavior were assessed during baseline, implementation, and probe periods. Results indicated abrupt and substantial increases in performance of most target behaviors, significant improvements in global individual functioning (p less than .025), positive changes in general ward behavior, and increases in social interaction during off-ward activities. The findings provide strong evidence for the efficacy of a token economy and indicate that the multiple-baseline design can be a useful method for evaluating token economy programs.

Activities of Daily Living↗
PubMed1978

Token economy, pimozide and chronic schizophrenia.

Response to a token economy was assessed in male chronic schizophrenic in-patients who were given, in a double-blind cross-over trial, pimozide (up to 20 mg daily) or chlorpromazine )up to 1,000 mg daily), each for three months. After six months there was little change in the patients' mental state, but general ward behaviour and token-rewarded "target" behaviours improved significantly. There were no statistically significant between-drug differences, but the trend was that general ward behaviour, but not token-rewarded behaviour, improved more on pimozide. The patients who showed initiative and cooperated best with staff were those whose token-rewarded behaviour was most satisfactory.

Behavior Therapy↗
PubMed1979

Internal control and success orientation in a token economy for emotionally disturbed adolescents.

Forty-one emotionally disturbed adolescents were tested at each of three token economy levels on Rotter's Internal-External Locus of Control Scale and Guevar's Success-Failure Inventory. Delay of reinforcement (immediate, daily, weekly) was the primary differentiation between levels. One-way analyses of variance indicated a change across levels in the direction of more perceived internal control of behavior (p less than .025) and a greater success orientation (p less than .005). Change scores were not correlated with length of time in the program. Results suggest that the token economy as an external source of control is not necessarily incompatible with increasing patient expectancies of present and future control of the environment.

Adolescent↗
PubMed1977

The effect of holidays on a token economy regime.

This preliminary study investigates the effect on patients' performance of a set time off, in the form of a short holiday, from a strict reinforcement (token economy) regime. Assessment was by the patients' mean token earnings before and after the holiday and their self-care and work performance throughout. The results suggest that a holiday from a token economy has beneficial effects for patients.

Behavior Therapy↗
PubMed1972

Item preference in a token economy ward store.

Token spending by 20 schizophrenic patients was monitored over a six-month period. It was found that: (1) token expenditures for cigarettes and "edibles" far surpassed other store item categories; and (2) percentage increases in token expenditures were greatest for categories of items relating to appearance and grooming, strongly suggesting that store purchasing patterns over time may provide an index of program effectiveness.

Journal Article↗
PubMed1973

Self-recording and student teacher supervision: variables within a token economy structure.

A token system was used to attempt to increase the accuracy with which special education students answered questions about reading assignments. In the token system, students recorded their own data, received toy money for accurately completing assignments, and were allowed to spend their toy money at the end of the week for educational activities. The accuracy with which students answered questions was higher when the token system was in effect than when it was not. When student teachers were used to manage the token system and when the self-recording feature of the system was removed, only slight changes in the accuracy of the student performance were obtained.

Journal Article↗
PubMed1976

Follow-up of a token economy applied to civilly committed narcotic addicts.

Thirty-one civil-commitment, male, heroin addicts participated in an intramural token economy designed to reinforce the rehabilitative process by programming the incentive of length of residential stay. The project evaluated participation in rehabilitative activities during intramural stay, personality change as measured by the MMPI, and follow-up of the participants' community aftercare retention. The token economy had a substantial impact on the participants' institutional adjustment but had little influence on the evaluative dimensions of personality change and rate of aftercare retention.

Adolescent↗
PubMed1987

The role of food substitutes in a token economy system.

Data from five behaviour management (token economy) units were analysed for periods of 10-20 weeks before and after the use of a food substitute (Complan), provided when insufficient tokens had been earned to buy a full- or part-meal. The efficacy of this form of negative punishment to control disturbed and aggressive behaviour was examined. No evidence was found to suggest that the contingent use of a food substitute made any contribution to the therapeutic process.

Adolescent↗
PubMed1989

An appeals system for fines received by adolescents in a token economy.

A system is described wherein adolescents participating in a token economy at a state hospital were allowed to appeal fines received from staff. Appeals were heard by a board composed of three residents and a psychology intern. The board met weekly and had full power to rescind or uphold fines. Before initiation of the appeal system, residents complained vigorously about fines received and about the "unfairness" of the staff and the token system, frequently denying responsibility for the infractions involved. Although almost half the fines were upheld, there were practically no more complaints of unfairness, and denials of responsibility declined drastically. The number of residents appealing fines fell from an average of four per week to less than one per week after the system had been in effect for one and one-half months. When asked why the system was not being used more often, residents grudgingly volunteered that most of the fines received were fair. It was not possible to determine whether this was due to changes in residents' attitudes or to actual changes in fining behavior by staff. Results are discussed in terms of effects on residents, acceptance by staff, and implications for further research.

Adolescent↗
PubMedDate not supplied

Analysis of outcome variables of a token economy system in a state psychiatric hospital: a program evaluation.

This study describes the outcome of a token economy treatment applied to 2 distinct patient populations on the same unit of a state psychiatric hospital: individuals with a dual diagnosis of mental retardation and a DSM-IV Axis I diagnosis of either (a) a severe behavior disorder (BD) or (b) a serious and persistent psychiatric disorder (PD). Results showed that patients in the PD group were more likely to complete the treatment (17/20) than those in the BD group (17/31) who were more likely to be terminated from the program (14/31). Individuals who did not complete the program were distinguished early, within the first 3 weeks of treatment. These noncompleters received significantly more fines and earned significantly fewer tokens than those who completed the program. At an average of 2.7 years post-discharge, there was no difference in the proportion of PD (12/16) and BD completers (9/11) and BD noncompleters (3/7) remaining in the community. These data show that diverse populations of patients can be treated within the same token economy program, thereby improving cost effectiveness. Future research should be directed toward characterizing those patients (e.g., BD) less likely to succeed when they enter treatment, and determining if modifications in the program can improve that outcome.

Adolescent↗
PubMed2001

The influence of a token economy and methylphenidate on attentive and disruptive behavior during sports with ADHD-diagnosed children.

Three children diagnosed with attention deficit hyperactivity disorder (ADHD) participated in a summer program designed to evaluate the influence of stimulant medication and a token economy on attentive and disruptive behavior during kickball games. Attentive and disruptive behavior were assessed using an interval coding system, and daily ratings on the ADHD Index of the Conners Teacher Rating Scale-Revised were also obtained. A multielement reversal design was used, and the results indicated that both interventions independently improved attentive behavior and decreased disruptive behavior for the participants. Contrary to other research, when the token economy and medication were compared in isolation, the token system appeared more effective in reducing disruptive behavior for 2 of the 3 participants. In addition, the token system generally enhanced the effects of stimulant medication.

Attention Deficit Disorder with Hyperactivity↗
PubMed1977

The effect of the absence of close supervision on the use of response cost in a prison token economy.

A naturally occurring experiment, in which direct supervision of a token economy in a penal system was removed and re-instated, is reported. A retrospective analysis revealed that in the absence of close supervision the use of response cost rose dramatically, both in terms of categories of behaviors for which response costs were levied and in the frequency of their use. The return of direct supervision led to a decreased use and and an end to the growth of categories of behaviors punished.

Administrative Personnel↗