Symptom changes in chronic schizophrenic patients on a token economy: a controlled experiment

An 18-month controlled experiment was conducted into the effects of a token economy programme on the ward behaviour and symptoms of chronic schizophrenic patients. An experimental group received tokens dependent upon appropriate behaviour, while a matched control group on the same ward received every aspect of the ward programme similarly except that tokens were not dependent upon their behaviour. Regular assessment showed that both groups improved substantially in social withdrawal. Over twelve months of treatment the experimental group improved no more than the control group. There were no symptomatic changes. The conclusions were that token economy is a treatment affecting withdrawl and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.