Token Economies

• Token Economies


  A form of behavioural modification where desirable behaviours are encouraged through reinforcement.
• Developing token economies

  • Token economy was used for a ward of women with schizo
  • Every time they did a task such as making their bed they got a token
  • These tokens gave privileges such as watching a movie
  • The number of tasks increased significantly
  • It was popular before but has declined in the UK due to the ethical issues
• Rationale for token economies

  • In institutions people develop bad habits such as not being able to keep good hygiene or socialising
  • This can help with personal care and social behaviour
  • It does not cure schizo but can help with improving the persons quality of life
  • It also 'normalises' behaviour so they can adapt back into the community
• What is involved in token economy?

  • The tokens are given immediately to individuals when they carry out the desirable behaviour
  • Target behaviour are decided on an individual basis
  • The tokens are then used to get rewards such as getting sweets or going for a walk
• Theoretical understanding of Token economies

  • Based on the behavioural approach based on operant conditioning
  • Tokens are secondary reinforcers as they are only useful once the person realises they can get a useful reward with it
  • The reward itself is the primary reinforcer as this will motivate them to do more desirable behaviours
• AO3 Token Economies: Evidence of effectiveness

  • Seven studies examined the effectiveness of token economies for people with schizo and involved patients in a hospital setting
  • All studies showed a reduction in negative symptoms and a decline in the frequency of unwanted behaviours
  • However seven studies is small and causes the file drawer problem
  • This is when only the positives are highlighted and leads to bias which leads to questioning the effectiveness of token economies
• AO3 Token Economies: May only work in some environments

  • Staff are required to give rewards immediately after the desirable behaviour is displayed
  • This makes the therapy more effective in the hospital setting where staff can monitor patients all the time
  • May be appropriate only within the hospital setting where the behaviours of patients needs to be controlled
  • Questions how effective token economies are in all settings
• AO3 Token Economies: Ethical Issues

  • Professionals are given huge amounts of power to control the behaviour of the patient
  • This involves imposing ones 'norms' on to others which can be problematic
  • The use of tokens is restricting to the patients as they have to earn privileges which can be distressing
  • Legal action is even taken by the families of patients leading to a decline in token economies
• AO3 Token Economies: Alternative Approaches

  • There are more pleasant alternatives that do not raise as much ethical issues as token economy
  • Art therapy may be a better alternative which is a high gain low risk approach
  • The benefits may not be high but there is no side effects or ethical issues
  • NICE also recommends art therapy which then questions the credibility of token economy