Token Economies

• Token Economies


  A psychological way of managing schizophrenia as opposed to treating it, as it makes behaviour more socially acceptable.

  They are reward systems that manage the behaviour of people who have developed patterns of maladaptive behaviour, to improve the patient's quality of life and be able to leave a hospital setting.
• Tokens and Rewards


  Tokens:

  • Physical objects given to patients after they carry out a desirable behaviour that has been targeted for reinforcement
  • Personalised to each individual
  • Immediacy of reward is important to prevent 'delay discounting'

  Rewards:

  • Tokens can be swapped for tangible rewards or privileges
• Token Economies


  Used mainly in the 70s-80s when the norm for schizophrenia was living in hospitals, but has since declined because of the growth of community-based care and the complex ethical issues.
• Eval : Strength


  Glowaki et al identified 7 studies that found token economies to effectively reduce negative symptoms and a decline in the frequency of unwanted behaviours.
• Eval : Weakness


  The use of token economies raises ethical issues because it allows professionals to control the behaviour of people, leaving room for imposing one's norms onto others. Also restricting rewards to people who don't behave desirably when they are seriously ill is ethically wrong.
• Eval : Weakness


  Chiang et al said that art therapy may be a good alternative because it has high gain, but low risk involved, unlike token economies.