L9 Token Economies

Question 1

What are Token Economies in relation to SZ?

Answer 1

• Reward systems used to MANAGE behaviour of SZ patients in hospital settings, especially those who have developed maladaptive behaviour
• Does not cure SZ but improves a patients quality of life and makes it increasingly likely for them to live out of hospital settings

Question 2

What principle are Token Economies based on?

Answer 2

• Based on operant conditioning when the patient is given a reward for carrying out good behaviour (positive reinforcement)
• This should encourage them to repeat good behaviours to receive rewards

Question 3

What are Tokens?

Answer 3

• e.g a coloured disc are given to patients when they carry out a desirable behaviour, e.g have a shower that has been targeted for reinforcement
• These tokens are handed to patients who do something they were previously not/struggling with
• Tokens are given to patients immediately so they associate positive behaviour with a reward rather than a delayed reward

Question 4

What are Rewards?

Answer 4

• Tokens have no tangible value in themselves but are swapped later for tangible rewards
• They act as secondary reinforcers as they only have value once the patient uses them for rewards

Question 5

What are strengths of Token Economies in treating SZ? (3)

Answer 5

No side effects
Flexible therapy
13 studies

Question 6

No side effects (+)

Answer 6

Unlike drug therapy, this form of treating SZ does not face side effects which are damaging to an individual

Question 7

Flexible Therapy (+)

Answer 7

• Token Economies are extremely beneficial as they can are flexible in their nature
• It can easily be altered to meet the demands of each patient and what motivates them to carry out good behaviour

Question 8

13 studies (+)

Answer 8

• Reviewed 13 studies that used token economies to treat SZ
• 11 of them reported beneficial effects which they attributed to the use of token economies
• Concluded that token economies are an effective way of treating SZ

Question 9

What are weaknesses of Token Economies in treating SZ? (2)

Answer 9

Ethical Issues
Only treats a few symptoms

Question 10

Only treats a few symptoms (-)

Answer 10

Token Economies are criticised as they only treat a few symptoms of SZ, but do not treat other ones such as hallucinations and delusions

Question 11

Ethical Issues (-)

Answer 11

• Token Economies could be said to be unethical as patients may be rewarded with things like out door time, recreational activity and food
• This is unethical as it can be seen as manipulation of the patients’ basic human rights to alter their behaviour
• This is doubled up with the fact that it is hard for SZ patients to give informed consent to be a part of a token economy scheme