Token economies

Question 1

What is token economies?
- who is for?
- why is it for them?

2. how does it work?
3. what can patients do with tokens?

Answer 1

• rewards system used to manage behaviours of people with schizophrenia
• those in particular who developed a maladaptive behaviour through spending lots of time in psychiatric hospital.
• it is common for those people to develop bad hygiene or perhaps to remain in pyjamas all day

2. patients are immediately given tokens when they carry out desirable behaviour that has been targeted for reinforcement such as getting out bed and dressed in the morning.
   - the immedicacy of the reward is important because it prevents “delay discounting” reduced effect of delaying reward.
3. although the tokens have no value themselves they can be swapped later for a more tangible reward.
   - it is based on operant conditioning tokens are secondary reinforcers because they only have value once the patient has learnt that they can be used to obtain rewards.

Question 2

what is study to support token economies
( strength)

also criticise it

Answer 2

1. Dickerson et al reviewed 13 studies in which researcher used token economies to carry out positive adaptive behaviours
2. he found 11/13 studies reported a improvement in schizophrenic patients behaviours
3. he also found token economies are effective when they were used with other treatments such as antipsychotic medications, cbt and family therapy.
4. this indicates token economies are effective in managing patients behaviours

however in a lot studies token economies were used on all schizophrenic patients in study at same time so there is no control group which decreases validity of studies. this is problem because even if it showed a improvement they couldn’t be sure it was really caused by token economies or the fact that it was medication

Question 3

what is limitation of token economies?

Answer 3

could be considered unethical.
- patients are treated like small children which might be humiliating and cause distress.
- might encourage the patients to become over dependent on being reward for their behaviour which could have negative effects once they leave the hospital.

Question 4

what is another limitation of token economies?

Answer 4

may not be useful outside hospital settings
outside the hospital it is harder to monitor patients behaviour and provide a immediate reward. this means patients are less likely to form a association between their positive behaviour and reward.