Long-Term Effects of a Simple Contingency Management Program with Chronic Psychiatric Patients

Numerous reports have described effective group contingency behavioral programs, i.e., token economies (Ayllon & Azrin, 1968). Due to staff shortages and legal restraints (Wexler, 1974) many ward-wide programs are difficult to implement. The present study provided long-term data on a program which may avoid many current difficulties. A ward of chronic male psychiatric patients whose duration of hospiralization ranged from 2 to 98 mo. served (N = 39 to 43; age = 19 to 55 yr., M = 34; IQ 70). Psychiatric diagnoses included 80% sch~zophrenia, chronic undifferentiated type; 5% mentally retarded, highly aggressive; and 15% other psychotic diagnoses. Nine measures were recorded in each of three categories: (1) required maintenance duties completed, e.g., getting up, dressing, making bed; (2) attending activity therapies; and (3) following directions, e.g., on walks, going for medication. Patients were monitored from 7 a.m. to 9 p.m. Ten days of baseline preceded a neatment of candy, coffee, and cigarette reinforcers presented on a 1%-hr. fixed DRO schedule contingent on completion of targeted activities staggered across the full day of programming. These items were in addition to those patients could provide themselves. TABLE 1 MEAN PBRCBNTAGB OF TARGET BBHAVIORS COMPLBT~D DURING THREE PERIODS

Contingency · Contingency management · Intervention (counseling · Psychiatry · Simple (philosophy · Term (time · Behavioral and Psychological Studies · Psychology