Psychological Treatments of Schizophrenia- Token Economy Flashcards
What is the aim of a token economy?
To manage schizophrenia through encouraging desirable behaviours by using selective reinforcement
How are the tokens used?
- Tokens can be exchanged for primary reinforcers
- Primary reinforcer meets a basic need (e.g. tokens can be swapped for TV, games, chocolate, etc…)
- They must be relevant and viewed as highly desirable by the patients
If the point is:
A strength of token economies as a psychological treatment is that, originally, it was classed as one of the first humane therapies to treat schizophrenia.
What is the explanation and link?
Explanation- In the past, schizophrenics would be isolated and confined in order to exercise control. Early use of token economies allowed patients to be treated more humanely with more freedom and independence, most likely contributing to the therapeutic effect.
Link- This suggests that token economies should be praised for their ethical treatment of schizophrenia.
If the point is:
A strength of token economies as a psychological treatment is that there is evidence to show that they’re very effective in the management of schizophrenia.
What is the evidence and link?
Evidence- Allyon and Azrin set aside an entire ward of a psychiatric hospital compromised of 45 female chronic schizophrenic patients with an average of 16 years hospitalisation. They screamed for long periods, were mute, assaultive, many were incontinent, and they no longer ate with cutlery. Following a token economy system, they were carefully reinforced with tokens for their hard work and self care behaviours which were later exchanged for chosen privileges. This regime led to a dramatic improvement in self care behaviours. However, when the system was removed these behaviours disappeared.
Link- This implies that token economies are a cost effective strategy to use with institutionalised patients suffering from schizophrenia.
If the point is:
A weakness of token economies as a psychological treatment is that some psychologists have questioned its ethics.
What is the explanation, evidence and link?
Explanation- It gives professionals significant power of control over the behaviour of the patients and imposes a ‘norm’ in the ward setting that some may argue isn’t appropriate.
Evidence- For example, a patient may not want to dress a certain way for the day or may prefer to bathe every 2 days. This is a restriction of personal freedom which may aggravate more distressing symptoms, especially if they’re not performing well and aren’t earning the required tokens that are pleasurable for the patient. This has led to legal action in the past, as families are not okay with personal liberties being taken away from the patient.
Link- This suggests that the use of token economy can create an ethical and moral dilemma.
If the point is:
A weakness of token economies as a psychological treatment is that many psychologists believe they do nothing to attempt to cure the disorder and provide nothing but ‘token learning’.
What is the explanation, evidence and link?
Explanation- It is difficult to keep this treatment going once the patients are back home in the community.
Evidence- Kazdin et al found that changes in behaviour achieved through token economies do not remain when tokens are withdrawn. This suggests that such treatments address the effects of schizophrenia rather than causes.
Link- This could imply that the benefits of token economies are institutionally bound and disappear when patients rejoin the real world.
What are the evaluation points for a token economy?
+ Originally, it was classed as one of the first humane therapies to treat schizophrenia
+ There is evidence to show that they’re very effective in the management of schizophrenia
— Some psychologists have questioned its ethics
— Many psychologists believe they do nothing to attempt to cure the disorder and provide nothing but ‘token learning’
