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The token economy
1. Behov.
Ther. & Exp. Psychral.
Vol. 9. pp. 91-92. Pergamon Press, 1978. Printed in Great Britain
BOOK REVIEWS Handbook of Behavior Modification and Behavior Therapy
By HAROLD LEITENBERG Prentice-Hall,
(Ed.)
Englewood Cliffs, N.J., 611 pp. desensitization or aversion therapy, meaningful comparisons are impossible. Some, undoubtedly, would be receiving therapy inappropriate to them as determined by a behavior (functional) analysis. This same issue is evident in other areas and is nicely explicated by Shapiro and Surwit in their chapter titled “Learned Control of Physiological Function and Diseases”. Regarding biofeedback treatment for essential hypertension, they state: “Mean arterial pressure is determined by cardiac output and total peripheral resistance. Though cardiac output and peripheral resistance are somewhat interrelated functions, they can also be seen to be independent in the etiology of hypertension. For instance, patients suffering from sustained hypertension are known to have increased peripheral resistance but normal cardiac output, while patients displaying labile hypertension show increased cardiac output and normal peripheral resistance. In deciding to use biofeedback for treating hypertension, different procedures might be indicated depending upon the stage of hypertension.” The handbook is an important contribution to the field of behavior therapy. Its reviews are excellent but a careful reading points out some of the difficulties in generalizing from past research. The field still has far to go to determine what kinds of treatment are effective for what kinds of patients under what conditions. STEVEN C. FISCHER Department of Psychiatry, Temple University Medical School c/o &stern Pennsylvania Psychiatric Institute Philadelphia, Pa. 19 129
This handbook contains 18 original chapters encompassing a wide range of subjects. There are three main headings: adults, children and youth, and general. Within each heading are reviews of major areas of interqst to both clinicians and researchers. The idea for this handbook, as stated by Leitenberg in the preface, was to “put together a text on behavioral research and mental health . . as applied to treatment and prevention of behavior disorders in adults and children”. To this end the authors have succeeded. Most chapters give a general historical overview of their areas plus a comprehensive behavioral review of the literature. The handbook itself if excellent. This single volume has the most complete reviews of any book to date. The shortcomings are not of the handbook itself, but of the behavior therapy field. For example, Marks’ review of firm sexual disorders is superb. Unfortunately, generalizations from research literature in this area and others in the handbook are inconclusive on two counts: (1) researchers tend to be primarily interested in topography, and (2) this may lead to inappropriate comparisons. Bancroft is cited by Marks as comparing aversion therapy and desensitization for homosexuals. If one is interested only in topography, this is a legitimate comparison; but it is likely that there are subgroups of homosexuals with differing problems functionally related to their homosexuality that call for different treatments. Some male homosexuals seeking treatment may lack heterosexual social skills and/or have anxiety upon making sexual responses to women. Others may have these skills, but simply find themselves aroused by men. If all these are pooled and randomly assigned to subjects
The Token Economy
by ALAN E. KAZDIN Plenum Publishing Corporation, The main purpose of this book is to provide an extensive, scholarly review and evaluation of research on token economies. While the book is written primarily for the researcher, it is relevant also for the practitioner, since
New York, $16.95
favorable therapeutic outcome is enhanced by attention to the empirical data bearing on treatment options. The book is quite broad in scope. The author begins with an overview of operant conditioning principles and the 91
92
BOOK REVIEWS
historical antecedents of today’s token economies. In the sequel he discusses such issues as the influence of selfadministration and peer administration of contingencies, modeling and vicarious reinforcement processes as additions to the token economy, the role of punishment in the token economy, generalization and maintenance of behavior change, selection of target behaviors, the application of economic principles to token economies, the diverse settings in which token economies have been established, and current legal and ethical implications involved in establishing a token economy. The author concludes that the existant research is favorable to token economy programs. However, as is his style, Kazdin’s objective review of the research indicates not only the strengths but also the weaknesses. Behavior modification procedures do not have to be perfect; the crucial issue is how they compare with the therapeutic alternatives currently available. Kazdin suggests that the available evidence indicates that token economies enhance client welfare and performance more than traditional institutionalization and more than various types of insight and nonspecific therapies; but notes that there is a paucity of outcome research on which to base conclusions.
The book is also forward looking. In light of the current legal decisions restricting behavior modification programs, the author suggests that token economies applied to institutional staff can indirectly benefit clients. He cites research indicating that such an approach can be quite beneficial in producing targeted behavior change as well as improving the quality of staff contact with clients. This strategy not only serves the client’s interests but also avoids legal and ethical problems. Consequently, it would provide token economists with a wider range of institutions and problems with which to work. Kazdin also discusses the use of token programs in social contexts, with behaviors relevant to such areas as energy conservation, pollution and job procurement. Overall, the book is excellent. It has elevated token economy research to a topic significant in its own right. No longer is the token economy simply a behavior modification technique. This book will provide numerous research topics and will be quoted often in the years to come. RALPHM.TURNER Department of Temple University School Philadelphia, 19129
Ther. & Exp. Psychral.
Vol. 9. pp. 91-92. Pergamon Press, 1978. Printed in Great Britain
BOOK REVIEWS Handbook of Behavior Modification and Behavior Therapy
By HAROLD LEITENBERG Prentice-Hall,
(Ed.)
Englewood Cliffs, N.J., 611 pp. desensitization or aversion therapy, meaningful comparisons are impossible. Some, undoubtedly, would be receiving therapy inappropriate to them as determined by a behavior (functional) analysis. This same issue is evident in other areas and is nicely explicated by Shapiro and Surwit in their chapter titled “Learned Control of Physiological Function and Diseases”. Regarding biofeedback treatment for essential hypertension, they state: “Mean arterial pressure is determined by cardiac output and total peripheral resistance. Though cardiac output and peripheral resistance are somewhat interrelated functions, they can also be seen to be independent in the etiology of hypertension. For instance, patients suffering from sustained hypertension are known to have increased peripheral resistance but normal cardiac output, while patients displaying labile hypertension show increased cardiac output and normal peripheral resistance. In deciding to use biofeedback for treating hypertension, different procedures might be indicated depending upon the stage of hypertension.” The handbook is an important contribution to the field of behavior therapy. Its reviews are excellent but a careful reading points out some of the difficulties in generalizing from past research. The field still has far to go to determine what kinds of treatment are effective for what kinds of patients under what conditions. STEVEN C. FISCHER Department of Psychiatry, Temple University Medical School c/o &stern Pennsylvania Psychiatric Institute Philadelphia, Pa. 19 129
This handbook contains 18 original chapters encompassing a wide range of subjects. There are three main headings: adults, children and youth, and general. Within each heading are reviews of major areas of interqst to both clinicians and researchers. The idea for this handbook, as stated by Leitenberg in the preface, was to “put together a text on behavioral research and mental health . . as applied to treatment and prevention of behavior disorders in adults and children”. To this end the authors have succeeded. Most chapters give a general historical overview of their areas plus a comprehensive behavioral review of the literature. The handbook itself if excellent. This single volume has the most complete reviews of any book to date. The shortcomings are not of the handbook itself, but of the behavior therapy field. For example, Marks’ review of firm sexual disorders is superb. Unfortunately, generalizations from research literature in this area and others in the handbook are inconclusive on two counts: (1) researchers tend to be primarily interested in topography, and (2) this may lead to inappropriate comparisons. Bancroft is cited by Marks as comparing aversion therapy and desensitization for homosexuals. If one is interested only in topography, this is a legitimate comparison; but it is likely that there are subgroups of homosexuals with differing problems functionally related to their homosexuality that call for different treatments. Some male homosexuals seeking treatment may lack heterosexual social skills and/or have anxiety upon making sexual responses to women. Others may have these skills, but simply find themselves aroused by men. If all these are pooled and randomly assigned to subjects
The Token Economy
by ALAN E. KAZDIN Plenum Publishing Corporation, The main purpose of this book is to provide an extensive, scholarly review and evaluation of research on token economies. While the book is written primarily for the researcher, it is relevant also for the practitioner, since
New York, $16.95
favorable therapeutic outcome is enhanced by attention to the empirical data bearing on treatment options. The book is quite broad in scope. The author begins with an overview of operant conditioning principles and the 91
92
BOOK REVIEWS
historical antecedents of today’s token economies. In the sequel he discusses such issues as the influence of selfadministration and peer administration of contingencies, modeling and vicarious reinforcement processes as additions to the token economy, the role of punishment in the token economy, generalization and maintenance of behavior change, selection of target behaviors, the application of economic principles to token economies, the diverse settings in which token economies have been established, and current legal and ethical implications involved in establishing a token economy. The author concludes that the existant research is favorable to token economy programs. However, as is his style, Kazdin’s objective review of the research indicates not only the strengths but also the weaknesses. Behavior modification procedures do not have to be perfect; the crucial issue is how they compare with the therapeutic alternatives currently available. Kazdin suggests that the available evidence indicates that token economies enhance client welfare and performance more than traditional institutionalization and more than various types of insight and nonspecific therapies; but notes that there is a paucity of outcome research on which to base conclusions.
The book is also forward looking. In light of the current legal decisions restricting behavior modification programs, the author suggests that token economies applied to institutional staff can indirectly benefit clients. He cites research indicating that such an approach can be quite beneficial in producing targeted behavior change as well as improving the quality of staff contact with clients. This strategy not only serves the client’s interests but also avoids legal and ethical problems. Consequently, it would provide token economists with a wider range of institutions and problems with which to work. Kazdin also discusses the use of token programs in social contexts, with behaviors relevant to such areas as energy conservation, pollution and job procurement. Overall, the book is excellent. It has elevated token economy research to a topic significant in its own right. No longer is the token economy simply a behavior modification technique. This book will provide numerous research topics and will be quoted often in the years to come. RALPHM.TURNER Department of Temple University School Philadelphia, 19129