token economy

what is token economy

• a behavioural therapy based on operant conditioning

• used to help chronic SZ patients in institutional settings who have maladaptive behaviours

  • poor hygiene, social withdrawal, aggression

• aims to increase desirable behaviours and make them more independent

how does token economy work

• tokens (secondary reinforcers) given immediately to patient after a desired behaviour is performed

• tokens exchange for rewards (primary reinforcers)

• creates a positive reinforcement cycle

positives of token economy

• ayllon and azrin 1968

  • female patients with chronic SZ in a hospital

  • increased desirable behaviours with introduction of token economy

  • positive reinforcement can shape behaviour in institutionalised patients

• McMonagle and Suntana 2009

  • reviewed 13 studies on token economy

  • results were mixed but there was improvement with behaviour and engagement

  • little evidence of long term benefits post discharge

negatives of token economy

• don’t treat positive symptoms

  • help manage behavioural problems 

  • usually + meds

• only good in a controlled hospital setting

  • hard to maintain when patients are home

  • ethical issues

    • patients declined basic privileges if they don’t get enough tokens

  • relapse is common when rewards stop