The Management of Sz - Token Economies A03 Flashcards
What did Glowaki identify within seven high quality studies published between 1999 and 2013 on the effectiveness of token economies in a hospital setting?
All the studies showed a reduction in negative symptoms and a decline in frequency of unwanted behaviours
This is a strength because this supports the value of token economies
Counter point to Glowaki is that seven studies is a small sample - one issue is the file drawer problem which leads to a cognitive bias towards positive published findings because undesirable results have been ‘filed away’
This is an issue because it means that there is a serious question over the evidence for the effectiveness of token economies
There are many ethical issues with using TE systems
Professionals have the power to control people’s behaviour and this means imposing one persons norms on to others
Also restricting here availability of pleasures to people who don’t behave as desired means that very ill people, already experiencing distressing symptoms, have an even worse time. This had let to family members taking legal action against those implementing a TE system, leading to its decline
There are other suitable alternative therapies which have fewer ethical issues E.g art therapy (Chiang 2019)
This is a limitation for the use of the TE systems because it suggests that art therapy might be a good alternative to token economies - no side effects or ethical issues
TE are hard to continue outside of a hospital setting - target behaviours cannot be monitored closely and tokens cannot be given immediately
On the other hand, some people may only get the chance to live outside a hospital if their personal care and social interaction improves
Are the benefits of TE worth the limitations?
This suggests that it is worth it despite the issues around using tokens in hospitals to give people a chance outside the hospital
