Token Economy

• What are token economies used for in the management of schizophrenia?

  Token economies are reward systems used to manage the behavior of patients with schizophrenia.
• What type of patients are primarily targeted by token economies?

  Patients who have developed maladaptive behavior through long periods in psychiatric hospitals.
• What is the basis of how token economies work?

  Token economies work on the basis of operant conditioning (positive reinforcement).
• What is required for maximum effectiveness of token economies?

  The patient must be rewarded immediately.
• What is the aim of token economies for long-term hospitalized patients?

  To enable them to live independently in the community and improve negative symptoms.
• What behaviors do clinicians set as targets in token economies?

  Behaviors that improve the patient's engagement in daily life, such as washing, eating, and interaction.
• What did Silverstein (2009) find regarding schizophrenia patients living in the community?


  They struggled to perform jobs where they were paid monthly but engaged when paid hourly or daily.
• What was the outcome of Allyon & Azrin's (1968) study on token economies?


  The average number of daily chores increased from 5 to 42, demonstrating success.
• What did Sran and Borrero (2010) find about the response rate to desirable behavior in token economies?


  Participants had a higher response rate when there was a variety of rewards available.
• What is a strength of token economies?

  Research supports their effectiveness, such as Chiang et al (2019) finding art therapy to be a high gain, low risk approach.
• What is a limitation of using token economies?

  Ethical issues may arise, impacting freedom and quality of life.
• What is another limitation of token economies regarding their effectiveness?

  They do not work outside of an institutionalized setting.
• What did McMonagle and Sultana (2009) find in their review of token economies?


  Only one of the three studies showed improvement in symptoms, and none yielded useful information about behavior change.
• What is the outline of token economies as a method used in the management of schizophrenia?

  • Awarding of 'tokens' for desirable behavior
  • Based on Skinnerian operant conditioning principles
  • Used for behavioral shaping and management
  • Aims to make patients easier to manage in long-stay hospitals
• What are the strengths and limitations of token economies in managing schizophrenia?

  Strengths:

  • Evidence suggests effectiveness in improving behavior
  • Provides a structured reward system

  
  

  Limitations:

  • Do not address symptoms of schizophrenia
  • Ethical issues regarding treatment of patients
  • Not effective with unresponsive patients
• What are the potential benefits of token economies in managing schizophrenia?

  They can improve behavior and help patients engage in daily activities.