Evaluation of treatment integrity on a child psychiatric unit: an illustration

The authors present a systematic evaluation of the implementation of a token economy protocol on a child psychiatric inpatient unit. Unobtrusive observations and staff responses to vignettes that depicted child behavior indicated that staff members did not always distribute tokens as scheduled and were inconsistent in their judgments about which behaviors should be rewarded. The results highlight the need for child psychiatric nurses to monitor systematically the implementation of care for which they are responsible.