Schizophrenia - Management

Question 1

Token economies

Answer 1

Reward-based systems to encouraged desired behaviour (conditioning)

Question 2

How token economies work (1)

Answer 2

Define target behaviours (3 categories: personal care, condition related & social)
- Must know patient to make individualised targets

Question 3

How token economies work (2)

Answer 3

Immediate association (provide for small behavioural changes [secondary enforcers] initially at the same time as primary enforcers to pair them)

Question 4

How token economies work (3)

Answer 4

Behaviour shaping (only provide for larger changes, increase the delay between primary & secondary, ASAP token administration, mastered behaviour leads to removal of the reward)

Question 5

How token economies work (4)

Answer 5

Outcomes (improves quality of life in hospital & normalises behaviour to adapt easier to life)

Question 6

Strengths of token economies w/schizophrenia

Answer 6

+ Effectiveness (Glowacki et al - reduction in negative symptoms & declining unwanted behaviour)
+ Easy (administered by anyone)
+ Cheap & cost-benefit analysis shows more benefits
+ Successful

Question 7

Limitations of token economies w/schizophrenia

Answer 7

• Small selections/samples (file drawer problem)
• Ethical issues (target behaviours w/o sensitivity, restricting pleasurable activities)
• Other alternatives (Art therapy - more positive experience [Chiang et al])
• May not easily transfer to home environment
• Requires carefully planned & controlled programmes