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The Modification of Schizophrenic Behavior

McLean Hospital and Harvard Medical School

The literature on treatment of schizophrenic behavior through operant conditioning, token economy, systematic desensitization, and social skills training was reviewed. Results from these studies indicate that operant procedures (particularly token economy) and skills training techniques are useful in altering some of the behaviors characterizing schizophrenia-most notably the regressed functioning associated with the "social breakdown syndrome," and components of appropriate social interaction. However, generalization and maintenance of appropriate behaviors after the patient has left the treatment program are more problematic. Equivocal results obtained with operant treatments of vocal psychotic symptoms suggested the need for a more complex analysis of the factors which contribute to hallucinations and delusions, and perhaps increased exploration of the utility of cognitive-behavioral approaches. The practical and ethical issues raised by procedures which include punishment of violent behavior are discussed.

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