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In the past decade there has been an increased awareness of the need for follow-up studies in psychiatry. It has been noted with criticism that systematic 'follow-up of psychiatric patients is remarkably rare.' The need for such studies has been accentuated by the findings of investigators such as Eysenck, Freeman and Simmons, and Lewis which show that the effectiveness of psychotherapy was difficult to establish. The purpose of this paper is to present the follow-up procedure and instrument utilized as an integral part of an experimental behavior modification program with hospitalized character and behavior disorder patients. The statistical findings of this program are being prepared for future publication. Preliminary results have already been presented by Stayer and Jones. The follow-up method described in this paper is a practical attempt to obtain objective and valid data on the long-range effectiveness of the treatment program as well as a means of learning more about this patient population.

A point economy based on operant conditioning theory as best described by Skinner (1938, 1963) and following the pioneer concepts of Ayllon and Azrin (1968) was established with a unique population: hospitalized soldiers diagnosed as character and behavior disorders. The usual handling of such men (discharge to duty with a negative recommendation) would have resulted in a loss of over 70% to a negative outcome. As seen in the comparison group which received positive or neutral recommendations, approximately 50% could be salvaged by this procedure alone, while utilization of a motivational environment based on operant theory resulted in 80% positive outcomes. An additional finding of significance is the value of this system in managing personalities who in other settings have been sources of frustration due to their inappropriate behavior. It is felt that these results indicate applicability in other settings with 'captive' groups such as committed alcoholics, reformatory inmates, etc.