MANAGEMENT - TOKEN ECONOMIES

• TOKEN ECONOMIES 


  based on the principles of operant conditioning in order to modify undesirable behaviours into new ones
• TOKEN ECONOMIES 


  3 main types of setting up TE:

  • Firstly the therapist would identify the undesirable or maladaptive behaviour and thus what the desirable behaviour would be.
  • Secondly they would remove any reinforcers in the environment that might be maintaining the undesirable behaviour.
  • Lastly they would give a reward for desirable behaviours (token)
• THE TOKEN 


  positively reinforces the desirable behaviour as it is given when the behaviour is completed, the token can be exchanged for tangible items e.g a cigarette. This technique is useful for patients who have become institutionalised and have developed bad habits like struggling to get dressed in the morning. It helps improve their quality of life whilst

  preparing them for their lives outside of the institution when they are released.
• TOKEN ECONOMIES 


  Each patient is treated individually and specific target behaviours for each person are identified. The tokens should be given immediately after the desirable behaviour is produced, as if there is a delay it can reduce the effectiveness of the therapy.
• (+) TOKEN ECONOMIES 


  AYLLON AND AZRIN = studied 45 female patients with sz who received tokens for good behaviours e.g making their beds or had tokens taken away for psychotic beh. = found that before the introduction of TE, they showed aggression and poor social skills but following the us of TE, there was a massive improvement in such beh. = it can be used to help manage sz beh in institutions. (-) we cannot generalise; only females
• (-) TOKEN ECONOMIES 


  doesnt show long term impacts = AYLLON AND AZRIN = looked at the use of TE whilst the patients were in an institution but failed to test how effective it would be once they had left. = there is no one to continue reinforcing beh once they leave, it is likely that the effect is short term, which could lead to high rates of relapse = it is only best to help manage beh. in hospitals and institutions but other treatments are needed; drug therapies to help with symptoms
• (-) TOKEN ECONOMIES 


  UNETHICAL = in the 1950s and 60s, nurses often 'rewarded' patients with cigarettes. due to the pivotal role of dopamine in sz, this led to a culture of heavy smoking and nicotine addiction in psychiatric hospitals of the era. = we need to weigh up the pros and cons of using this treatment as it may actually cause more harm