Schizophrenia: Token economy and the management of schizophrenia Flashcards
What is a token economy?
Form of therapy where desirable behaviours are encouraged through the use of selective reinforcement.
How is token economy implemented?
Tokens rewarded for desired actions.
Reinforces are exchanged for benefits such as a film or coffee.
What do tokens become?
Secondary reinforcers because they are paired with rewarding stimuli.
What behavioural processes are involved in token economy?
Classical conditioning - tokens become associated with rewards (secondary reinforcers).
Operant conditioning - behaviours more likely to be repeated due to rewards (positive reinforcement).
What is the focus of token economy?
Shaping and reinforcing positive behaviours but not on punishing undesirable behaviours.
Alleviates negative symptoms such as poor motivation.
Nurses view patients more positively, raising staff morale.
How can token economy reduce positive symptoms?
Not rewarding such behaviours, but rewarding desirable ones instead (self-care, taking medication, work skills, treatment).
How can effectiveness of token economy be compromised?
If more time passes between presentation of token and exchange for the reward. Patients are not reinforced quickly enough to produce desired behaviours.
AO3: Token economy
+Research support
+Benefit of using non-standard care
-Difficulties in researching economy
-Ethical concerns
(+AO3) Describe research support for the token economy.
Dickerson et al.
Reviewed 13 studies of the use of tokens economies. 11 reported beneficial effects directly attributed to use of TE.
Concluded it was valuable in increasing the adaptive behaviours of SZ patients. However, cautions of weak methodologies.
(+AO3) What is a benefit of using non-standard care?
No side effects.
Antipsychotics cause extrapyramidal side effects - Parkinson’s disease-like symptoms, Tardive dyskinesia.
Token economy successful and without side effects.
However may only improve medical compliance (studies include patients on token economy and drugs), so would be ineffective by itself.
(-AO3) What are the difficulties in researching token economy?
Studies are uncontrolled.
All participants participate in programme, rather than one experimental and one control group.
Therefore improvements can only be compared with past behaviours.
This can be misleading as other factors (increased staff attention) reduce the validity of the results.
(-AO3) What are the ethical concerns over the token economy?
To make reinforcements effective, clinicians need to exert control over primary reinforcers such as food, privacy, pleasurable activities.
Vital for process of token economy.
But all humans have basic human rights to these things that cannot be violated.
Means token economy must be carried out cautiously to avoid human rights violations.
