Described is an Operant Conditioning-Token Economy Program, teaching patients to be responsible for their own behavior, to make choices, and to be motivated to change. The program was instigated with mentally ill patients in a state hospital and was later used with institutionalized mentally handicapped groups. After two years, only four of the original 140 chronic regressed schizophrenics had not progressed enough to be placed in the community. The problems of the seven operant conditioning-token economy programs set up are discussed and suggestions for successful planning and implementation are made. Considered are the main features of preparation, staff orientation, clarification of terms, mechanics of the basic reinforcement program, and construction of individual behavior modification plans. Sample forms for collecting observational data and maintaining complete information on behavior modification programs are included. (KW)