TOKEN ECONOMY AO1 & AO3

Question 1

The token economy system (TES)

Answer 1

• is based on operant conditioning and is used to manage behaviour, in particular those who have developed maladaptive behaviour after spending long periods in psychiatric hospitals.
• Modifying behaviour doesn’t cure SZ but improves quality of life and makes it more likely they
  can live outside of the hospital.
• Tokens are given each time they carry out a desirable behaviour, and act as positive reinforcement for the patients causing behaviour to be more likely to be repeated.
• This immediate reward prevents ‘delay discounting’ (the reduced effect of a delayed reward)

Question 2

One limitation of TES is that it has limited usefulness.

Answer 2

• For example, Kazdin and Bootzin have claimed that the TE does not lead to permanent changes in behaviour and that once the reinforcement is removed, the undesirable behaviour returns to its initial level.
• This means it’s not a long term management of the condition, which is often required to maintain stability and prevent relapse.
• Disadv as it may not be the best treatment option for schizophrenics who require ongoing support to manage their symptoms and behaviours.
• Furthermore, TES requires consistency so staff have to be trained- which is costly and time consuming as it requires a lot of input from these staff

Question 3

One limitation of TES is that it can raise ethical issues.

Answer 3

• For example, TES have proven controversial, with privileges, services, etc., becoming more available to patients with mild symptoms and less so for those with more severe symptoms of schizophrenia that prevent them complying with desirable behaviours.
• This means the TES is discriminating against severely ill patients who may be unable to comply with desirable behaviours.
• This is a disadvantage as it shows that TES may not be a fair treatment for all patients with SZ and has resulted in reduced the use of token economies in the psychiatric system.
• Furthermore, other psychological therapies CBT may raise ethical issues when challenging a patient’s beliefs, as it may interfere with an individual’s freedom of thought.