Token economies

• What is Token economies

  A form of behavioural modification, where desirable behaviours are encouraged by the use of selective reinforcement
• The tokens are secondary reinforcers and can be exchanged for primary reinforcers e.g. privileges, prizes, activities
• Why token economies?

  Institutionalisation- develops after prolonged hospitalisation. People often develop bad habits e.g. maintaining good hygiene or stoping socialisation. So token economies help patients maintain personal care, social behaviour and condition related behaviour
• How does token economies work ?

  1. Tokens (initially hold no value) are paired with rewarding stimuli (that does hold value)
  2. Patient engages in ‘target’ (desirable) behaviours or reduce inappropriate ones
  3. Patients given tokens for engaging in target behaviours
  4. Patients trades these tokens for access to desirable items or privileges. This should be done quickly to be effective
• Benefits of token economies

  1. Improves QOL within the hospital setting
  2. ’Normalises’ usual everyday behaviour and makes it easier for people who have spent time in a hospital to adapt back into life
• How do you make token economies more effective

  • If patients have a list of activities they can choose to swap their tokens more e.g. like when you hand in tickets at an arcade
  • Staggering how many tokens each behaviour is worth
• Research supporting the effectiveness of token economies - Ayllon and Aaron (1968)

  • Trialled a token economy in a ward of women with schizophrenia
  • Every time patients carried out a task such as making their beds or cleaning up they were given a plastic token
  • These tokens could then be swapped for privileges

  = number of tasks carried out increased significantly
• Strengths of token economies

  • improves patients QOL while living in hospital
  • Normalises behaviour and makes it easier to adapt back into real life
• Limitations of token economies

  • success depends of consistency from staff
  • could lead to relapses when patients are out of care
  • can be manipulative and dehumanising
  • issues around ethics and ‘privileges‘
• Overall effectiveness of Token Economies

  Token economies have been found to be effective in improving the social and functional skills of individuals with schizophrenia by reinforcing desirable behaviors with tangible rewards. However, their effectiveness may be limited by the need for consistent implementation and may not address the underlying causes of the disorder, such as delusions or hallucinations.