Function and Disability Journal (Jan 2023)
Token Economy for People With Severe Mental Illness: A Narrative Review of the Literature
Abstract
Background: People with chronic mental illness have long been rejected from society and lost their self-identity and self-efficacy due to individual obstacles, such as continuous negative symptoms, lack of motivation, or social obstacles, like stigma, which reduce their self-confidence and prevent them from engaging in healthy activity patterns. One of the behavioral therapy methods used to increase the motivation of people with severe mental illness is token economy. Objectives: The purpose of this narrative review was to review and investigate the impact of the token economy on people with severe mental illness. Methods: A search for studies published from 2002 to 2022 in PubMed and Google Scholar databases was conducted using the keywords “token economy”, “token reinforcement”, “contingency management”, “severe mental disorder”, “serious mental illness”, “chronic psychiatric disorder”, and “participation”. Results: In the initial search, 92 articles were obtained, and after reviewing and rejecting duplicates, 44 articles related to severe mental illness and token economy remained. Finally, 15 articles met the inclusion criteria and were selected for review. token economy can be an effective method in improving the performance of daily life activities, reducing the symptoms of mental illnesses and avoiding drugs, reducing alcohol consumption, and quitting smoking Conclusion: token economy can be an effective method in improving the performance of daily life activities, reducing the symptoms of mental illnesses, drug abstinence, reducing alcohol use, and quitting smoking, but in reducing violence, the results of the studies were contradictory. It is recommended to carry out wider studies on the impact of the token economy method on the occupational performance and participation of chronic mental patients.
