Psychological Treatment for Anorexia : Token Economy

• What is a token economy?

  A behavioral treatment based on operant conditioning
• What is the aim of a token economy?

  To modify maladaptive behaviors and encourage adaptive behaviors
• Where are token economies typically used?

  In closed institutions where behavior can be monitored
• What do token economies reward in anorexia treatment?

  Target behaviors like eating a full meal
• What is a secondary reinforcer in a token economy?

  A token that can be exchanged for a primary reinforcer
• How are tokens decided in a token economy?

  By patients and carers discussing rewards and exchanges
• What happens when a target behavior is shown in a token economy?

  A token is given to positively reinforce that behavior
• What did Stunkard et al. find about positive reinforcement in anorexia treatment?

  It successfully encouraged normal eating in anorexics
• What is a potential weakness of token economy programs (TEPs)?

  They may create a power imbalance and learned helplessness
• What should target behaviors in a token economy be like?

  Achievable and realistic, broken into small steps
• Why should rewards be given immediately in a token economy?

  To maintain trust and avoid withdrawal symptoms
• What did Garfinkel et al. study about TEPs?

  They found rapid weight gain in patients
• What did Paul and Lentz suggest about TEPs?

  They may be ineffective without medication
• How do tokens function as reinforcers in a token economy?

  They are exchanged for significant primary reinforcers
• What is the role of monitoring phone time in TEPs?

  To prevent access to pro-anorexia sites
• What can negative reinforcement lead to in TEPs?

  It can decrease motivation in patients
• What did Field et al. find about TEPs?

  Many participants were non-responsive to TEPs
• What is shaping in the context of TEPs?

  Making tokens harder to earn as progress is made
• What is a limitation of TEPs regarding long-term effects?

  Behaviors may disappear once reinforcement stops
• How can TEPs be integrated with other therapies?

  By using them to reinforce attendance in therapies
• What is an alternate treatment for anorexia mentioned?

  Drug treatment using antipsychotics and SSRIs
• What is a potential drawback of drug treatments for anorexia?

  They can have side effects leading to dropout
• How can psychological treatments improve quality of life for anorexia patients?

  By unlearning maladaptive behaviors through reinforcement
• What are the key components of a token economy for treating anorexia?

  • Operant conditioning principles
  • Target behaviors rewarded with tokens
  • Tokens exchanged for primary reinforcers
  • Immediate rewards to maintain trust
  • Involvement of patients in decision-making
• What are the strengths and weaknesses of token economies in treating anorexia?

  Strengths:

  • Effective in encouraging normal eating
  • Flexible with other therapies
  • Immediate reinforcement increases engagement

  
  

  Weaknesses:

  • Potential for power imbalance
  • Short-term solution with risk of relapse
  • May not work for all patients