The most serious research undertaken in the late 60s. of the last century by clinical psychologists J. Ethow and L. Krasner, was devoted to testing the effectiveness of the token reinforcement system as a means of modifying behavior in patients in the psychiatric department of a hospital for veterans, while most of them had previously been diagnosed as chronically ill with schizophrenia, the rest had a head injury. brain.
The study lasted for 20 months and consisted of three stages. The first six months were the main, or operant, period, during which the researchers recorded the frequency of occurrence of the behavior to be sequentially suppressed each day. This was followed by a three-month shaping period, when patients were informed of the activities they had to engage in in order to receive a token and “realize” it in the hospital canteen. Finally, over the course of an 11-month experimental period, patients received tokens for behaving in the desired manner—serving themselves, attending classes, socializing with others, or showing responsibility. Everyone received a token immediately after completing the desired activity, social approval from the staff was expressed by the words «great job» or a smile.
An analysis of the results showed that patients began to behave in the “right” way more often, they had increased initiative, activity, responsibility, and improved social communication skills.
In addition, as reported by J. Athow and L. Krasner, as a result of the use of the token system, the number of regimen violations committed by patients has significantly decreased.
It must be said that representatives of other psychological schools were rather critical of the results obtained by J. Athow and L. Krasner, pointing out that in this case the “Mayo effect” worked, i.e. changes in the behavior of patients were due not so much token reinforcement , how much increased attention to them from both the experimenters and the medical staff of the hospital. However, a number of similar experiments, additionally conducted by supporters of the behavioral approach both in psychiatric clinics (T. Eilon, N. Ezrin), and in groups of ordinary adolescents and adolescents with delinquent behavior (A. Kazdin, R. Butzin), generally confirmed the effectiveness of token reinforcement systems.