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Clinical Update

Establishing a Token Economy in a Psychiatric Unit: Guidelines and Benefits

July 1, 2024

J. Brandon Birath, PhD and Victoria Hendrick, MD

J. Brandon Birath, PhD. Director of Psychology Training, Olive View-UCLA Medical Center, Los Angeles, CA.

Victoria Hendrick, MD. Chief, Inpatient Psychiatry, Olive View-UCLA Medical Center, Los Angeles, CA; Editor-in-Chief, The Carlat Hospital Psychiatry Report.

Dr. Birath and Dr. Hendrick have no financial relationships with companies related to this material.

Token economies utilize a system where positive behaviors are rewarded with tokens that can be exchanged for desired items or privileges, fostering increased patient engagement and autonomy. We outline the essential steps for initiating and overseeing a token economy within a psychiatric unit.

Research Update

Antipsychotics in Inpatient Children and Adolescents with Seclusion and Restraint

August 1, 2023

Susie Morris, MD.

Susie Morris, MD. Dr. Morris has no financial relationships with companies related to this material

How effective are antipsychotic agents in reducing agitation in kids? According to this study, they don’t seem all that helpful, at least not in terms of reducing kids’ time in seclusion or restraints. While several confounding factors complicate the authors’ conclusions, try alternative interventions, like behavioral approaches, until we have more definitive data.

Telehealth for Inpatient Psychiatry: Strategies in the Age of COVID-19

March 26, 2020

Daniel Carlat, MD

Social distancing is very difficult on our typically crowded and small inpatient units. The ultimate social distancing technique is to avoid setting foot in the unit, which is where telehealth comes in.

Should We Allow Smartphones on the Psych Unit?

September 25, 2019

It’s a bit of dogma that goes rarely challenged in inpatient psychiatry—patients can’t use smartphones. There are multiple reasons for this, ranging from privacy issues (patients might Instagram other patients), clinical issues (patients might isolate themselves and not go to groups), safety issues (they might break and use the screen...