Token economies

• > Token economies are a behaviourist approach to manage the behaviour of patients with schizophrenia

  > It is mainly used with patients who have spent a long time in hospital and therefore who have developed maladaptive behaviour (institutionalised) such as bad hygiene or lack of communication with others
• Aim of token economies - To change a patients behaviour so that they are easier to manage, we will have a better quality of life and therefore enabling them to live outside of a hospital setting
• How it works

  > The technique uses Skinners operant conditioning principles of positive reinforcement

  > Patients receive rewards in the form of tokens, immediately after producing a desired behaviour such as self-care or social interaction

  > The tokens can then be later exchanged for goods or privileges such as hours watching tv, magazines, a walk outside or sweets.
• Token economies AO3

  :( Limited evidence to support the effectiveness

  > A review of 3 studies investigating the use of token economies found that there was a limited impact on the management of patients with schizophrenia

  > As only 1 of the 3 showed any improvement in symptoms and no significant positive change in maladaptive behaviour

  > Therefore casting doubt on the effectiveness of token economy
• Token economies AO3

  :( Can raise ethical issues

  > Privileges may become more available to those who have more mild symptoms compared to more severe ones as they may prevent them from complying with desirable behaviour

  > Token economies suggests that symptoms of schizophrenia can easily be bypassed if they seek the reward. However, this leads to the most severely ill patients suffer discrimination, as the severity of their symptoms prevents them from accessing this programme

  > Reducing the use of token economies in the psychiatric system to manage schizophrenia
• Token economy AO3

  :( Doesnt get to the root cause

  > The aim is to make schizophrenia more manageable and improve patients' quality of life; it helps by making patients' behaviour more socially acceptable so that they can better integrate into society

  > However it doesnt treat schizophrenia

  > Mainly effective in institutions and when patients are sent back home, they lose the structure they had to help manage their behaviour

  > Questioning the appropriateness and effectiveness of the therapy in managing schizophrenia