The token economy program in the psychiatric hospital: a review and analysis

Reports of token economy programs with hospitalized psychiatric patients are reviewed with emphasis on three general aspects of function :(1) effectiveness. (2) factors influencing effectiveness, and (3) experimental methodology. Token economies are effective in modifying a wide variety and range of patient behavior, but it is still unclear which variable or combination of variables operating in the program are primarily responsible for the changes effected. The methodological aspects of program evaluation were found to be less than adequate in most cases because of failure to control probable operational variables. A systems analysis of the token economy program was offered in which influential aspects of the program including feedback effects were recognized and accounted for in conceptualizing function and evaluation.