SCHIZOPHRENIA: Token Economy

Question 1

What is the Token Economy?

Answer 1

Form of behavioural therapy used in the management of SZ. Used to shape and manage behaviour so that patients in long stay hospitals are easier to manage. Based on Behaviourist/Learning Theory

Question 2

What does Token Economy involve?

Answer 2

• Involves desirable behaviours being encouraged through selective reinforcement
• Rewards are given immediately as secondary reinforcers when patients engage in desirable behaviours,
• These have no value but can be swapped for primary reinforcers. Encourages behaviour to be repeated

Question 3

Can Token Economy cure SZ?

Answer 3

It cannot cure SZ but it improves patients quality of life and makes it more likely that they can survive outside the hospital setting.

Question 4

What is the cycle of the Token Economy?

Answer 4

1. Tokens are paired with rewarding stimuli and so become secondary reinforcers
2. Patients engages in ‘target’ behaviours or reduces inappropriate ones
3. Patient is given tokens for engaging in target behaviours
4. Patient trades these tokens for access to desirable items or other privileges.

Question 5

What is a Primary Reinforcer?

Answer 5

Anything that gives pleasure or removes unpleasant states (e.g. alleviates boredom). Do not depend on learning in order to acquire their reinforced value.

Question 6

What is a Secondary Reinforcer?

Answer 6

Initially have no value to the individual, but acquire their reinforcing properties as a result of being paired with primary reinforcers. In a token economy, the tokens given out when a patient engages in target behaviour are secondary reinforcers.

Question 7

What is the process of assigning value to tokens?

Answer 7

It needs to be repeatedly presented alongside or immediately before the reinforcing stimulus. The reinforcing stimulus may take the form or food, privileges or other incentives. By pairing the neutral tokens with the stimulus, the neutral stimulus acquires the same reinforcing properties. This classical conditioning leads these tokens to become secondary reinforcers and can be used to modify behaviour.

Question 8

What is the process of ‘The Trade’?

Answer 8

The exchange of tokens for backup rewards chosen by the clinician. Effectiveness of TE may decrease with the amount of time passing between presentation of token and exchange for back up (Kazdin 1977)