AO3

• Research suggests that token economies can be effective in improving patients’ functioning.

  -For example, Ayllon and Azrin (1968) found that chronic schizophrenia patients showed significant increases in desirable behaviours such as self-care and work participation after a token economy system was introduced.

  -This supports the view that behavioural principles can bring about positive changes in patients’ behaviour.
• A strength of Token economies is that they can make life in institutional settings more manageable and humane.

  -By encouraging self-care and social interaction, they can reduce the burden on hospital staff and improve patients’ quality of life.

  -This is especially useful for patients who have been institutionalised for long periods, as it helps them relearn daily living skills and prepare for life outside the hospital.
• A major criticism is that token economy does not address the underlying causes of schizophrenia, such as biological or cognitive dysfunctions.

  -It focuses purely on outward behaviour rather than the mental processes behind the disorder. As a result, improvements may be superficial and symptoms can return if the rewards stop being provided. This means token economy is best seen as a management technique rather than a treatment.
• There are ethical concerns about using token economies, particularly regarding control and discrimination.

  -Patients with more severe symptoms may struggle to earn tokens, meaning they are denied basic privileges, which could be seen as unethical.

  -This raises questions about fairness and informed consent, as some patients might not fully understand the system.
• Finally, token economies are rarely used outside institutional settings because they require consistent monitoring and reinforcement by staff.

  -Once patients leave the controlled environment, rewards may no longer be available, and behaviours often do not generalise to everyday life.

  -This limits the external validity and long-term usefulness of the treatment.