Management of schizophrenia - token economy

Definition of Token economy

Token economies are rewards systems used to manage the bahviour of patients who spend long periods in psychiatric hospitals.

What are the Tokens used for

Tokens are given out to patients once they have completed desirable behaviours, for example getting dressed, showering and making their bed.

Relation to operant conditioning

This reward positively reinforces the desirable behaviour and this helps influence patients to complete the behviour again, getting them into a routine that was lost due to avolition.

Secondary Reinforcers

Tokens have no value in themselves but can be swapped for tangible rewards such as sweets, more family visits or walks outside. This makes them a secondary reinforcer as their value is attached to the learned association with the innate primary reinforcers.

A limitation of Token economy is that it could be considered unethical.

The idea of token economy is to reinforce desirable behaviours, however these tasks have been suggested as only completable by patients with mild symptoms and are less completed by severe sufferes of the condition. This is a problem as it suggests that only mild SZ sufferes will be getting the rewards for completeing the task because they physically are able to, this could be seen as discriminatroy towards more severly impacted patients who cannot physically complete tasks.

A strength of the treatment is that there is evidence to support its effectiveness.

The idea of token economy is to reinforce desirable behaviours, however these tasks have been suggested as only completable by patients with mild symptoms and are less completed by severe sufferes of the condition. This is a problem as it suggests that only mild SZ sufferes will be getting the rewards for completeing the task because they physically are able to, this could be seen as discriminatroy towards more severly impacted patients who cannot physically complete tasks.

C/A for supporting evidence

However, the token economy system only improved a range of social behaviours in chronic schizophrenics. The system did not reduce the frequency or intensity of hallucinations or dellusions. Therefore the reseacrh was only successful because it helped improve the patients behviours in hospital, but it was not beneficial towards curing the patients.