A token economy in the framework of a hospital therapeutic community -- practice and psychosocial implications

A token economy (TE) aimed at enhancing self care, work habits, and social participation was initiated in conjunction with the restructuring of a chronic ward into a therapeutic community. Recorded data over a year revealed a differential impact of the TE on various patients. An attempt is made to characterize differential response modes to the TE and to delineate their correlates. Both participants in the program and therapeutic agents were interviewed as to their attitudes towards the TE. Beneficial effects were demonstrated mainly in patients with a relatively late onset of psychiatric illness, but a favorable attitude towards the TE was displayed by both patients and staff members. Implications for psychosocial readaptation are discussed taking into account humanistic and psychodynamic points of view. The reconsideration of possible merging of different therapeutic techniques seems to be desirable.