Token programs in an acute psychiatric hospital.

The author has used individually prescribed token economies with about 5 percent of his acute psychiatric inpatients. Previous reports have dealt primarily with chronic patients. Case reviews indicated that patients chosen for these programs fell into four categories (which are illustrated by case histories): depressed complainers, apathetic and withdrawn patients, agitated psychotics, and impulsive, acting-out nonpsychotics. The author recommends techniques for patient selection, goal setting, and determination of reinforcers, and suggests that use of token programs may forestall the social breakdown syndrome in very disturbed patients.