Schizophrenia - management: token economies

Question 1

what is a token economy

Answer 1

reward system with immediate cause and effect. helps manage behaviour of patients with schizophrenia, particularly those who have been in hospital for a long time. helps modify behaviour and improve quality of life

Question 2

secondary reinforcer

Answer 2

given immediately (e.g. a token)

Question 3

primary reinforcer

Answer 3

secondary reinforcer is swapped for a tangible reward

Question 4

what is an important element of token economies

Answer 4

no punishment is used!!!!

Question 5

Ayllon and Azrin (token economies)

Answer 5

study on women’s psychiatric ward, token economies use personalised targets and motivation. TE’s effective in increasing patient responsibility

Question 6

why is it used

Answer 6

to alleviate negative symptoms e.g. poor motivation
reduce positive symptoms as not rewarding them

Question 7

what approach do token economies steal principles from

Answer 7

behaviourist - operant conditioning

Question 8

what are the three categories covered in token economies (Matson et al)

Answer 8

personal care, social behaviour and condition related behaviour

Question 9

strengths of token economies

Answer 9

+ Paul + Lentz: TE led to better patient functioning and lowered hospital costs
+ Upper + Newton: weight gain associated with medication can be addressed through TE
+ McMonagle + Sultana: treatment reduced symptoms

Question 10

limitations of token economies

Answer 10

• very few supporting studies
• how long do effects last after hospitalisation?
• dehumanising?
• 1950s/60s had reward of cigarettes -> nicotine addictions
• more severely ill = less likely to enjoy privileges
• people getting different rewards for different behaviours = unfair? upsetting for patients?