management of SZ

Question 1

strengths of token economies to treat SZ
Ayllon and Azrin

Answer 1

Ayllon and Azrin used token economies in women’s ward in a mental institution in the US. They were rewarded with tokens for self care. these could be exchanged for privileges like watching films etc. Desirable behaviours increased significantly.
However these decreased significantly once the system was withdrawn.

Question 2

strength of token economies to treat SZ
effectivness Glowacki et al.

Answer 2

Glowacki et al. reviewed 7 high quality studies of token economies for those in a hospital setting which showed a reduction in negative symptoms and decline in unwanted behaviors.
However used particularly small selections leading to the ‘file drawer problem’ which means questionable evidence.

Many other studies also support its effectivness.
However, 10-20% of people do not respond well to the programmes.

Question 3

strengths of token economies to treat SZ
easy

Answer 3

can be administered by anyone with training and tokens and rewards are relatively cheap so the programme is not expensive and there are more benefits than costs.
However, programmes have to be carefully planned and controlled and there are many areas where problems can occur such as lack of consistency from staff.

Question 4

weaknesses of token economies to treat SZ
ethics

Answer 4

possible ethical issues- identifying target behaviours without sensitivity, seriously restricting pleasurable activities of those with the disorder. Families have taken legal action over this.

Question 5

weakness of token economies to treat SZ
Chiang et al.

Answer 5

Chiang et al. concluded that art therapy might be a good alternative. The evidence base is relatively small and has some methodological issues, but it appears to show that art therapy is a high-gain low-risk approach to managing SZ and is a more positive experience.