Schwab, Avi-Yonah M.. Does graduation from a token economy predict long-term outcomes of a residential treatment program?. Retrieved from https://doi.org/doi:10.7282/T3RX9CDK
DescriptionToken economies are efficacious and widely-used treatments for disruptive adolescents in residential settings. However, the literature suggests that positive effects of these treatments may not maintain or generalize when artificial reinforcement is no longer available. Theory and research from both social and behavioral psychology suggest that generalization could be enhanced if acute behavior change in token economies is followed by a phase that emphasizes self-regulation training and natural and logical consequences over token reinforcement. At Girls and Boys Town's family-style residential program for youth with multiple behavioral and environmental problems, youth who succeed in the program progress through motivation system levels, from traditional token economy levels to a motivation system that emphasizes self-regulation and natural and logical consequences. It was hypothesized that youth who ended their treatment at higher motivation system levels would have better outcomes at 5-16-year follow-up, even when controlling for a proxy of general success in the treatment program (Favorable Departure Rating). One cohort of former residents was surveyed 16 years, on average, after departure (n = 207; 42% of the total cohort), and another cohort of former residents was surveyed 5 years after departure (n = 131; 61% of the total cohort). Data on respondents were also collected from treatment records. Analyses of the 16-year follow-up group suggested that discharge from higher motivation systems positively predicted educational attainment, household income, and military service and marginally predicted locus of control and happiness. However, when controlling for Favorable Departure, motivation system marginally predicted only two outcomes. Favorable Departure was a more reliable predictor of happiness, highest grade completed, and (marginally) respondents' retroactive evaluation of the treatment at follow-up than motivation system was. Neither measure significantly predicted outcome on 13 other long-term outcome measures. In the 5-year follow-up group, motivation system was again a strong predictor of military service, even when controlling for Favorable Departure. However, neither motivation system nor Favorable Departure was a significant predictor of any of the other 16 long-term outcome measures. Exploratory analyses of predictors of post-treatment success and long-term follow-up outcomes of residential treatment were also conducted. Extensive recommendations for follow-up research are offered.