Management of Schizophrenia Flashcards
What is a token economy?
Behavioural modification where desirable behaviours are encourage by selective reinforcement (given rewards)
=> Tokens with no value exchanged for privileges
Who is token economies used for?
Often those with maladaptive behaviour patterns through long term institutionalisation
=> e.g. poor hygiene, lack of socialisation
Effects of Token Economies
- Modifies behaviours, doesn’t cure SZ
=> improves quality of life of those in hospitals
=> normalises behaviour to allow transition back into community
How Token Economies Work
Under principles of operant conditioning
- perform a desired behaviour (e.g. take a shower) => token given as immediate reinforcer (delayed is less effective)
(S) Evidence for effectiveness
Glowacki et al (2016) - identifies 7 studies between 1999-2013 on TE’s effectiveness in hospitals
=> all studies showed reduction in negative symptoms + decline in freq. of unwanted behaviour
Supports => value of token economies
COUNTER to effectivenes of TEs
7 studies is a small evidence base
=> likely has ‘file drawer problem’ - bias towards publishing positive findings
Means => serious question over token economies’ effectiveness
(L) Ethical Issues Raised
- Professionals have power to control behaviour by imposing own norms on others
- Restricts availability of pleasure to those who don’t behave as desired - those with distressing symptoms suffer further
Means => pros of TEs may be outweighed by impact on freedom + short term reduction of quality of life
(L) Existence of more pleasant ethical alternatives
e.g. art therapy - high gain low risk approach to managing SZ (Chiang et al, 2019)
- despite having modest results, this is true to all treatment and management of SZ
Means - art therapy may be a pleasant alternative to TEs - no side effects or ethical abuses
