REAL-WORLD INPATIENT PROGRAMS - SHEDDING SOME LIGHT - A CRITIQUE

This critique is a response to an article by Morisse, Batra, Hess, Sil verman, and Corrigan (1996), in which ''a token economy for the real w orld'' is promulgated as an alternative to the comprehensive social-le arning program and assessment technology presented by Paul and Lentz ( 1977). The article misrepresents the treatment-and-assessment procedur es that have been empirically validated as the most effective and cost -efficient for inpatient programs, The article also inappropriately ci tes the results of prior reports as support for an oversimplified appr oach to the development and implementation of inpatient programs. The promoted approach is in direct opposition to the widely recognized nee d for empirically validated interventions and evaluations in mental he alth services. Not only are data lacking to support assertions of effe ctiveness for the resulting program but illustrative examples demonstr ate technically unsound procedures as well as an ethically questionabl e emphasis on staff desires to the exclusion of patient needs. We atte mpt to correct Morisse et al.'s inaccuracies and misconceptions regard ing the work of Paul and colleagues, note the major problems with thei r perfunctory approach, and provide recommendations for implementation and maintenance of empirically validated procedures for inpatients.