Token Economy Flashcards
What is token economy?
A form of therapy where desirable behaviours are encouraged by the use of selective information.
Rewards are given as secondary reinforcers when individuals engage in correct/socially desirable behaviours.
The tokens can then be exchanged for primary reinforcers - food or privileges
What is the aim of token economy?
Clinicians set target behaviours that will improve the patients engagement in daily activities.
When are tokens are awarded?
When the patient engages in one of the target behaviours.
What did Ayllon and Azrin do?
Gave schizophrenic patients plastic tokens for behaviours such as carrying out domestic chores.
These tokens were then exchanged for privileges such as being able to watch a movie.
This procedure was effective in maintaining patients adaptive behaviours as long as the token economy remained in effect.
How are neutral tokens given value?
It is repeatedly presented alongside or immediately before the reinforcing stimulus.
By pairing the neutral tokens with the reinforcing stimulus, the neutral token eventually acquires the same reinforcing properties.
What happens during the early stages?
Frequent exchange periods mean that patients can be quickly reinforced and target behaviours can then increase in frequency.
What affects the effectiveness?
It may decrease if more time passes between presentation of the token and exchange for the backup reinforcers.
How does token economy work?
The behavioural principles employed in token system are based mainly on the theory of operant conditioning.
The principles of OC describe the relationship between a behaviour and environmental events.
Key within this relationship is the idea of positive reinforcement, i.e. an increase in the frequency of a particular behaviour when it is followed by a desirable event.
What are the stages?
Tokens are paired with rewarding stimuli and so become secondary reinforcers.
Patient engages in target (i.e. desirable) behaviours or reduces inappropriate ones.
Patient is given tokens for engaging in these target behaviours (e.g. dressing themselves).
Patient trades these tokens for access to desirable items or other privileges.
What are the evaluation points?
Research support
Difficulties assessing the success
Less useful for patients living in the community
Ethical concerns
What is meant by research support?
Dickerson (2005) provided research support for the effectiveness of token economies in a psychiatric setting.
They reviewed 13 studies of the use of token economy systems in the treatment of schizophrenia, 11 of which reported beneficial effects that were directly attributable to the use of token economies.
However, the authors cautioned that many of the studies reviewed had significant methodological shortcomings that limited their impact in the overall assessment of token economies.
What is meant by difficulties assessing the success?
A problem in assessing the effectiveness of token economies is that studies of their use tend to be uncontrolled.
Typically, all patients on a ward are on the programme rather than having an experimental groups and a control group.
As a result, patients improvements can only be compared with their past behaviours rather than with those of a control group.
This comparison may be misleading, as other factors (e.g. an increase in staff attention) could be causing patients improvement rather than the token economy.
What is meant by less useful for patients living in the community?
Although the token economy has shown to be effective, it has only really been shown to work in a hospital setting.
There are problems administering a token economy with outpatients. Within a psychiatric ward, staff are able to monitor and reward patients appropriately. This is not possible with outpatients living in the community.
Therefore, even if the token economy does produce positive results within the ward setting, these results may not be maintained beyond that environment.
What is meant by ethical concerns?
There are concerns about the use of token economy programmes is psychiatric settings.
Clinicians may withhold important primary reinforcers such as food, privacy or access to activities that alleviate boredom.
Patients gain access to these rewards by exchanging tokens awarded for demonstrating target behaviours.
However, human beings have certain basic rights (to food, privacy, etc) that cannot be violated regardless of the positive consequences that might be achieved by manipulating them within a token economy programme.
