TOKEN ECONOMY

• GLOWACKI SUPPORT FOR EFFICACY (AO3)

  • GLOWACKI ET AL (2016) Conducted a systematic review of seven high-quality studies published between 1999 and 2013, investigating the effectiveness of token economies in managing chronic mental health conditions including schizophrenia
  • FOUND: All studies reported a reduction in negative symptoms. Unwanted behaviours declined, suggesting increased patient engagement in daily activities
  • Token economies were effective across different institutional settings, indicating consistency in their benefits
  • Highlights overall how token economy is a useful behavioural intervention but does not assess the long-term effectiveness after the patient leaves structured environments.

  HOWEVER, use of a meta-analysis and a small sample size for it, may call into question the validity and generalisability of the findings in application to the efficacy of token economies.
• ETHICAL ISSUES (AO3)

  • Can be suggested the systems of token economies are controversial as privileges and services become more available to patients with mild symptoms and less for those with more severe symptoms.
  • This may be an issue as this prevents serious sufferers from complying with desirable behaviours and therefore suffer from discrimination.
  • This has resulted in the reduced use of token economies as a treatment within the psychiatric system due to the discriminatory nature/focus on patients with less severe experiences.
  • Also exhibits a power imbalance between patients and carers
  • Can lead to potential coercion or pressure to participate due to fear of losing privileges
  • Therefore lacks appropriacy
• NOT TREATMENT (AO3)

  • Token economies may help improve desirable behaviours within patients through the reward system, increasing the likelihood those behaviours will be repeated helping the sufferer to function in a more socially acceptable way and therefore allows them to have a chance to reintegrate into society
  • However, token economy is not necessarily a treatment or cure for schizophrenia, it simply helps sufferers to function properly which their condition may prevent, therefore may be a weakness as it cannot address the root cause/issues with schizophrenia.