management of schizophrenia Flashcards
how can schizophrenia be managed
through token economies.
give a brief explanation as to what token economies are
are reward systems used to manage behaviour of people with schizophrenia. Especially those who have developed maladaptive behaviour through spending long times in psychiatric hospitals.
how did the development of token economies take place
- carried out by Ayllon and Azrin (1968)
- trialled in a ward of women with a diagnosis of scz
- everytime they carried out a basic task like making their bed they’d be given a token
- the tokens could be swapped for privilages like being able to watch a film.
- used in 60’s and 70’s
- come with ethical issues.
what is the rationale for token economies
- Matson et al. (2016) identified 3 categories of institutional behaviour: personal care, condition related behaviours and social behaviour.
- modifying these behaviours have two major benefits: improves persons quality of life in hospital, allows people who have spent a long time in hospital to adapt back into normal life.
what is involved in a token economy
- token given immediatley to individuals when they carry out a desirable behaviour
- target behaviours are decided
- tokens can be swapped for more tangiable rewards
- tokens are given as soon as possible to target behaviour.
what is the theoretical understanding of token economies.
- are an example of behaviour modification- based on operant conditioning. Tokens are secondary reinforcers bc they only hold value once they person recieving them has learnt they can be used to obtain meaningful rewards. Secondary reinforcers are called generalised reinforcers.
- these meaningful rewards are primary rei forcers.
link management of schizophrenia to approaches
token economies are a form of operant conditioning from the behaviourist approach: desirable behaviour is positively reinforced with immediate reward- results in repitition of the desired behaviour as the patient will be motivated to recieve another reward.
what are the strengths of token economies
- useful for ppl whose symptoms are mild and need some motivation to enable them to cope with everyday life and social interactions and personal hygiene.
- less harmful than drug therapy so it may be more ethically valid to some extent.
what are the limitations to token economies
- Monagle and Sultana (2000) concluded that research is unclear as to how much long term effect they have and whether they can be maintained.
- could be viewed as patronising treating patients like children. Means there are ethical concerns about the protection of patients who are enrolled in such a system.
