Token economies

• P: one strength of token economies for the management of schizophrenia is evidence for their effectiveness

  E: Glowacki identified seven high quality studies that examined the effectiveness of token economies for people with chronic mental health issues such as schizophrenia and involved patients living in a hospital setting. all the studies showed a reduction in negative symptoms and a decline in the frequency of unwanted behaviours.
• link for strength

  L: this therefore shows the value of token economies and suggests that it may still be a valuable method for managing schizophrenic patients within a hospital setting
• P: a limitation of token economies is the existence of more pleasant and ethical alternatives

  E: a review by Chiang concluded that art therapy might be a good alternative. the evidence base is regularly small and has some methodological limitations, but it appears to show that art therapy is a high gain low risk approach to managing schizophrenia.

  L: this suggests that there may therefore be better alternatives to managing schizophrenia which may be more appropriate that token economy
• P: another issue with token economies is that they are very difficult to continue once a person is outside a hospital setting

  E: Corrigan argues that there are problems administering the token economy method with outpatients who live in the community. within a psychiatric ward setting, inpatients receive 24h care and so there is better control for staff to monitor and reward patients. outpatients living in a community only received treatment for a few hours a day, so the token method could only be used for part of the day
• Link for person outside a hospital setting

  L: as a result, even if the token economy did produce positive results within the ward setting, these results may not be maintained beyond that environment, calling into question the long term benefits of token economy in the management of sz