Token economies

• What’s are reward systems used for?

  Used to manage maladaptive behaviour patterns due to extended periods of time in hospital.
• When was token systems used a lot in?

  Used a lot during 60s and 70s - long term hospitalisation was the norm.
• How does token system work?

  -Tokens are given to patients immediately after they have carried out a desirable behaviour.Delays reduce the effectiveness so have to give out the reward immediately and target behaviours are individual.

  -tokens have no value in themselves ,but they can be swapped for tangible rewards E.g sweets 
• Is behaviour modification operant or classical conditioning?

  classical conditioning
• Are tokens secondary reinforcers?

  Yes as they have no value in themselves and they gain their power through being paired with a primary reinforcer (reward).This generally happens at the start of the programme and administered together at first.
• What is institutionalisation ?

  institutionalisation is the process of embedding a belief, norm, social role, particular value or mode of behaviour when living within an organisation.This makes re-adjusting to ‘life outside’ very difficult.
• What does institutionalisation cause?

  Bad habits
• What’s matson et al research?

  They identified 3 categories of institutional behaviour tackled by token economies which were personal care,condition related behaviour and social behaviour 
• What is behaviour modification not?

  -not a cure

  -improves lives within a hospital setting 

  -makes it easier to adapt back to life in the community after a stay in hospital
• What was Ayllon & nazrin (1968) study ?

  -Ward of women with sz

  -carrying out a task e.g making bed gives a token

  -swap for a gift/privilege 

  -resulted in the number of increasing

  -use has decreased more recently due to a change of care routines,but also due to ethical issues.
• One strength of token economies is there is research support for the effectiveness of token economies. Dickerson et al (2005) conducted a

  meta-analysis of 13 studies and found that 11 of these studies had reported beneficial effects.This suggests token economies are effective in increasing the adaptive behaviours of SZ patients in institutional care.
• Counterbalance for research support - Dickerson et al

  Although,most of the research didn’t have a control group so can’t establish a cause and effect relationship between sz and good behaviour.
• Another limitation of token economies is they may only be useful in institutions.It can be argued that they work because the environment in an institution is carefully structured so that good behaviour can consistently be rewarded. As the outside world is very different, patients may find it hard to transfer what they have learned to everyday life once released.This suggests although token economies may be effective in institutions, they may not be effective preparation for life in the outside world.
• P a criticism of using token economy in psychiatric institutions is that it raises ethical concerns

  E this is because token economies work on the principles of rewarding patients with every day pleasures (watching TV) and this could be seen as unethical as they are denying people with Schizophrenia these pleasurable activities until they behave in a way the institution finds desirable
• ethical concerns (2)

  E whereas these activities= freely available outside the institution

  L raises serious ethical and moral questions as to whether token economy should be used as a way of managing symptoms of SZ within hospital setting