Schizophrenia: Token economies used in management of Schizophrenia

Question 1

Token economies are a …

Answer 1

reward system used to manage the behaviour of SZ patients

Question 2

What do token economies aim to improve ? (1)

What are they based on the principle of?

Answer 2

a patients quality of life

based on the principle of operant conditioning

Question 3

Describe how operant conditioning is used in token economies …

make 2 points

Answer 3

-institution staff positively reinforce patients by giving them tokens when they perform desirable behaviour such as getting dressed

-tokens are the secondary re-inforcer that can be swapped for rewards such as walks outside of hospital

Question 4

Discuss the issues with appropriateness regarding token economies …

there are 6

Answer 4

1)they don’t address the cause of SZ so they are not a treatment
2)they only manage the negative symptoms
3)patients are seen as lab rats who can be manipulated based on principles of animal behaviour so this underestimates the cognitive factors
4)can be humiliating and patronising
5)acts to control patients so its more beneficial to staff than patients
6)priviliges become more available to patients with less severe symptoms and less available to more severe patients , so can be seen as discriminatory

Question 5

Who provides evidence for the effectiveness of token economies?

Describe this

Answer 5

McMonagle and Sultana 2009-did meta analysis of token economy systems involving 110 people with SZ

-found slight evidence of improved mental state especially with negative symptoms , which gives limited support for the system

Question 6

Give a however point for this slight supporting evidence

Answer 6

-only 3 studies were involved in the final trials as these were the only ones that were randomised and controlled trials

this means its likely that patients with less severe symptoms would be in the token economy group , so it wouldn’t be surprising if they were more likely to improve