A controlled evaluation of token economy procedures with chronic schizophrenic patients

1977 ◽  
Vol 15 (3) ◽  
pp. 261-283 ◽  
Author(s):  
J.N. Hall ◽  
R.D. Baker ◽  
K. Hutchinson
1974 ◽  
Vol 124 (581) ◽  
pp. 367-384 ◽  
Author(s):  
Roger Baker ◽  
John N. Hall ◽  
Keith Hutchinson

The token economy is an application of operant conditioning theory which is particularly relevant to the treatment of patients in institutions. The basic idea is to motivate the patient to behave more appropriately and constructively by giving him tokens whenever he behaves in such a way. The tokens have an incentive function, as the patient can cash them in for a number of different things, such as pleasant single room accommodation, cigarettes, magazines, TV viewing, drinks etc., depending upon what is programmed into the token economy. The theory of operant conditioning is that not only does the token motivate the patient to behave in certain ways, but ‘reinforces' his behaviour. Such reinforced behaviour should eventually become an integral part of the ‘way he is', continuing even when the token is removed.


1994 ◽  
Vol 165 (S24) ◽  
pp. 32-37 ◽  
Author(s):  
Feifei Li ◽  
Mingde Wang

This paper discusses the effectiveness of an in-patient rehabilitation programme administered by nurses that combines life skills training, active encouragement, and a token economy. Fifty-two chronic schizophrenic patients with prominent negative symptoms who had been continuously in hospital for at least a year were randomly assigned to the experimental or control group. The training and associated reinforcement schedule were administered daily to experimental subjects by two specially trained rehabilitation nurses. Control subjects did not receive training or reinforcement but were individually asked to perform the same daily tasks and participate in the same activities as the experimental-group subjects. Patients in both groups received their previous dosage of medication throughout the trial. After three months the severity of negative symptoms, as assessed by blind evaluators, decreased in both groups of subjects, but the improvement in the experimental group was much greater than that in the control group. These findings demonstrate the efficacy of behavioural interventions for chronic schizophrenic in-patients in China and highlight the importance of changing the role of Chinese psychiatric nurses from that of custodians who control patients' behaviour to that of therapists who provide psychological and behavioural treatment.


1976 ◽  
Vol 17 (1) ◽  
pp. 272-282 ◽  
Author(s):  
LARSGÖRAN ÖST ◽  
LENNART MELIN ◽  
K. GUNNAR GÖTESTAM

1975 ◽  
Vol 126 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Susan J. Mumford ◽  
Ian C. Lodge Patch ◽  
Nirmala Andrews ◽  
Lesley Wyner

The application of techniques of behaviour modification to chronic adult psychiatric in-patients has for the most part been directed towards individual patients, and to specific problems such as hoarding, eating, soiling or speech (Ayllon, 1963; Ayllon and Haughton, 1962, 1964; Ayllon and Michael, 1959; Bachrach et al., 1965; Isaacs et al., 1960; Mertens and Fuller, 1963; Kennedy, 1964; Sherman, 1965). In this country, Baker (1970, 1971) and Kassorla (1968) have reported on the use of operant conditioning in reinstating speech in mute schizophrenics. There have, however, been few British reports relating to groups of patients, for example in wards where nurses have been trained to function as ‘behavioural engineers' (Ayllon and Michael, 1959); whereas Krasner and Attowe (1968) specified no fewer than 200 institutions and individuals in the U.S.A. currently involved in token reinforcement programmes, concerned with disturbed or autistic children, delinquent adolescents and the mentally handicapped; 22 projects involved chronic adult psychiatric in-patients.


1967 ◽  
Vol 113 (500) ◽  
pp. 731-742 ◽  
Author(s):  
N. S. Kline ◽  
G. L. Barclay ◽  
J. O. Cole ◽  
A. H. Esser ◽  
H. Lehmann ◽  
...  

On 30 March, 1966, at the Symposium “Enzymes in Mental Health” sponsored by the Carl Neuberg Society for International Scientific Relations, A. Hoffer (1) described the apparently successful treatment in 13 of 17 (acute and chronic) schizophrenic patients in 3 to 5 days by the daily oral use of 1 to 2 grams of nicotinamide adenine dinucleotide (NAD), better known as diphosphopyridinenucleotide (DPN). Widespread publicity given to this announcement attests to the need of more effective treatment for this illness. It also occasioned frequent and persistent inquiry from schizophrenic patients and their relatives as to the suitability of this treatment in their own instance. Rapid confirmation of the findings would justify widespread efforts to evaluate this preparation, whereas failure of confirmation would provide reasonable grounds for a more cautious approach to its use. The members of the Council of the American College of Neuropsycho-pharmacology decided that, as a group of impartial scientists, it would be appropriate for them to carry out such an investigation as rapidly as was compatible with adequate determination of the usefulness of the preparation.


1977 ◽  
Vol 131 (4) ◽  
pp. 381-393 ◽  
Author(s):  
R. Baker ◽  
John Hall ◽  
K. Hutchinson ◽  
G. Bridge

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 withdrawal and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.


1992 ◽  
Vol 16 (10) ◽  
pp. 616-618
Author(s):  
S. K. Lekh ◽  
B. K. Puri ◽  
I. Singh

Since its inception (Hounsfield, 1973), computerised tomography (CT) has become an invaluable diagnostic and research tool, particularly in clinical neurology and neurosurgery. Clinically, CT has proved useful in differentiating between ‘functional’ and ‘organic’ psychiatric disorders where it is particularly helpful in the diagnosis of potentially treatable organic disorders. For example, Owens et al (1980) found clinically unsuspected intracranial pathology in 12 of 136 chronic schizophrenic patients examined by CT and Roberts & Lishman (1984) found diagnosis, management, and/or prognosis were influenced in approximately 12% of cases referred by psychiatrists for CT imagining.


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