token economy a03

• One strength of the TE is that it seems to be effective in managing schizophrenia, Dickerson reviewed 13 studies which used the TE in therapeutic settings. They found that 11 of these reported beneficial effects could be directly attributed to the TE. This suggests that the TE can increase the target behaviours of schizophrenics. Furthermore token economies help to create a safer environment for patients and staff. This is because, reinforcing desirable behaviours, behaviours such as aggression should eventually cease to continue within the establishment. alloyn and arzin used in a ward of schizophrenia patients and found it increased dramatically the number of desirable behaviours they performed each day
• However, an issue with token economy systems is that patients may become dependent on reward and therefore only behave well to receive a token. This can lead to low transference to real life because when patients leave the institution they no longer receive immediate reinforcement. For example, they may struggle to hold down a job with monthly pay as they expect to be rewarded immediately. They found that while TES reduced negative symptoms (by acting as a motivational tool), it was unclear whether patients maintained these behaviours after the treatment programme.Therefore, it could be argued that token economies are helpful for the short term management of schizophrenia but can actually be detrimental to schizophrenics in the long term
• Ethically, there are issues with TE. First and foremost, it gives professionals/medical staff significant power of control over the behaviour of the patients. It imposes a ‘norm’ that, which is not fair to expect this perfection off of patients (for example, a patient may not want to dress a certain way for the day, or may prefer to bathe every two days). it may aggravate more distressing symptoms by removing pleasurable/escapist activities from the patient. If they are not performing well, and not earning tokens, it has a significant impact on the patient’s daily life.. It seems unfair to deprive of favourite things because you were having a bad day.

  This is a restriction of personal freedoms, and it is unethical to deprive people of their rights.