management of schizophrenia

• institutionalisation


  -result of being in an institutionalisation for a long time leading to maladaptive behaviour

  -people who have been hospitalised become institutionalised & develop maladaptive behaviours, token economies can help counteract this
• token economies

  -form of behaviour modification, desirable behaviours are encouraged via selective reinforcement, based on positive reinforcement

  -patients are given a token when they display desirable behaviours and can then exchange these tokens for desirable outcomes
• categories of institutionalisation (Matson et al)


  -personal care

  -condition-related behaviour

  -social behaviour
• benefits to token economies


  -improved quality of life

  -normalises behaviours so that people can adapt to life outside of the institution (helps them reintegrate back into their community)
• primary reinforcers & secondary reinforcers

  -primary reinforcers are the main drive of behaviour, this is the the end reward

  -secondary reinforcers are not fully reinforcing the behaviours but lead to the primary reinforcer. In token economies, tokens are a neutral stimulus and are the secondary reinforcer
• management of SCZ (token economy) - AO3


  Strength:

  -supporting research shows the effectiveness. A psychologist found that the token economy system reduced negative symptoms of SCZ. It has use. D: not good at reducing positive symptoms of SCZ so not a fully effective/useful management option

  
  

  Weaknesses:

  -only effective in the institution. This management option can only be used in certain circumstances as it is not useful in real-world settings. No one is there to regulate & give tokens for desirable behaviours in the real world. This management option cannot be generalised to wider contexts

  -alternative options may be more effective. People with SCZ have avolition so are unlikely to engage with the token economy. Methods that don't require motivation, like antipsychotics, may be better as patients will consistently use them. Treatment options might be better than management options

  -not a cost effective management option as the rewards and tokens need to be paid for. D: if the management is effective, SCZ patients will be able to return to work and give money to the economy. There are positive economic implications