Management of schizophrenia

Question 1

Developing token economies with schizophrenia

Answer 1

• classic demonstration carried out by Ayllon and Azrin (1968) who trialled a token economy system in a ward of women with schizophrenia
• every time a participant carried out a simple task such as making their bed they were given a plastic token
• the token could be swapped for ward privileges
• The number of tasks carried out increased significantly
• extensively used in the 60s and 70s when the norm for treating schizophrenia was long term hospitalisation

Question 2

rationale for token economies

Answer 2

• an outcome of institutionalisation is the development of bad habits like ceasing to maintain good hygiene
• Matson et al (2016) identified 3 categories of institutional behaviour commonly tackled by token economies
• personal care,condition related behaviours and social behaviour
• has two main benefits : improves the person quality of life within the hospital setting and normalises behaviour, making it easier for people who have spent time in hospital to adapt back into life in the community

Question 3

what is involved in a token economy

Answer 3

• tokens are immediately given to individual when they carry out a desirable behaviour
• tokens are swapped later for more tangible rewards
• having some form of immediate reward for target behaviour is important as delayed rewards are less effective
• tokens are administrated as soon as possible after a target behaviour

Question 4

theoretical understanding of token economies

Answer 4

• example of behaviour modification - behavioural therapy based on operant conditioning
• tokens are secondary reinforces because they only have value once the person receiving them has learned that they can be used to obtain meaningful rewards
• meaningful rewards are primary reinforces
• in order for tokens to become secondary reinforces they are paired with primary reinforces

Question 5

strengths of token economies

Answer 5

1. evidence of effectiveness
   - Glowacki et al (2016) identifed 7 high quality studies publisjed between 1999 and 2013 that examined the effectivness of token economies for people with schizophrenia