management of sz

Question 1

token economies

Answer 1

-based on operant conditioning+developed as way to deal w negative symptoms + maladaptive behaviours+promote more functional behaviours from patients
-doesnt cure but aims to improve quality of life+make it easier for them to function outside institutional setting
-helps repeat desired behaviours
-give award immediately bc prevents delay discounting
-so by classical conditioing the tokens become secondary reinforces+used to modify behaviours
-tokens=secondary reinforcers
-rewards=primary reinforcers
-exchanged tokens for reward=generalised rainforcers

Question 2

ayllon+azrin (1968)

Answer 2

-first carry out of it: they trialed it in ward of women w diagnosis of sz. every time they did task they were given token. then they could be swapped for ward privilidges eg watch film
-staff no longer allowed to interact w patients either thus removing any chance of them gaining attention+reinforcement behaviour
-found it as huge success as ppts displayed more desired+functional behaviours. gd behviour=highest when reinforcements were imposed n lowest when not
-also staff n patient morale imporved as ppts less apathetic+irresponsible whilst staff became more enthusiatic in their jobs

Question 3

ao3

outside of instituion criticsm

Answer 3

• Corrigan (1991) argues is applying this therapy in the community where patients are not under 24 hour care and tokens are not available.
• -uses operant condiitoing so when desired rewards of tokens r removed it makes it ineffctive
• also as reward given immediately makes it more effective in hospitals where they monitor ppts constantly
  -BUT therapy also has the advantage of making the hospital environment more healthy and productive.
  -so they facilitate a safer+therapeutic enviroemtn+staff+ppt injuries reduce and both have more positive regard

Question 4

ao3

research support
sultana et al
ost et al

Answer 4

-Sultana et al (2000) did a meta-analysis review of TE regimes over 15 year period finding they did reduce negative symptoms in sz ppt showing effectiveness in management of sz symps.
-It was however unclear if these behavioural changed were maintained beyond the treatment programme themselves.
-Ost et al treated 12 sz w TE regimes for 8 months found positive changes in behaviour. –Of the 5 ppt discharged, none had been readmitted in the 1-year follow-up= behavioural changes can be maintained after treatment ends for ST at least.
-Whether this treatment was effective in the LT however is still questionable

Question 5

ao3

effective w ap drugs

Answer 5

-upper et al found weight gain w use of ap could be addressed w te+sz able to reach target 3pounds weight loss a week
-but sample size was small making it difficult to generalise to wider pop
-but suggests combo of drugs n te treatment may be effective in managing side effects of ap + promote positive behaviours such as exercise
-=help management of sz more effective as drugs could help reduce symps while te used to promote desired behaviours

Question 6

ao3

ethical issues

Answer 6

-gives professionals power to control behaviour of ppl in role of patient. this involves imposing ones norms on to others=problematic if target behaviours r not identified sensitively
-eg someone who likes to look scruffy+get up late might have these personal freedoms curtailed or more serius have availability of pleasures restricted
-relatives may take legal action which leads to decline of use of te
-benefits may be outweighed by their impact on personal freedom + st reduction in quality of life