outline and evaluate token economies for schizophrenia

Question 1

outline

Answer 1

token economies are reward systems (operant conditioning) used to manage the behaviour of patients with schizo who spend long periods in psychiatric hospitals

tokens (e.g. coloured discs) are given to patients immediately after carrying out a desirable behaviour to stop delay discounting

tokens have no value but can be swapped for tangible rewards e.g. sweets

tokens are secondary reinforcers as they only have a value once the patient has learned that they can be used to obtain rewards

Question 2

how do token economies work

Answer 2

tokens are paired with rewarding stimuli e.g. sweets and so become secondary reinforcers

patient engages in target behaviours or reduces inappropriate ones

patient is given tokens for engaging in these target behaviours

patient trades tokens for access to desirable items or other privilages

Question 3

strength 1

Answer 3

supporting research evidence

ayllon & azrin (1968)

used a sample of schizophrenic patients (hospitalised for an average of 16 yrs) who were rewarded for demonstrating behaviours such as daily hygiene and taking medication

average number of daily chores completed increased from 5 to 42

suggests token economies are effective in improving patients motivation and sense of responsibility

Question 4

strength 2

Answer 4

further supporting research

paul & lentz 1977

who found token economy led to considerable improvements in self care and pro-social behaviours (e.g. less time in bed). also, after 4 yrs on the scheme, 98% had been released from the institution compared to 71% under other treatments

suggesting that token economies are effective in improving patients self care & pro-social behaviours, increasing releases from institutions

Question 5

limit 1

Answer 5

number of ethical issues with use in psychiatric settings

as token economies may violate some patients basic human rights, which they have the right not to experience

e.g. severely ill patients may be less able to comply with desirable behaviours meaning these patients may experience discrimination towards their basic human rights (e.g. restrictions to privacy & food consumption)

these ethical issues make psychological therapies controversial and cause us to question the appropriateness of such a treatment