Token Economies

• :( limited evidence

  > a review of 3 studies, investigating the use of token economies, found there was a limited impact of the management of patients with schizophrenia - only one of the studies showed any improvement in symptoms and no significant positive change in maladaptive behaviours

  > casts doubt on the effectiveness of token economies
• :( ethical issues

  > privileges become more available to patients with mild symptoms, and less available to those with more severe symptoms that prevent them from complying with desirable behaviours

  > leads to severely ill patients suffering discrimination - prevented from accessing the programme

  > not appropriate for all patients
• :( does not get to root cause

  > aims to make schizophrenia more manageable so patients can integrate into society - does not treat schizophrenia

  > mainly effective in an institutionalised setting, so when patients return home, they lose the structure they had to help manage their behaviour e.g. no one to give them a token

  > questions the appropriateness and effectiveness, as there is a high chance of relapse when patients are given independence