A Token Economy Ward Programme with Chronic Schizophrenic Patients

1975 ◽  
Vol 126 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Susan J. Mumford ◽  
Ian C. Lodge Patch ◽  
Nirmala Andrews ◽  
Lesley Wyner
Keyword(s):  
Operant Conditioning ◽  
Token Economy ◽  
Autistic Children ◽  
Token Reinforcement ◽  
Mentally Handicapped ◽  
Behaviour Modification ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients

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.

A Token Economy Project with Chronic Schizophrenic Patients

1974 ◽  
Vol 124 (581) ◽  
pp. 367-384 ◽  
Author(s):  
Roger Baker ◽  
John N. Hall ◽  
Keith Hutchinson
Keyword(s):  
Operant Conditioning ◽  
Token Economy ◽  
Tv Viewing ◽  
Chronic Schizophrenic ◽  
Conditioning Theory ◽  
Single Room ◽  
Schizophrenic Patients ◽  
Operant Conditioning Theory ◽  
The Way

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.

A Behavioural Training Programme for Chronic Schizophrenic Patients

1994 ◽  
Vol 165 (S24) ◽  
pp. 32-37 ◽  
Author(s):  
Feifei Li ◽  
Mingde Wang
Keyword(s):  
Negative Symptoms ◽  
Skills Training ◽  
Training Programme ◽  
Token Economy ◽  
Psychiatric Nurses ◽  
Control Group ◽  
Behavioural Treatment ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients ◽  
Experimental Group

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.

Activity in chronic schizophrenic patients: comparison of pimozide with fluphenazine in a double blind trial

1975 ◽  
Vol 5 (2) ◽  
pp. 161-164 ◽  
Author(s):  
A. C. P. Sims ◽  
I. G. Burnside
Keyword(s):  
Operant Conditioning ◽  
Crossover Trial ◽  
Double Blind Trial ◽  
Double Blind ◽  
Blind Trial ◽  
Chronic Schizophrenic ◽  
Free Operant ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
Psychiatric Rating

SynopsisA double-blind crossover trial was carried out comparing pimozide with fluphenazine. The effects of the drugs on the activity of 20 chronic inert male schizophrenic patients were measured using nursing observations, psychiatric rating, and an operant conditioning method. When activity was assessed in these different ways, no significant difference was found between the two drugs on any of the measures. It is concluded that pimozide does not effectively increase the activity in such patients. It is considered that the free operant conditioning method used was shown to be a useful measure for comparing therapy in chronic schizophrenic patients.

A token economy program for chronic schizophrenic patients

1976 ◽  
Vol 17 (1) ◽  
pp. 272-282 ◽  
Author(s):  
LARSGÖRAN ÖST ◽  
LENNART MELIN ◽  
K. GUNNAR GÖTESTAM
Keyword(s):  
Token Economy ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients

Symptom Changes in Chronic Schizophrenic Patients on a Token Economy: a Controlled Experiment

1977 ◽  
Vol 131 (4) ◽  
pp. 381-393 ◽  
Author(s):  
R. Baker ◽  
John Hall ◽  
K. Hutchinson ◽  
G. Bridge
Keyword(s):  
Matched Control ◽  
Social Withdrawal ◽  
Token Economy ◽  
Controlled Experiment ◽  
Control Group ◽  
Matched Control Group ◽  
Chronic Schizophrenic ◽  
Schizophrenic Patients ◽  
Symptom Changes ◽  
Experimental Group

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.

scholarly journals The use of computerised tomography in mental handicap patients

1992 ◽  
Vol 16 (10) ◽  
pp. 616-618
Author(s):  
S. K. Lekh ◽  
B. K. Puri ◽  
I. Singh
Keyword(s):  
Psychiatric Disorders ◽  
Research Tool ◽  
Clinical Neurology ◽  
Computerised Tomography ◽  
Chronic Schizophrenic ◽  
Mental Handicap ◽  
Schizophrenic Patients

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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