psychological therapy for sz-token economies

Question 1

A01

Outline Token economy as a form of therapy for SZ

Answer 1

Token economy- form of behavioural therapy where desireable behaviours are encouraged by the use of selective reinforcement & is based on operant conditioning
When desirebale behaviour is displayed e.g getting dressed, Tokens(in form of coloured disks) given immediately as secondary reinforces which can be exchanged for rewards e.g sweets
Tokens are secondary reinforces as only have value once patient learned they can only be used to obtain rewards
These rewards are primary reinforces

Question 2

Outline Rationale for Token economies

Answer 2

Matson et al. (2016) identify three categories of institutional behaviour:
issues with personal care,
condition-related behaviours (e.g. apathy)
social behaviour,
all of which are said to be improved by a token economy in the following ways by:
* Improving the person’s quality of life within the hospital setting
* Normalising behaviour (for example getting dressed in the morning; making the bed) which makes it easier for people who have spent a great deal of time in hospital to adapt back into life in the community

Question 3

A03

Evidence for effectiveness of Token economies-Gloacki

strength

Answer 3

Gloacki et al(2016) identified 7 high quality studies that examined the effectiveness of token economies for people with SZ & involved patients living in hospital setting
All studies showed a reduction in negative symptoms & decline in frequency of unwanted behaviours
supporting the value of Token economies

Question 4

A03

ethical issues

limitation

Answer 4

Token economy systems raise ethical issues & have proved controversial
the issues-privledges, services etc become more available to patients with mild symptoms & less available with severe symptoms of SZ that prevents them from complying with desireable behaviours, means most severe patients suffer discrimination, the use of token economies are reduced in psychiatric system

Question 5

A03

token economies-cannot be continued outside hopsital setting

strenth With counterpoint

Answer 5

One problem with token economies is that they are very difficult to continue once a person is outside a hospital setting, this is because target behaviour cannot be monitored closely & tokens cannot be administrated immediately,
* but some ppl with SZ may only get chance to live outside a hospital if their personal care & social interaction can be improved achived through token economies during hospital care