Social learning for chronic mental inpatients.

With chronic institutionalized psychiatric patients, an intensive social learning program resulted in greater increases in adaptive functioning, reductions in bizarre behavior, less prescribed medication, and over 98 percent of patients being successfully discharged into the community. The social-learning program was more cost-effective than custodial hospital care, and nonprofessional staff were able to apply the treatment with a high degree of competence. Especially effective elements of the social-learning program included integrated procedures emphasizing the acquisition of patient skills and the reduction of bizarre, inappropriate behavior; a token economy structure; and consistent pacing and generalization training. More recent research in the area has sought to identify the remediative aspects of social-learning programs, to specify patient variables that are related to improvement in a token economy, and to offer patients more specialized interventions (e.g., social skills training) in conjunction with a standard token economy. With the demonstrated and operationalized efficacy of social-learning procedures, the rehabilitation of chronic psychiatric patients has become more feasible.