Management Of Sz- Token Economy

Question 1

What is a token economy

Answer 1

reward system used to manage behaviour of Sz patients who developed maladaptive behaviours as a result of institutionalisation (Prolonged hospitalisation)

Question 2

Example of a token economy

Answer 2

Ayllon & Azrin
Used Token Economy 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However, these decreased significantly once the system was withdrawn.

Could also be used as evaluation

Question 3

Process of token economy

Answer 3

Identify target behaviours- mateson identified 3 target behaviours- personal care, condition-related behaviour + social behaviour. Cooper suggests individualising

Operationalise
Then - immediate association- token secondary, prize primary

behavioural shaping- gradual withdrawal- increase delay between secondary and primary

outcome- normalise behaviour to help adapt to real world

Question 4

limitation token economies (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

strength token economies (effective)

Answer 5

Effectiveness - Glowacki et al (2016) 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 behaviours.

Some of these reviews (e.g. Glowacki) use particularly small selections leading to the ‘file drawer problem’ - which means questionable evidence.

Question 6

strength token economy (simple)

Answer 6

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.