Token Economies

Question 1

What is token economies?

Answer 1

It is a behaviourist therapeutic approach to the management of schizophrenia, where tokens are awarded for demonstrations of desired behavioural change.

Question 2

When was token economies introduced and when is it used?

Answer 2

• It was introduced in the 1970’s
• The therapy is mainly used with long term hospitalised patients to enable them to leave hospital and live independently within the community.

Question 3

What symptoms is token economy mainly aimed at changing?

Answer 3

• Token economy is aimed at changing mainly negative symptoms such as anhedonia, avolition and affective flattening.
• But can sometimes be used to change positive symptoms such as hallucinations.

Question 4

What learning principle is token economies based on?

Answer 4

The technique uses operant conditioning principles

-It involves patients receiving reinforcements in the form of tokens immediately after producing a desired behaviour. The tokens are then later exchanged for goods or privileges.

Question 5

What are examples of desired behaviours?

Answer 5

• Self care
• adherence to medication regimen
• Social interaction
• Going to CBTp

Question 6

AO3 for token economies

Answer 6

• Side effects
• only useful in institutions (Carrigan)
• Silverstein (instant rewards)

Question 7

Outline Carrigans research?

Answer 7

• token economy is only useful to certain schizophrenics according to cardigan and his research
• He found a hospital setting would allow a patient to reap the benefits from the treatment but a schizophrenic that is an outpatient will not.
• Implementing token economies can be done around the clock constantly in hospitals as they are always on the presence of the schizophrenic patients but in a setting such as the home setting desired behavioural changes cannot be reinforced instantly.
• This is due to a therapist only being able to see an outpatient for a couple hours a day.
• This means the treatment is only affective within a treatment setting which a hospital can provide 24/7. So token economy may not be the best treatment for schizophrenia.

Question 8

Outline Silverstein research

Answer 8

• Schizophrenics have trouble performing at their jobs as the rewards for success at the job is usually rewarded such as pay on a long term basis (monthly)
• This shows schizophrenics have difficulty engaging in desired behavioural change if a reward is distant.
• Schizophrenics respond well to token economy, and engage quite quickly to produce desired behavioural change as rewards are given instantly to them.
• this shows us schizophrenics should be paid on a short term basis if desired behavioural change at work to occur.