Token Economy

[krys0922]

Does anyone have any experience utilizing a token economy for inpatient behavior modification. I am trying to implement this inpatient but need some guidance on developing the program and templates. I am not sure how this would work for adults/geriatrics but we need some sort of incentive to get them to participate more. Ideas are welcome..

Thanks

[verene, MSN]

Not in in-patient, but I worked in an ALF that implemented a token economy while I worked there. Residents got "points" which could be redeemed twice a week at the "point store." Points could be earned for a variety of things - meeting room inspection, to volunteering for extra chores around the house, to attending group activities. We had a guide with lists of chores that residents could sign up for (e.g. assisting staff in cleaning up dining hall after meals) with a description of the task and how many points it was worth. Residents could then sign up with a staff member to complete that task. We tried to make it pretty easy for everyone to get at least a few points each week because capacities were different and we didn't want anyone to be completely left out.

The point store was open for a couple of hours twice a week. We stocked a variety of items from snacks and instant/microwavable (non-perishable) meals, to hygiene items that were important for our residents to own but that they didn't want to spend their own money on (most were on very limited income with little to no family support), to fun items like coloring books and markers. We were open to resident suggestions on what we should stock and our actual inventory could vary a bit.

It was really popular with the majority of the residents. Many started doing chores for the points but kept doing it because they felt like they were contributing to their own home which boosted self-confidence. We also saw increased cooperation between residents as some of the more able would help some of the less able complete tasks so that the less able could also earn points or would conduct trades of purchased items.

We started out with the points just being marked in a log by staff, but realized residents liked having something tangible to remind themselves of what they'd accomplished. So our points became house themed monopoly-like money that we would hand out after a task or activity was completed.

Over all it was fairly successful. A few glitches along the way, but I think that is true for any new system.