token economy

• Token economy is a form of behavioural modification where desirable behaviours are encouraged by the use of selective reinforcement. Primary used in institutions & hospitalisation where bad habits may develop e.g. lack of hygiene/social behaviour
• token economy

  Patients are given tokens e.g. discs, when they have carried out desirable behaviour based on their needs e.g. showering, eating all their food etc.

  Tokens can later be swapped for rewards e.g. sweets, magazines, activities etc.
• Token economy is a behavioural therapy based on operant conditioning where desired behaviours are reinforced with rewards.

  Tokens are secondary reinforcers as they only have value once used to redeem a reward.

  The rewards act as primary reinforcers as they are meaningful rewards.
• Several high-quality studies have shown a reduction in negative symptoms and undesirable behaviours in patients in hospital settings where token economy’s used.
• The use of token economies raises ethical issues as it gives professionals power to control the behaviours of patients and impose their norms on them. It also takes away the patient’s freedom and their access to pleasurable things (rewards).
• token economies weakness

  There are other approaches with research support which have less ethical issues. It has been suggested that art therapy may be a good alternative for example and this is the suggested management tool by NICE.
• Token economies are difficult to maintain outside of a hospital setting as target behaviours cannot be monitored closely and tokens aren’t given to patients immediately after the behaviour.