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Token economy in a hospital rehabilitation system
Author(s) -
Baker Roger
Publication year - 1988
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/j.1365-2648.1988.tb01457.x
Subject(s) - token economy , rehabilitation , psychiatric ward , security token , service (business) , nursing , psychiatric rehabilitation , medicine , psychiatric hospital , psychiatry , psychology , economy , physical therapy , economics , mental health , social psychology , computer science , computer security , reinforcement , mental illness
A ward‐based token economy programme which formed one part ofa larger rehabilitative serviee for long‐stay psychiatric patients is described. The elinical effectiveness ofthe programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is foliowed‐up as they move to different parts ofthe rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts ofthe service. Comparison ofthe present clinical programme with the earlier research programmes on the ward indicated that the present regime was superior. The advantages and problems of token economy as a rehabilitative facility are discussed, outlining the various different roles for token economy with psychiatric rehabilitation. Finally, the future of token economy for long‐stay patients is considered, questioning whether it might more appropriately be replaced by other structured ward programmes.