The lack of motivation of the patients, the poor relations between ward-staff and patients and the lack of job satisfaction of nursing staff are some problems pointed out in treating chronic patients.
As a contribution to the solution of these problems, a token economy is proposed.
In this first paper about a T.E. program with 30 male chronic patients, the preparation of the program, procedures, target behaviours of the basic program and the effects of token reinforcement upon specific behaviours are described.
After one year, all behaviour reinforced had increased in comparison with base-line condition.
The importante of adequate training of personnel, carefuil descripton of procedures, the integration of industrial and other activity programs into the token progam and communication with other parts of the hospital are discussed.
The problem of 'deprivation' of the patients, sometimes mentioned by critical reviewers is recognized; it was argumented that introduction of new reinforcers and the increase of the number of reinforcers is more acceptable than letting patients pay for those few things they still have.