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.