Token Economies

Question 1

AO1

Answer 1

Token economies are a behaviorist approach to manage the behavior of patients with SZ. It is mainly used with patients who have spent a long time in hospital and therefore who have developed maladaptive behavior such as bad hygiene or lack of communication with others

Question 2

AIM

Answer 2

The aim of token economies is to change the patients behavior so that they are easier to manage will have a better quality of life and thus enabling them to live outside of a hospital setting

Question 3

How it works

Answer 3

The techniques used skinners operant conditioning principles of positive reinforcement whereby patients receive reinforcement in the form of tokens such as colored discs immediately after producing a desired behavior such as self care or social interaction. The tokens can be layer exchanged for goods or privileges such as hours watching tv magazines a walk outside or sweets

Question 4

Think further

Answer 4

The tokens are secondary reinforcers these are not rewarding by themselves. However the patients learn to associate them with meaningful rewards such as going for a walk sweets or watching a film

In order for the token to become secondary reinforcers they need to be paired with the primary reinforcers so at the start of a token Economy programme the tokens and primary reinforcers are administered together

Question 5

AO3

Answer 5

P- One limitation of token economies as a management technique for SZ is that there is limited evidence to support the effectiveness.

E- A review of 3 studies investigating the use of token economies found that there was limited impact on the management of patients with SZ as only one of 3 studies showed any improvement in symptoms and no significant positive change in maladaptive behaviors.

E- this shows that using operant conditioning may not be the most effective method of creating positive behavior change in schizophrenics.

L- therefore casting doubt on the effectiveness and lowering the validity of token economies as a management technique for SZ.

Question 6

AO3

Answer 6

P- moreover the use of token economies can raise ethical issues.

E- the major issue is that privilege’s become more severe symptoms of SZ that prevent them from complying with desirable behaviors.

E - Token economies suggest that symptoms of SZ can easily be bypassed if they seek the rewards. However this leads to the most severely ill patients experiencing discrimination as the severity of the symptoms prevents them from accessing this behavior management technique.

L - therefore this has reduced the use of token economies in the psychiatric system to manage SZ as they may not be appropriate for all patients.