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Token programs in an acute psychiatric hospital.

T J Crowley

    The American Journal of Psychiatry
    |May 1, 1975
    PubMed
    Summary

    This study explores individually prescribed token economies for acute psychiatric inpatients, identifying four patient categories and recommending selection techniques. Token programs may prevent social breakdown syndrome in disturbed patients.

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    Area of Science:

    • Psychiatry
    • Behavioral Psychology
    • Clinical Psychology

    Background:

    • Previous research on token economies focused mainly on chronic psychiatric patients.
    • Acute psychiatric inpatients represent an understudied population for token economy interventions.

    Purpose of the Study:

    • To investigate the application and efficacy of individually prescribed token economies in acute psychiatric inpatients.
    • To identify patient profiles suitable for token economy programs and recommend implementation strategies.

    Main Methods:

    • Case reviews of approximately 5% of acute psychiatric inpatients who participated in individually prescribed token economies.
    • Categorization of patients into four distinct groups based on their presenting symptoms and behaviors.

    Main Results:

    • Patients suitable for token economies were identified in four categories: depressed complainers, apathetic/withdrawn, agitated psychotics, and impulsive/acting-out nonpsychotics.
    • The study outlines recommended techniques for patient selection, goal setting, and the determination of appropriate reinforcers.

    Conclusions:

    • Individually prescribed token economies can be effectively applied to specific patient profiles within acute psychiatric settings.
    • The implementation of token economy programs may serve as a preventative measure against the development of social breakdown syndrome in severely disturbed patients.

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