Management Using Token Economies

Question 1

what are token economies

Answer 1

reward system where desirable behaviours are encourages- selective reinforcement

Question 2

token economies as operant conditioning

Answer 2

primary reinforcer- meaningful rewards
secondary reinforcer- tokens
generalised reinforcer- tokens can be exchanged for other rewards- more powerful reinforcer

Question 3

prolonged hospitalisation can lead to…

Answer 3

institutionalisation and formation of bad habits

Question 4

Matson (2016) 3 behaviours tackled

Answer 4

-personal care
-condition related behaviour
-social behaviours
as well as
-improving quality of life in hospital and after discharge

Question 5

uses of token economies

Answer 5

aylion and azrin (1968) female schizophrenic ward
-tokens given for tasks
-can be swapped for ward privileges
-tasks completed increases significantly

Question 6

AO3 evidence for effectiveness

Answer 6

Glowacki (2016) compares studies between 1999 and 2013 examining the effectiveness of token economies for mental health patients in hospitals
-all studies showed reduction in negative symptoms and a decline in unwanted behaviours

Question 7

AO3 evidence for effectiveness counterpoint

Answer 7

-small evidence base- file drawer problem
-leads to bias towards published findings because undesirable behaviours are filed away
-questions the effectiveness

Question 8

AO3 ethical issues

Answer 8

-professionals have considerable power to control behaviour of patients, imposing a persons normals as they have lack of freedom
-restricts the availability of pleasures to those who don’t show desired behaviour- those who are seriously ill will have an even worse time
-benefits may be outweighed by ethical issues

Question 9

AO3 alternative approaches

Answer 9

Chaing (2019) after therapy may be a good therapy
-evidence base is small and has methodological problems but shows it has a high gain low risk approach
-pleasant without any side effect or ethical issues, NICE recommends art therapy