Management of sz (token economies)

Question 1

what is t.e

Answer 1

reward desirable behaviour with tokens which are then exchanged for privleges.
Type of behaviour modification

Question 2

What are tokens considered? why?

Answer 2

secondary reinforcers because they obtain value once patients learn they can be used to get rewards, e.g. sweets

Question 3

What are rewards considered

Answer 3

primary reinforcers

Question 4

what is t.e. based on

Answer 4

operant conditioning principles from Skinner

Question 5

What are the 3 categories of institutional behaviour targeted by TE.

Answer 5

personal care
conditioned related behaviours (i.e. apathy)
social behaviour

Question 6

What does modifying the 3 institional behaviours do

Answer 6

improve quality of life
Normalises behaviour making it easier for people to adapt back into society

Question 7

What does te hope to acheieve?

Answer 7

Used for behavioural shaping and management so that patients in long-stay hospitals are easier to manage

Question 8

Evalutions?

Answer 8

Not effective with unresponsive patients eg with negative symptoms

Token economies do not address symptoms of schizophrenia, so they are not a ‘treatment’

Ethical issues

Question 9

ao3: Not effective with unresponsive patients eg with negative symptoms

Answer 9

e.g. avolition - lack of motivation and speech poverty -reduction in quality and quantity
TE rely on paitients engaging with the system by showing desirable behaviour.
However people with severe negative symptoms lack motivation to participate in first place.
Means they wouldnt engage making the treatment ineffective.

Therefore not suitable for all patients (maybe only positive symptoms) More suitable treatments such as drug therapy

Question 10

ao3: Token economies do not address symptoms of schizophrenia, so they are not a ‘treatment’

Answer 10

do not target cognitive/ biological causes of schizophrenia, i.e. dopamine action in brain (talk about dopamine hypothesis)

may show temporary improvement in behaviour in hospital setting.
But core symptoms - hallucinations, delusions, avolition, speech poverty, remain untreated.

Once pateints leave hospital benefits of te arent maintained as symptoms arent targeted. Therefore it may be more effective when used alongside something else.

Question 11

ao3: ethical issues

Answer 11

treats paitients like patients/lab rats
Professionals are given considerable power to control the behaviour of patients.
May impose ones norms and eliminate the paitients norms which removes any sense of freedom.
Patient may experience a worse time in hospital because of the system as rewards may have been normally obtained but now they have to show good behaviour to obtain them.