The Evolution of the Token Economy: From its Origins to Current Use in an Adolescent Treatment Program
Christensen, Marin T.
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The token economy utilizes operant conditioning, reinforcing targeted behaviors through tokens that are exchanged for goods or privileges. Ayllon & Azrin (1968) published a landmark study applying the principles to a clinical population. Paul & Lentz ( 1977) demonstrated the token economy to be an effective and economical means of treatment. This work was extended to many other populations, including juvenile delinquents. Critics of the token economy oppose operant conditioning as abusive and argue it does not address patient needs. There remains criticism that some patients do not respond and effects do not generalize. Token economy programs face barriers due to staff unfamiliar with the theory, insufficient staffing or resources, and shortened length of stay. Although there are strategies for overcoming these barriers, some may be insurmountable by a traditional token economy. Borgess Behavioral Medicine Adolescent Treatment Program utilizes a token economy to motivate participation and compliance with program rules. The new system successfully accomplished this, but continues to be difficult for staff to implement.