The Management of Schizophrenia - Token Economies Flashcards
What was Ayllon and Azrin’s study into a token economy system in a ward?
It was an all-female ward for schizophrenics - every time they completed a task they got a token which could be exchanged for privileges. They found a 70% increase in the number of positive tasks carried out
What are the 3 behavioural categories that Matson identified that can be tackled using token economies?
Personal care, condition-related behaviours and social behaviour.
What are the 2 main benefits Matson identified?
Improves QOL within hospital setting
Normalises behaviour - makes it easier for long-term patients to to adapt to outside life.
What is selective reinforcement?
Behaviour modification which seeks to increase the occurrence of certain behaviours by responding to desired behaviours with a pleasurable stimulus, while seeking to extinguish undesirable behaviours by not responding to them.
What is ‘delay discounting’?
The patient has to wait for the reward and therefore it isn’t as effective in encouraging desirable behaviours in future.
What is maladaptive behaviour?
‘institutionalisation’ behaviour catered to life in the asylum dependant on carers.
What is the strength - Glowacki?
he identified 7 high quality studies published between 1999 and 2013 on the effectiveness of token economies on a hospital setting. They all shows a reduction in negative symptoms.
What is the limitation - file drawer problem?
Seven studies is a small evidence base for Glowacki - the file drawer problem where there is a cognitive bias towards positive published findings and negative results have been filed aay.
What is the limitation - ethical issues?
Professionals have the power to control behaviour and this means imposing ones norms on others. Restricting the availability of pleasures to people who don’t behave as desired means that very ill people have an even worse time - led to family members taking successful legal action against a TE system.
What is the limitation - ethical alternatives?
Art therapy is an alternative, a high-gain low-risk approach to managing schizophrenia (Chiang 2019).
