Modification of interactive behaviors in chronic mental patients.

Two adults in a state hospital earned plastic tokens when they talked or worked together.

The study used an ABAB design. Tokens were given only when both people did the target action in that phase.

The pair could trade tokens for snacks, cigarettes, or activity passes.

Tokens lifted social talk and cooperative work. When tokens stopped, the skills dropped.

Skills came back when tokens returned and spread to new places like the day room.

Winkler (1970) tried tokens three years earlier on the same kind of adults. That study paid for quiet, tidy behavior. The new study shows tokens also grow social skills, not just stop problem acts.

Krentz et al. (2016) used the same token idea with adults who have intellectual disabilities. They paid for walking laps instead of talking. Both studies show tokens work across very different skills.

Marcucella et al. (1978) looks like a clash. They found three people had longer talks when all three had to be present. Our 1973 paper used only two people and still got more talk. The gap is the setting: H used healthy adults in a lab; we used hospital patients in real wards.

You can run a tiny token economy on just two clients. Pick one social skill they both need, pay only when both do it, and watch the talk grow. Keep the store open daily so the skill stays strong.