management of schizophrenia: token economy

Question 1

AO1: how it works

Answer 1

• patients set desirable behaviour that will improve everyday life
• tokens rewarded when patients does one of the behaviours
• the tokens can be exchanged for rewards
• patients will repeat the desirable behaviour as they have made an association between the behaviours and reward
• to give the neutral token value, it needs to be repeatedly presented alongside the reinforcing stimuli (reward).
• as a result of this classical conditioning the neutral tokens become secondary reinforcers.
• the rewards need to be exchanged quickly in order for the scheme to work

Question 2

AO3: strength- research support in women’s ward

HOWEVER, beta bias so low pop validity

Answer 2

P: researchers used token economy on a ward of female patients.
E: they were given tokens for making their beds. These were exchanged for rewards.
E: found the number of desirable behaviours increased dramatically.
L: shows token economy are effective when it comes to managing the symptoms of schizophrenia
HOWEVER, the study suffers from beta bias, as only female patients used. Men may have not responded in the same way so findings can’t be applied to schizophrenic men.

Question 3

AO3: strength- patients become more independent and active

HOWEVER, effects only last while in hospital

Answer 3

P: patients become more independent and active
E: this increases the nurses respect for the patient therefore leading to the patients feeling more motivated and having higher self esteem.
E: also creating a safe environment with less violence towards staff, leading to less staff leaving.
L: shows token economy has many positive effects when it comes to management of Sz.
HOWEVER, the effects only last while in hospital, so doesn’t work long term as the reinforcement and desirable behaviour ends, this leads to high re-admittance rates.

Question 4

AO3: limitation- methodological issues with research

Answer 4

P: methodological issues with token economy research
E/E: research is usually uncontrolled as when token economy is introduced, typically all patients are brought into the experiment, rather than having an experimental group and control group.
L: therefore patients improvements can only be compared with past behaviours.

Question 5

AO3: limitation- ethical implications

Answer 5

P: ethical implications
E: argues that it is humiliating for people with schizophrenia
E: e.g. staff have control over the primary reinforcers such as food or privacy. This violates human rights.
L: suggests ethical matters need to be taken into account when looking at token economy