token economy

Question 1

what are token economies?

Answer 1

• a behaviourist approach to managing sz
• aims to change neg symptoms like low motivation, poor attention and social withdrawal

Question 2

how do token economies work?

Answer 2

1. clinicians set target behaviours they believe will improve the patients engagement in their daily activities
2. tokens are awarded when the patient engages in one of these behaviours, these can be exchanged for rewards later
3. the behaviours become associated with these rewards
4. the tokens are neutral so are paired with the reward to give the token the same reinforcing qualities
5. in early stages, frequent exchange periods means patients are quickly reinforced

Question 3

give a strength of token economy
1/2

Answer 3

research indicates they are effective in managing sz. ayllon and azrin (1968) gave female patients who had been hospitalised for years plastic tokens for certain behaviours, these were later exchanged for rewards. they found this significantly increased the number of desirable behaviours each day. this highlights that token economies are an effective treatment for sz. they were however found to work best in combination with drugs, so perhaps token economies shouldn’t be used alone to treat sz

Question 4

give a strength of token economy
2/2

Answer 4

patients become more independent and active, which can increase nurses’ respect for the patients, leading the patients to be more motivated and develop pos self-esteem. therefore token economies are effective at helping with institutionalisation. also, when used in wards they help create a more healthy and safe environment for both staff and patients

Question 5

give a limitation of token economy
1/3

Answer 5

the way research into token economies is carried out is often criticised. comer (2013) suggests the main issue in assessing its effectiveness is that studies tend to be uncontrolled. when a token economy is introduced to a ward, all patients are used, rather than having an experimental and control group, therefore patients improvements are compared only with their past behaviour. this can be misleading and other factors like increased staff attention may be causing the improvements instead

Question 6

give a limitation of token economy
2/3

Answer 6

any positive effects are often short-lived, it doesn’t appear to work long term as the behaviours become dependent on reinforcement. when patients are released into the community, this reinforcement ends which often leads to high re-admittance rates. without professionals constantly reinforcing the behaviour, they cannot engage in these behaviours outside the hospital

Question 7

give a limitation of token economy
3/3

Answer 7

the ethics of this treatment are often questioned, with critics arguing it may be humiliating for those with sz. to make the reinforcement effective, clinicians will often control primary reinforcers like food or privacy. however, it is accepted that everyone has basic human rights that cannot be violated regardless of the positive actions that could come from manipulating them.