Management of schizophrenia (Token Economies)

• Token economies - Reward systems used to manage behaviour of people with schizophrenia, particularly those who developed patterns of maladaptive behaviour via spending long periods of time in psychiatric hospitals.
• Developing token economies - Ayllon and Azrin (1968) trialled token economy system in a ward of women with schiz. They were given ward priveledges when carrying out a task such as making their bed.

  The no. of tasks completed increased significantly in the 1960s and 70s.
• The use of token economies in the UK declined due to increased community based care and more ethical issues raised by restricting rewards to people with mental disorders. But token economies are still standard in other parts of the world.
• Instiutionalisation develops under prolonged hospitalisation. the outcome could be that they develop bad hygiene.
• Matson et al (2016) identified 3 categories of institutionalisational behaviour commonly tackled by token economies: personal care, condition related behaviour and social behaviour.
• Token economies do not cure behaviour but brings out benefits such as increased quality of life. eg. makeup for someone who takes pride in their appearance. And it normalises behaviour. eg. getting dresses in the morning.
• In token economies, a form of coloured discs can be used to exchange for priveledges. eg. in a hospital setting, can include objects like sweets/magazines
• Token economies are an example of behaviour modification based on operant conditioning . Tokens are secondary reinforcers that are given to the patient for good behaviour (because there is learning value attached to the tokens.