Token Economies

• Token Economies are a form of behavioural modification where desirable behaviours are encouraged by using tokens as secondary reinforcers
• Ayllon & Azrin trialled a token economy system on a ward of women with schizophrenia and found that the number of tasks carried out increased significantly
• Token economies were used most in the 1960s & 70s when long-term hospitalization was the norm for treating schizophrenia
• Use of token economies has declined in the UK due to growth of community-based care and closure of psychiatric hospitals
• There are ethical issues with token economies as they restrict availability of pleasure & personal freedom
• An ethical issue of token economies is that professionals have the power to control the actions of patients and imposing their own norms on to them
• Token economies aim to improve the patients quality of life, and to normalise behaviours
• Token economies improve quality of life by providing patients with rewarding reinforcers
• Token economies normalise behaviours to make it easier for patients who have been hospitalized for a long time to adapt back to life in the community
• There is evidence for the effectiveness of token economies e.g. Glowaki
• Glowaki identified seven high quality studies that examined effectiveness of token economies on people with chronic mental health issues and found a reduction in negative symptoms and frequency of unwanted behaviours
• Glowaki's study is limited as seven studies is only a small evidence base to support effectiveness, suggesting a file drawer problem
• A File Drawer problem is when undesirable studies may have been 'filed away ' in reviews with a small number of studies due to bias towards positive published findings
• Token economies is limited by the presence of more pleasant & ethical alternatives e.g. art therapy, family therapy
• There is evidence to support the effectiveness of art therapy e.g. Chiang
• Chiang conducted a review of studies into art therapy and concluded that it may be a good alternative as it is a high-gain low-risk approach