token economies.

• Token economies use operant conditioning to encourage positive behaviour by associating the positive behaviour with a reward.
• Token economies are used to manage patient behaviour in the hospital as patients are given tokens when they engage in positive, adaptive behaviour which can be exchanged for rewards. The patient learns to repeat positive, adaptive behaviours through positive reinforcement.
• The patient learns to associate the behaviour with the token through classical conditioning. At first, the token is a neutral stimulus. Through repeated association with the reward, the token becomes a conditioned stimulus and the patient develops a conditioned response to the token.
• Supporting evidence for token economies. Dickerson et al reviewed 13 studies investigating the effectiveness of token economies and found 11 studies reported improvements in patient behaviour and token economies were especially useful in combination with other therapies. This is positive as it highlights the usefulness in using token economies to manage schizophrenic patients. However, the studies often lack a control group and we can't be sure there is a cause and effect relationship. This is problematic as it lacks validity.
• Token economies may not be useful outside a hospital environment. Token economies are used in hospitals to help manage a patients behaviour however, outside of the hospital, it’s harder to monitor patient behaviour and provide an immediate reward for positive behaviour. This is problematic because token economies have limited use outside the hospital.
• Ethical issues. Patients are treated like children, which might be humiliating and cause distress. Also, rewards might encourage patients to become over-dependent on being rewarded for their behaviour, which could have negative effects once they leave the hospital. This is problematic as it goes against the BPS code of ethics.