Token Economies

Question 1

What are token economies?

Answer 1

• a method of managing behaviour
• used to help/manage symptoms of Sz
• operant conditioning ( + reinforcement)

Question 2

Token economies: Avllon & Azrin (1968)

Answer 2

• trialled token economy in a ward of women with Sz
• positive tasks were given “tokens” which could be swapped for ward privileges
• number of tasks increased significantly

Question 3

How does this treat schizophrenia?

Answer 3

It doesn’t! Rather it aims to manage behaviour and improve the patient’s quality of life
-> makes it easier for people who have spent a time in hospital adapt back into the community

Question 4

How often are they used?

Answer 4

• extensively used in the 60s/70s since the norm to treating Sz was long-term hospitalisation
• Declined in the UK
  -> growth of community based care
  -> complex ethical issues

Question 5

Token economies :) efficacy

Answer 5

Glowacki et al. (2016): examined 7 high quality studies
- all studies showed a reduction in negative systems and a decline in unwanted behaviour

Dickerson et al. (2005): 13 studies of the use of token economy systems
- Eleven of these studies had reported beneficial effects that were directly attributable

Question 6

Token economies: :( ethical issues

Answer 6

• the ‘privileges’ that patients receive upon displaying appropriate behaviours are actually rights.
• Preventing patients from calling home or exercising outside may increase their stress and so aggravate their condition further

Question 7

Token economies: :( not useful to all patients

Answer 7

• Corrigan (1991) argues that there are problems administrating the token economy method with outpatients who live in the community
  → outpatients may not follow their behaviours when out of the hospital
  → may only work for them for a few hours a day/week