Social Learning/Token Economy Programs

for Schizophrenia

Status: Strong Research Support


Token economy programs are generally used in long-term care setting such as long-stay inpatient units and residential care settings, but can be adapted for shorter stay and less intensive treatment programs as well. They are comprehensive behavioral programs, based on social learning principles, in which participants receive reinforcers (such as tokens or points) for performing clearly defined target behaviors. These reinforcers are provided immediately after a desired behavior and then exchanged at a later time for tangible goods or desired privileges. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. Examples of typical target behaviors include self-care, medication adherence, work skills, and treatment participation. The primary goals of a token economy program are to increase the presence of adaptive behaviors and reduce the frequency of maladaptive or inappropriate behaviors, with the ultimate goal of preparing each participant for greater independence and improved functioning. Token economy programs appear to be most effective when implemented in the context of appropriate medication management, individualized treatment planning, and other evidence-based psychosocial treatments.

Key References (in reverse chronological order)

Clinical Resources

Training Opportunities

Steven M. Silverstein, Ph.D.
Director, Division of Schizophrenia Research University of Medicine
and Dentistry of New Jersey University Behavioral Health Care, and
Dept. of Psychiatry, Robert Wood Johnson Medical School
151 Centennial Avenue
Piscataway, New Jersey, 08854
Phone: (732) 235-5149
Wendy Tenhula, Ph.D. VA Capitol Health Care Network Mental Illness Research,
Education and Clinical Center
10 N. Greene Street, BT/MIRECC
Baltimore, MD 21201