Management of schizophrenia

Question 1

What is a token economy?

Answer 1

• A form of behavioral modification, where desirable behavior is encouraged by the use of selective reinforcement.

Question 2

How does it work?-

Answer 2

• Allows patients to live outside the hospital setting by rewarding them with tokens for desirable behavior. Acts as a secondary reinforcer.
• Tokens can be swapped for tangible rewards (primary reinforcers.)
• Encourages the behaviour to be repeated (operant conditioning.)

Question 3

Strength: helps improve functioning

Answer 3

• It reinforces basic behaviors such as getting dressed, hygiene which patients often struggle with due to lack of motivation.
• Helps establish healthier habits, increases independence and improves quality of life.
• Helps patients transition more smoothly into society.

Question 4

Weakness: ethical issues

Answer 4

• Those who are much more seriously ill would have a harsh time as they may struggle to function more.
• Due to professionals have considerable power to control behavior of people.
• Legal action by families who see relative in this position has been a major factor in decline of token economies.
• Benefits may be outweighed by impact of personal freedom and short term reduction in quality of life.

Question 5

Strength: supports hospital management

Answer 5

• SZ patients may exhibit disruptive behaviors such as aggression or withdrawal.
• Token economies encourage compliance with rules and participation in daily activities due to reinforcement.
• Facilitates a safer environment, less injuries to patients and staff, as well as increase motivation and reduce effects of institutionalisation.

Question 6

Weakness: evidence that it is not that effective.

Answer 6

• McMonagle and Sultana found only 3 studies into token economy where ppts have been randomly allocated to conditions of only 110 patients, only 1 of 3 showed improvement in symptoms.
• ## None yielded useful information about behavior change.