evaluations of management of schizophrenia

Question 1

What is one strength of token economies for managing schizophrenia?

Answer 1

Evidence for their effectiveness

Studies show a reduction in negative symptoms and unwanted behaviors in patients.

Question 2

How many high-quality studies did Krista Glowacki et al. (2016) identify regarding token economies?

Answer 2

Seven studies

These studies were published between 1999 and 2013.

Question 3

What phenomenon raises concerns about the evidence for token economies?

Answer 3

File drawer problem

This leads to a bias towards positive published findings.

Question 4

What ethical issue is associated with the use of token economies?

Answer 4

Imposing norms on patients

This involves controlling patient behavior and may restrict personal freedoms.

Question 5

What might happen to individuals who exhibit non-desired behaviors in a token economy?

Answer 5

Their personal freedoms may be curtailed

For example, restrictions on looking scruffy or getting up late.

Question 6

What serious consequence can arise from restricting pleasures in token economies?

Answer 6

Worsening of symptoms in seriously ill patients

This can lead to legal action from families.

Question 7

What alternative to token economies is mentioned as being more pleasant and ethical?

Answer 7

Art therapy

Recommended by NICE guidelines for schizophrenia management.

Question 8

What did the review by Mathew Chiang et al. (2019) conclude about art therapy?

Answer 8

It is a high-gain low-risk approach

Evidence base is small but shows benefits without major risks.

Question 9

True or False: Token economies are the only effective method for managing schizophrenia.

Answer 9

False

Other approaches exist with comparable evidence bases.

Question 10

Fill in the blank: The ethical issues of token economies often involve the _______ of professionals over patients.

Answer 10

Power

Question 11

What is a potential downside of the small number of studies in the evidence base for token economies?

Answer 11

Serious questions over effectiveness

Small evidence base may not represent the true effectiveness.

Question 12

What impact can token economies have on quality of life?

Answer 12

Short-term reduction in quality of life

This may outweigh the benefits of the approach.