Published online by Cambridge University Press: 06 October 2014
Developments over the last twenty years in the use of token economies in psychiatric institutions are reviewed. Token economies are considered in the context of two systems: the internal social system of psychiatric institutions and the mental health service system as a whole. Two themes emerge: the first concerns difficulties in establishing and maintaining token economies and the second, the impact of deinstitutionalization policies. It is argued that, although token economies remain viable for intervention goals internal to the institution, they have not been proven viable in furthering the goals of deinstitutionalization. Post-institutional programmes and community alternatives to institutions are of more current value than token economies in institutions.