Improving Behavior in a Residential Service for Youth in Drug and Alcohol Rehabilitation

Abstract

A token reinforcement program, named 'Thumbs Up', was introduced in a residential therapeutic community for drug and alcohol rehabilitation. Sixteen young people aged 14-17 years participated for varying durations. Participants were able to negotiate target behaviors and choose backup reinforcers. We evaluated the program within a multiple baseline design across participants, settings, and behaviors. Improvements occurred in positive verbal statements across settings, timely room cleaning, and leadership responsibilities. Inappropriate statements were also measured and did not change. One staff member was trained in the use of Thumbs Up with positive results. Difficulties with implementing behavioral interventions in a non-behaviorally oriented treatment service were identified. Despite needing refinements, it was concluded that a token reinforcement program can be an effective and acceptable means of improving behavior within a therapeutic community framework.

Training Employment Acquisition Skills for Adolescents with a Substance Abuse History

“…The most significant limitation of the study concerned retention of participants in the facility, which was a sine qua non of participating in the job acquisition program. The same difficulty had been noted in our reports on a token economy (Taylor & Mudford, ) and on improving preparedness for adventure activities (Taylor et al, ) at the same facility. Although residents in senior levels at the facility generally stayed for longer, six of nine participants left without completing the entire job acquisition program.…”

“…We had conducted other behavioral research in the same organization (Taylor, Anderson, & Mudford, ; Taylor & Mudford, ). The center accommodated a maximum of 11 residents at any time.…”

“…A token economy (Taylor & Mudford, ) was already in place at the facility, and was used to reward participation, but not performance, in the employment acquisition skills program. Tokens could be used to purchase items such as candy, art supplies, or activities such as table tennis or using the guitar.…”

Residential interventions with justice involved youths.

“…For example, staff retention and turnover (Connor et al, 2003), burnout (Seti, 2008), compassion fatigue (Eastwood & Ecklund, 2008), staff attitudes toward treatment (Ahonen & Degner, 2013), and safety concerns (Orlando, Chan, & Morral, 2003) have all been related to implementing effective programs in residential settings. In addition, the effectiveness of behavior management programs (Holmqvist, Hill, & Lang, 2009;Taylor & Mudford, 2012), size of the youth census (Sternberg et al, 2013;Walker & McCormick, 2004), proportion of highly delinquent peers relative to total census (Dodge & Sherrill, 2006), length of stay (Jones, Chancey, Lowe, & Risler, 2010;Sternberg et al, 2013), and physical plant issues (e.g., layout, surveillance; M. Scott, 2009;Underwood, Warren, Talbott, Jackson, & Daily, 2014)…”