clients with schizophrenia, who are often resistant to common behavioral treatment approaches. Sometimes the token economy is used as a lasting prosthesis. Sometimes it's used to help such clients reach resocialization. A token economy, in combination with other interventions, succeeded in the community reintegration of 78% of the clients within an average period of 110 days, after more than seven years of uninterrupted hospital stay. Research shows clients experience the token economy with positive reception. Several recent reviews of psychosocial treatment for schizophrenia explicitly mention token economy as an effective, evidence-based treatment and one systematic review specifically examined token economy. The token economy approach may have effects on symptoms such as apathy and poverty of thought, but it is unclear if these results are reproducible, clinically meaningful and are maintained beyond the treatment programme. Acute units The application of token economies has been extended from psychiatric rehabilitation services to acute psychiatric units. A token economy was successful in decreasing the aggression on a ward where clients on average stayed for less than three weeks. Substance abuse As a result of ethical criticism, token economies developed a negative stigma and, as a result, systems were sometimes introduced with aliases. This was especially the case in substance abuse treatment settings (although some systems for smoking cessation continue to use the term token economy). For some time, systems derived from token economies were used under the name contingency management; initially this was more broadly defined and referred to any direct coupling of consequences (reinforcements or punishments) with behavior (for example staying clean ); later it referred specifically to one kind of token economy. The community reinforcement approach can be combined with contingency management; ‘tokens’ are used, whereas contingency management employs the term "vouchers" (or related terms). Research shows this kind of token economy is easily applied outside of hospitals and is effective, allowing for less hospital-based treatment - although contingency management is used in the treatment of drug abuse in both inpatient and outpatient settings. Developmental disorders Token economy has also been applied in settings for adults with developmental disabilities. Target behaviors can vary in types of social behavior and self care, or the decreasing of inappropriate and/or disruptive behavior. Children and adolescents Token economies have been applied to children and adolescents with developmental disabilities as well as in schools. Developmental disabilities A token economy has proven effective in increasing attentiveness and motivation