Token economy approaches for psychiatric patients. Progress and pitfalls over 25 years.

Glynn (1990) looked back at 25 years of token economies in psychiatric hospitals.

The paper is a narrative review, not a new experiment.

It charts when token systems worked, when they faded, and why many wards dropped them.

Token economies reliably improved self-care, reduced aggression, and increased participation.

Yet by 1990 most hospital units had stopped using them.

Staff turnover, union push-back, and lack of carry-over to community life were the main killers.

Alba et al. (1972) and Weitz (1982) told the same story earlier: tokens work but generalization fails.

Regnier et al. (2022) later showed you can fix the fade-out by thinning token schedules and adding self-management.

degli Espinosa et al. (2024) now supersedes Glynn (1990) with step-by-step checklists that tackle the exact pitfalls named in 1990.

Kaiser et al. (2022) extends the idea to elementary schools, proving large effects still happen when you tailor backup reinforcers to general-ed versus special-ed rooms.

If you run a token system today, you are repeating a proven method that once died from poor maintenance. Use the new checklists, train staff with a manual like Gutierrez et al. (2020), and build thinning plus self-monitoring into the plan from day one. Your clients keep the gains, and your program survives staff changes.