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Symptom Changes in Chronic Schizophrenic Patients on a Token Economy: a Controlled Experiment

Published online by Cambridge University Press:  29 January 2018

R. Baker ,
John Hall ,
K. Hutchinson  and
G. Bridge
R. Baker
Affiliation:
Department of Psychology, Royal Cornhill Hospital, Aberdeen
John Hall
Affiliation:
Department of Psychology, Whitchurch Hospital, Cardiff
K. Hutchinson
Affiliation:
Department of Psychiatry, Leeds University
G. Bridge
Affiliation:
Department of Psychiatry, Leeds University
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Abstract

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 withdrawal and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 131 , Issue 4 , October 1977 , pp. 381 - 393
Copyright
Copyright © Royal College of Psychiatrists, 1977 

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References

Appleby, L. (1963) Evaluation of treatment methods for chronic schizophrenia. Archives of General Psychiatry, 8, 8–21.CrossRefGoogle ScholarPubMed
Ayllon, T. & Azrin, N. H. (1968) The Token Economy. New York: Appleton-Century-Crofts.Google Scholar
Baker, R., Hall, J. N. & Hutchinson, K. (1974) A token economy project with chronic schizophrenic patients. British Journal of Psychiatry, 124, 367–84.CrossRefGoogle ScholarPubMed
Bridge, G. W. K. (1974) Review of token economy studies using general assessment procedures. Unpublished report, Department of Psychiatry, Leeds University.Google Scholar
Burdock, E. I. & Hardesty, A. S. (1968) Psychological tests for psychopathology. Journal of Abnormal Psychology, 73, 62–9.CrossRefGoogle ScholarPubMed
Carlson, C. G., Hersen, M. & Eisler, R. M. (1972) Token economy programs in the treatment of hospitalized adult psychiatric patients: current status and recent trends. Journal of Nervous and Mental Disease, 155, 192–204.CrossRefGoogle ScholarPubMed
Creer, C. & Wing, J. (1974) Schizophrenia at home. A report by the National Schizophrenia Fellowship, London.Google Scholar
Davison, G. C. (1969) Appraisal of behavior modification techniques with adults in institutional settings. In Behavior Therapy: Appraisal and Status (ed. Franks, C. M.), pp 220–78. New York: McGraw-Hill.Google Scholar
Elliott, P. A., Barwell, F., Hooper, A. & Kingerlee, P. E. (1976) The token economy package: social versus token reinforcement. Paper presented at the Annual Conference of the British Association for Behavioural Psychotherapy, Exeter.CrossRefGoogle Scholar
Fraser, D., McLeod, W. L., Begg, J. C., Hawthorne, J. H. & Davis, P. (1976) Against the odds: the results of a token economy programme with long-term psychiatric patients. International Journal of Nursing Studies, 13, 55–63.CrossRefGoogle ScholarPubMed
Freeman, T., Cameron, J. L. & McGhie, A. (1958) Chronic Schizophrenia. London: Tavistock Publications.Google Scholar
Gorham, D. R. & Green, L. W. (1970) (with critical comments by Caldwell, L. R. & Bartlett, E. R.) Effect of operant conditioning techniques on chronic schizophrenics. Psychological Reports, 27, 223–34.CrossRefGoogle ScholarPubMed
Gripp, R. F. & Magaro, P. A. (1974) The token economy program in the psychiatric hospital: A review and analysis. Behavior Research and Therapy, 12, 205–28.CrossRefGoogle ScholarPubMed
Hall, J. N. (1974) Inter-rater reliability of ward rating scales. British Journal of Psychiatry, 125, 248–55.CrossRefGoogle ScholarPubMed
Hall, J. N. (1977) The content of ward rating scales for long-stay patients. British Journal of Psychiatry, 130, 287–93.CrossRefGoogle ScholarPubMed
Hall, J. N., Baker, R. & Hutchinson, K. (1977) A controlled evaluation of token economy procedures with chronic schizophrenic patients. Behaviour Research and Therapy. In press.CrossRefGoogle Scholar
Hamilton, M., Smith, A. L. G., Lapidus, H. E. & Cadogan, E. P. (1960) A controlled study of thiopropazate dihydrochloride, chlorpromazine and occupational therapy in chronic schizophrenics. Journal of Mental Science, 106, 40–55.CrossRefGoogle Scholar
Hersen, M. & Eisler, R. M. (1971) Comments on Heap, Boblitt, Moore and Hord's ‘Behaviour-milieu therapy with chronic neuropsychiatric patients’. Psychological Reports, 29, 583–6.CrossRefGoogle Scholar
Kazdin, A. E. & Bootzin, R. R. (1972) The token economy: an evaluative review. Journal of Applied Behavior Analysis, 5, 343–72.CrossRefGoogle ScholarPubMed
Marks, J., Sonoda, B. & Schalock, R. (1968) Reinforcement versus relationship therapy for schizophrenics. Journal of Abnormal Psychology, 73, 397–402.CrossRefGoogle ScholarPubMed
Mumford, S. J., Patch, I. C. L., Andrews, N. & Wyner, L. (1975) A token economy ward programme with chronic schizophrenic patients. British Journal of Psychiatry, 126, 60–72.CrossRefGoogle ScholarPubMed
Pattie, A., Williams, A. & Emery, D. (1975) Helping the chronic psychiatric patient in an industrial therapy setting. British Journal of Psychiatry, 126, 30–3.CrossRefGoogle Scholar
Presly, A. S., Black, D., Gray, A., Hartie, A. & Seymour, E. (1976) The token economy in the National Health Service: possibilities and limitations. Acta Psychiatrica Scandinavica, 53, 258–70.CrossRefGoogle ScholarPubMed
Shean, G. D. & Zeidberg, Z. (1971) Token reinforcement therapy: a comparison of matched groups. Journal of Behaviour Therapy and Experimental Psychiatry, 2, 95–105.CrossRefGoogle Scholar
Steffy, R. A., Hart, J., Craw, M., Torney, D. & Marlett, N. (1969) Operant behaviour modification techniques applied to a ward of severely regressed and aggressive patients. Canadian Psychiatric Association Journal, 14, 59–67.CrossRefGoogle Scholar
Stoffelmayr, B. E., Faulkner, C. E. & Mitchell, W. S. (1973) The rehabilitation of chronic hospitallized patients—a comparative study of operant conditioning methods and social therapy techniques. Final report to the Scottish Home and Health Department, August.Google Scholar
Stone, A. A. & Eldred, S. H. (1959) Delusion formation during the activation of chronic schizophrenic patients. Archives of General Psychiatry, 1, 77.CrossRefGoogle ScholarPubMed
Wincze, J. P., Leitenberg, H. & Agras, W. S. (1972) The effects of token reinforcement and feedback on the delusional verbal behavior of chronic paranoid schizophrenics. Journal of Applied Behavior Analysis, 5, 247–62.CrossRefGoogle ScholarPubMed
Winkler, R. C. (1970) Management of chronic psychiatric patients by a token reinforcement system. Journal of Applied Behavior Analysis, 3, 47–55.CrossRefGoogle ScholarPubMed
Wing, J. K. (1961) A simple and reliable subclassification of chronic schizophrenia. Journal of Mental Science, 107, 862–75.CrossRefGoogle ScholarPubMed
Wing, J. K. & Brown, G. W. (1970) Institutionalism and Schizophrenia. Cambridge: University Press.CrossRefGoogle Scholar
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