token economy management

• token economy

  • behavioural therapy using tokens and exchange to increase frequency of target behaviours
  • based on theory of operant conditioning
  • primary and secondary reinforcer
• example

  • Ayllon and Azrin used to increase desirable behaviours (eg. making bed) in a female sz ward
• assigning value to tokens

  • repeatedly presented alongside reinforcing stimulus
  • neutral tokens become secondary reinforcers due to classical conditioning
• reinforcing target behaviours

  • tokens awarded when desirable target behaviours
  • then exchanged for rewards
  • when token can be exchanged for range of rewards it's a generalised reinforcer - more effective
• trading

  • during early stages, frequent exchange periods mean quick reinforcement
  • effectiveness decreases if more time between token and backup reinforcers
• research support

  Dickerson et al

  • 11/13 of studies using token economies to treat schizophrenia had direct beneficial effects in increasing adaptive behaviours

  BUT many of these studies had methodological flaws --> limited application in assessment
• difficulty assessing success of token economy

  Comer suggests a flaw is that many studies are uncontrolled

  • generally no control group
  • patient's improvement compared against their own past

  could be other factors causing improvements
• less useful for patients living in community

  only useful for hospital setting

  • as 24hr care - better control for rewarding
  • outpatients only monitored for few hours each day

  positive results can't be maintained
• ethical concerns

  to work, clinicians must be in control of primary reinforcers like food and privacy

  • contradicts idea that humans have rights to these without having to earn them

  possibly shouldn't be used as treatment