Token Economies to use in a Hospital or Community Setting - Recorded Webinar

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Webinar Duration: 60 minutes

RECORDED: Access recorded version only for one participant; unlimited viewing for 6 months (Access information will be emailed 24 hours after the completion of payment)

SPEAKER: Timothy J. Templin

OVERVIEW:
In hospitals, schools, group homes and in private residential settings, behavior problems are one of the most challenging areas to address. Issues such as physical aggression, self-injury and poor communication and compliance are the very barriers that can keep one from attaining personal independence. Improvements in behavior that free an individual from restrictive methods and punishing contingencies, as well as enable one to live life as he or she chooses, are always a step forward. The problem with many methods of improving behavior is that it is difficult to reinforce appropriate behavior in a timely manner. Conversely, destructive and counter-productive behavior is often reinforced (in surprising ways) much sooner than the opposite.

One of main problem with behavior improvement programs is the reinforcement (for appropriate behavior) comes too far after the time of the replacement behavior. This fundamental problem can be resolved with an innovative technique called the token economy.

In efforts to assist clients in numerous settings achieve autonomy, the token system is one of the most economical, practical and effective methods available. As written about by some of the leading researchers in psychology and behavior analysis, the benefits of token economies are that they may be potent reinforcers, can bridge the gap between the target response and the backup reinforcer and using multiple reinforcers can reduce the likelihood of a client losing interest in one reward or another.

As a behavior specialist, and licensed mental health counselor, I have had many patient/clients with problems of aggression, self-injury, non-compliance or other situations where addressing the problem of behavior was necessary to improve lives and move forward with greater independence. I have found token economy systems to be one of the best methods when working with patients, staff and administrators. The main reasons are that token economies can establish rules with which all parties can become familiar.

As each new challenge and situation comes about, the token economy system is flexible enough to adapt, and yet continues a regimen of reinforcement for improved behavior. In addition, the token economy system can provide a continuity of care, whereby patients who are transferred to other settings and treatment centers can continue with the same system, although with adjustments as necessary, ensure success as they enter a new environment.

In this webinar, examples of token economy systems that were implemented in hospital and community settings are described. In one case, a patient who had been in the psychiatric hospital system for over twenty years was able to start earning tickets to create origami artwork and started to progress from the highest security unit to the ultimate transfer out of the hospital setting. In another, a client completed simple word-matching exercises, so he could participate in a competency to stand trial restoration program.

Another example involved a young woman in a community setting that began earning tokens in a versatile exchange system so she could succeed in the transition from a group home to a more independent setting. The pitfalls and real-life dilemmas of such practices will be honestly reviewed, as well as what remedies the author has found to keep an intervention from "disappearing in a black hole,"or remaining in place as a mere superficial presentation as opposed to a useful, measurable practice.

From: Kazdin, A.E. (2008).Behavior modifications in applied settings (6th ed.).Long Grove, IL: Waveland Press, Inc.

Why should you Attend: In the last few years, numerous state psychiatric facilities have closed nation-wide. At the same time, mental health services in community settings have also been curtailed in many parts of the country. While the modernization of our nation's mental health services reduced options for long-term stays in state facilities, the clients who would once have occupied such places are now being served by other providers. When a client displays severe behavior problems, what are the options available? If a client requires certain skills to maintain independence, how can a service provider best promote the ability to live independently?

Within numerous areas of mental health care, providers witness problems related to habits/behaviors and other significant areas that need to be addressed. Often, mental health practitioners are attempting to "modify"behavior through various methods without the proper understanding of techniques like token economies. The term token economy has been used, sometimes incorrectly, sometimes in a pejorative way and at other instances in an accurate, useful manner. The ease at which token economies can be applied makes them very popular. However, there should be a certain standard in place for a program to be ethical and effective.

Without proper training on the development and implementation of a token economy system, patient progress may be delayed or the behavior problems could even become worse.

Part of the challenge of providing a token economy is the time management and the training of staff. In addition, there has to be an effective way to determine if the client has earned tokens and how many. A behavior specialist, social worker, mental health administrator, or other service provider should become well acquainted with token economy plans to best serve their consumers.

Areas Covered in the Session: The use of a token economy system can be of benefit where:
- There is an identified target behavior
- There is an established inventory of reinforcers for the client to select from
- There is an understanding among the staff serving the client of how the system works

This webinar will cover the above three areas in each case presentation. In addition, some of the history of token economy systems are presented, with a focus on contingency management programs in the correctional and other settings.

Learning Objectives:
- What kind of client/patient situation can a token economy be used to improve?
- Identifying and defining the target (problem) behavior
- Measuring the progress of your token economy system
- Using a baseline-treatment comparison to assess the effectiveness of a program
- Why the focus on positive behavior (those to increase) is important
- Assessing the power of a reward in each case
- What should I, as a one developing a treatment plan, use as tokens? What are the physical items I should provide that would serve as tokens and how should they be distributed?
- Are the tokens I have selected:
- Easy to administer?
- Difficult to duplicate (counterfeit)?
- Easily recordable to account for they are earned and spent?
- What are the backup reinforcers in each case? Why are they so important?

Who Will Benefit:
- BAs
- MA
- PHDs
- JDs
- Others who are Interested in Psychology, Sociology and other Fields will Benefit from the Information Presented

SPEAKER PROFILE:
Mr. Timothy J. Templin a counselor and behavior analyst with many years working in the mental health field. He has made presentations at the Association of Behavior Analysis International, and other similar organizations, in San Antonio, Texas, Denver, Colorado, Indianapolis, Indiana, Nashville, Tennessee, Kyoto, Japan and Gol, Norway. He is the author of a book, When I Was Thirty-Five I Had a Very Good Year, about his fathers art career.

He will be presenting at Association of Behavior Analysis International’s Annual Convention, this year, in San Diego, California, regarding the Behavior Analysis and Crime special interest group. In addition, a poster session will feature Criminal Behaviorology. In development is a regular podcast about Criminal Behaviorology. Mr. Templin has master's degrees in Forensic Psychology (John Jay College of Criminal Justice), Clinical Psychology (University of Indianapolis). He is a licensed mental health counselor and Board Certified Behavior Analyst.
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