Management of schizophrenia

Question 1

Token economies

Answer 1

A from of behaviour modification, where desirable behaviour are encouraged by the use of selective reinforcement

Question 2

What approach is token economy based on

Answer 2

Behaviourism

Question 3

What principle of behaviourism is token economy using

Answer 3

Operant conditioning

Question 4

What is involved in token economy

Answer 4

• Behaviour modification
• Operant conditioning
• Token = SR
• Reward = PR
• Token has value once they receive the reward (learn association- given together)
• Immediate = best effect

Question 5

What is the Primary reinforcer is token economy

Answer 5

Reward (sweets, magazine or trip outside)

Question 6

What is the Secondary reinforcer is token economy

Answer 6

Token

Question 7

Developing token economies with SZ (Ayllon and Azrin)

Answer 7

• Every time they carried out desirable task (make bed or clean up) = Token
• Tokens exchanged for privileges
• No. of tasks increased sig

Question 8

Why has there been a decrease in usage of token economy for SZ now

Answer 8

Due to more long term psychiatric hospitals being closed down due to ethical issues

Question 9

Rationale for token economies

Answer 9

• Institutionalisation
• People can develop bad habits (stop maintaining good hygine) due to living outside with a lack of routine and little pleasures in life

Question 10

Matson (2016) stated that there were 3 types of institutionalised behaviour, what are they?

Answer 10

1) Personal care
2) Condition-related behaviour (apathy)
3) Social behaviour

Question 11

What are the benefits of modifying institutional behaviour through TE

Answer 11

1) Improve the persons quality of life within hospital setting
2) Normalises behaviour to make it easy for people in care to adapt back into normal life

Question 12

Management of SZ evaluation points- Evidence of effectiveness

Answer 12

STRENGTH

7 high quality studies in hospital setting showed a decrease in negative symptoms and unwanted behaviour (Glowaki)

Question 13

Management of SZ evaluation points- Evidence of effectiveness counterpoint

Answer 13

LIMITATION

• A small evidence base (7 studies)
• One issue is the file drawer problem
• only positive results published

Question 14

Management of SZ evaluation points- Ethical issues

Answer 14

LIMITATION

• Professionals have the power to control behaviour
• Impose their norms and values
• Restrict pleasures
• Increase legal activity from families of SZ
• Benefits outweighed by reduction in quality of life

Question 15

Management of SZ evaluation points- Alternative approaches

Answer 15

LIMITATION

• Other approaches
• Art therapy
• No ethical abuse