TEP for AN Flashcards
What is a token economy programme?
A TEP is a behavioural treatment based on the principle of operant conditioning and is a form of behaviour modification.
What is operant conditioning?
A method of learning that uses rewards and punishments as a way of learning a behaviour or modifying a behaviour.
Why is TEP often only used on in-patients who have been hospitalised?
Patients who suffer from AN will often resist treatment as they are not in a position mentally to understand what they are doing to their body. Most of the time, the patient will be so undernourished that they are forced to go into hospital anyway because they are in serious need of professional help in order to bring their weight back up.
What is a primary reinforcer?
A reward given to a patient. For someone with AN this would be a biological reinforcer such as food. Because an AN patient will not eat this and feel rewarded, a secondary reinforcer is needed.
What is a secondary reinforcer?
A physical reward that can be traded in for a privileges. A secondary reinforcer for example may be money, or tokens in the case of TEP.
What is a TEP for
It uses operant conditioning to get sufferers of AN to eat. The behaviour of eating food is reinforced by the use of tokens which are secondary reinforcers. These tokens can be exchanged for privileges such as make-up or cosmetic products, outing or watching a favorite TV show, access to a mobile device etc. These secondary reinforcers must be something the patient wants so that they carry out the behaviour that is wanted of them.
How do TEP work?
Daily fluids and weight are all tracked, along with how many times the person goes to the toilet etc. If the person vomits after a meal, they should be watched for a few hours after vomiting occurs. Each individual should aim to consume between 1,500 and 2,000 calories per day, and this intake increases gradually as the patient makes treatment gains.
How many meals should the patient have a day?
6 small meals with equal feedings, although this may not always be possible.
Factors that are important (The token)
The patient and the carers must decide together what they will receive when they trade in the tokens. This is personal for every patient and it must make them want to eat in order to get that reward.
Factors that are important (Target behaviour)
The behaviour must be realistic, for example if the patient has severe AN then asking them to eat 6 meals a day is not achievable, The patient must start from eating small meals but regular instead of big meals but not regular.
Factors that are important (Consistency)
The carer has to reinforce all behaviour or the trust between patient are carer will be lost. This means that the carer cant forget to give the patient their tokens and they must always provide them with a reward in order for the to consistently show that eating behaviour.
Factors that are important (Primary reinforcers)
These are significant to the patient. You cannot expect an AN patient to consume lots of calories right away, this takes time.
Factors that are important (Recording progress)
This might give the patient motivation to carry on eating and seeing their weight increase and being rewarded for it might give them incentive to carry on trying.
