Glynn S, Mueser K T
Schizophr Bull. 1986;12(4):648-68. doi: 10.1093/schbul/12.4.648.
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.
对于长期住院的精神病患者，一项强化社会学习项目带来了适应性功能的更大提升、怪异行为的减少、药物处方量的降低，以及超过98%的患者成功出院回归社区。该社会学习项目比住院监护治疗更具成本效益，非专业工作人员也能够高度胜任地应用这种治疗方法。社会学习项目中特别有效的要素包括强调患者技能习得和怪异、不适当行为减少的综合程序；代币经济结构；以及持续的节奏训练和泛化训练。该领域最近的研究试图确定社会学习项目的补救方面，明确与代币经济中改善情况相关的患者变量，并结合标准的代币经济为患者提供更专门的干预措施（如社交技能训练）。随着社会学习程序已得到证实的有效性和可操作性，慢性精神病患者的康复变得更加可行。
