Conditioning and post-hospital generalization of nondelusional responses in a chronic psychotic patient

An operant conditioning approach was successful in getting a chronic psychotic patient to give factual answers to direct questions that had previously elicited only delusional responses. Multiple baseline and reversal controls established that the changes were due to the experimental procedure. The subject was a female patient classified as paranoid schizophrenic who had persisted in giving bizarre responses to direct questions regarding her identity, age, and personal history during 26 yr of hospitalization. She was discharged after factual answers to these questions had been obtained, but operant conditioning trials were continued in the community to promote generalization. Two follow-up interviews were conducted 36 and 52 days after discharge to evaluate generalization. No generalization was found in the first interview, but the second gave evidence of some generalization.