Token Economy Programmes

Question 1

What are Tokens?

Answer 1

• patient and carers decide together

Question 2

What are target behaviours?

Answer 2

• achievable, realistic e.g. eating breakfast

Question 3

What is contingency and contiguity?

Answer 3

• need to reinforce all behaviours agreed as part of the plan or patients will lose trust. Rewards need to be given in a timely manner

Question 4

What are primary reinforcers?

Answer 4

• must be significant and rewards for the patient + tailored approached

Question 5

What is the exchange system?

Answer 5

• clear rules, where/when/how

Question 6

What are schedules of reinforcement?

Answer 6

• need to be under constant review, schedules of reinforcement should change to keep the patient motivate

Question 7

What are types of reinforcement?

Answer 7

• positive reinforcement only, negative can be counter productive

Question 8

What is the recording progress?

Answer 8

• review and feedback the chance to reflect and receive positive feedback on progress acts as a good motivators for encouraging behaviours

Question 9

TOKEN ECONOMY REQUIRES HOSPITALISATION

Answer 9

• Hospitalisation of anybody for a mental disorder can be a confusing and emotion-wrought decision
• Family members or significant others may need to intervene in the patient’s life to ensure they do not starve themselves to death.
• Hospitalisation is not only necessary, but a prudent treatment intervention
• Family members should be aware that individual who suffer from anorexia will often resist treatment of any sort
• important to come to any agreement about the need for such step and not to be swayed by the patient’s please for seeking alternative treatment options/

Question 10

LIFE AS AN INPATIENT

Answer 10

• This program rewards patients for eating regular meals and ensuring they do not purge afterwards
• as the patient gains weight, additional hospital privileges may be granted
• a specific target weight should be set as the treatment goal, upon which time the patient should be granted from the hospital into an outpatient program consisting of individual therapy.
• Treatments will usually continue in an outpatient modality
• if such behaviour is not implemented in the impatient treatment facility, the treatment progress will likely to be slower

Question 11

How operant conditioning principles and token economy programs work in situations?

Answer 11

• Daily fluid intake and weight should be tracked.
• If the person vomits after meals, they should be watched for a few hours after each meal to ensure no
  vomiting occurs.
• The individual’s diet should begin between 1,500 and 2,000 calories per day. This calorie intake can increase
  gradually as the patient makes treatment gains.
• The patient should have six equal feedings throughout the day, although this may not always be possible.
• Severely anorexic patients can be started on a liquid food supplement (e.g., Sustagen) or an IV, if necessary.
• Inpatient programs (especially) should be careful not to overemphasize the importance of a person’s weight,
  however. Weight is only the symptom in this disorder of poor body image and self-esteem problems. These
  primary difficulties should be the focus of any treatment approach for an eating disorder.
• Weight gain can be used as an objective measure as to treatment progress.