Management - Token Economies Flashcards
Token economy is a way of
MANAGING BEHAVIOUR
Treating =
Illeviating symptoms
Managing
Changing behaviour
Token economies based on principles of
Operant conditioning and focus on negative symptoms
First token economy research conducted by
Ayllon and Azrin
What did ayllon and azrin do
- worked on a ward of female patients
- were given a token for activities like making their bed
- tokens could then be exchanged for privileges
- leading to increased frequency of desireable behaviour
Where are token economies used
Psychiatric hospitals, where patients have become institutionalised
Reasons token economies are used: to stop…
- not getting dressed
- poor hygiene
- social withdrawal
- independence
Long term aims of token economy
- increased likelihood of living outside of hospital setting
- improve quality of life
Expamples of desireable behaviours
- getting dressed
- making bed
- false teeth in
- showering
Examples of tangible rewards
Sweets, magazines, walk outside, more pleasant accommodation
Step 1
Individual assessment - desireable behaviour for the individual patient is identified and targeted for reinforcement
Stage 2
Patient receives token for carrying out desireable behaviour
Stage 3
Desireable behaviour is reinforced immediately to prevent ‘delay discountinf’
Def delay discounting
A reduced effect of reinforcement bevause of a time of day
Stage 4
Tokens have no monetary value but can be exchanged for more tangible rewards
Stage 5
Tokens seen as secondary reinforcers because they only have value when patients learns that they can be used to obtain rewards
3 evaluation points
Strength - evidence to support effectiveness
Weakness - ethical concerns
Weakness - lack of usefulness
Elaboration strength - evidence to support effectiveness
Dickerson reviewed studies using token economy and found majority reported beneficial effects
- support for effectiveness increasing adaptive behaviours meaning treatment can be beneficial
- though few trails have been conducted so lack of support in real world
- therefore leaves unanswered questions
Elaboration weakness - ethical concerns
- ethical concerns regarding method in psychiatric settings
- in order to make some aspects effective eg reinforcement, clinicians need to access necessities eg food
- basic human right and not allowed for patients to exchange tokens for them
- regardless of benefits, system is limited due to raising ethical questions
Elaboration weakness - lack of usefulness
- not useful for patients who live in community
- only shows to reduce neg symptoms in hospital setting
- Corrigon argues there are problems because method can only be used minimally
- application in real world doesn’t produce same effects
