Token economy

Describe and evaluate token economy as a treatment of schizophrenia

A01
- tokens used to reinforce desirable behaviours (operant conditioning)

- token economies are reward systems (operant conditioning) used to manage the behaviour of patients with schizophrenia who spend long periods in psychiatric hospitals
- tokens (e.g. coloured discs) are given to patients who carry out desirable behaviours (e.g. getting dressed, making a bed, etc)
- this reward reinforces the desirable behaviour & because it is given immediately prevents 'delay discounting' (reduced effect of a delayed reward)

A01
- tokens are secondary reinforcers

- tokens have no value in themselves but can be swapped later for tangible reward (e.g. sweets, a walk outside, etc)
- they are secondary reinforcers because they only have value due to the learned association (classical conditioning) with innate primary reinforcers

A03
+ research support

- Paul & Lentz found token economies led to better overall patient functioning & less behavioural disturbance
- furthermore, because of this, token economies are more cost effective due to lower hospital costs
- this suggests that token economies are effective in treating schizophrenia

A03
x ethical issues

- severely ill patients cannot get privileges because they are less able to comply with desirable behaviours than moderately ill patients- so severely ill patients

A03
x psychological therapies may help but not cure

- token economies help to make patients' behaviour more socially acceptable
- these things are all worth doing, but should not be confused with curing schizophrenia
- biological therapies do not cure schizophrenia either but they do reduce the severity of the symptoms & thus may be more desirable