Schizophrenia- Token Economy

Question 1

What is the aim of token economy (TE) ?

Answer 1

Aims to increase the frequency of adaptive behaviour and reduce maladaptive ones

Token economy does not treat SZ but helps to manage it!

Question 2

How does it work?

Answer 2

Tokens are given to reinforce good behaviour

Token are withdrawn to punish negative behvaiour

Question 3

What are the advantages of using tokens as a reinforcer?

Answer 3

1) Can be given immediately after desired behaviour, without disrupting behaviour
2) Cab be exchanged for a wide variety of reinforcers, patients will not be bored- ‘satiated’
3) Work individually, as patients choose their reinforcer

Question 4

Allyon and Azrin (1963)

Answer 4

44 Female psychiatric patients showed difficulty in daily behaviours. A+A modified habits like face-washing and teeth-brushing recording baseline frequencies.

Plastic tokens exchanged for rewards significantly increased desired behaviours. Suggests that the tokens allow us to encourage desirable behaviours.

Question 5

[S] Dickerson

Answer 5

Meta analysis reviewed 13 studies

11 reported beneficial effects of token economy, reduces maladaptive behaviour

Question 6

[S] Glowacki

Answer 6

Reduces negative symptoms and unwanted behaviour

Question 7

[C] Comer

Answer 7

However it is difficult to assess the success of TE

Question 8

Appropriateness of TE

Answer 8

+ Paul and Lentz: after 4 years, 98% patients treated with TE were released from institution compared to 71% without
+ LePage: 43% reduction in violent behaviour of acute psychiatric patients

• Expensive, time-consuming and needs commitment and effort
• Comer: helps patients cope with life but does not cure illness