Token Economy

• What are token economies used for in schizophrenia treatment?

  To manage the behaviour of people with SZ

  
• What maladaptive behaviour do token economies address?

  Spending long periods in psychiatric hospitals
• Who developed the token economy system in 1968?

  Ayllon and Azrin
• What did participants in Ayllon and Azrin's study receive for completing tasks?

  Tokens
• What was the significant change in the number of tasks completed in the study?

  Increased from 5 to 42
• What are the three categories of institutional behaviour addressed by token economies according to Matson et al.?

  Personal care, condition-related behaviours, social behaviour
• What are the two major benefits of behaviour modification in schizophrenia treatment?

  Improves hospital life and community adaptation
• What are tokens in a token economy?

  Coloured discs given for desirable behaviour
• Why is it important to know the individual when deciding target behaviours?

  To identify appropriate target behaviours
• What do tokens represent in a token economy?

  Secondary reinforcers
• What are primary reinforcers?

  Rewards that are directly rewarding, like food
• What is the definition of behaviour modification?

  A behavioural therapy based on operant conditioning
• What are generalised reinforcers?

  Tokens exchanged for various primary reinforcers
• What are the benefits of the token economy system for people with schizophrenia in a psychiatric hospital?

  • Improves daily functioning
  • Reduces negative symptoms
  • Enhances social interactions
  • Facilitates reintegration into the community

  
• What evidence supports the effectiveness of token economies?

  Seven high-quality studies showed positive results
• What is a limitation of the evidence base for token economies?

  It consists of a small number of studies
• What is the file drawer problem in research?

  A bias towards publishing positive findings
• What ethical issue arises from the use of token economies?

  Imposing one person's norms on others
• How might token economies negatively impact patients?

  They may worsen distressing symptoms
• What is an alternative to token economies that avoids ethical issues?

  Art therapy
• What is a benefit of art therapy compared to token economies?

  It is a pleasant experience
• What are the strengths and weaknesses of token economies in treating schizophrenia?

  Strengths:

  • Evidence of effectiveness from multiple studies
  • Reduces negative symptoms

  
  

  Weaknesses:

  • Small evidence base
  • Ethical concerns regarding control
  • Existence of more pleasant alternatives