Token Economies for Schizophrenia

Outline how Token Economies work

• Someone receives a secondary reinforcer of a token for desired behaviour

• They can exchange these tokens for goods and privileges (primary reinforcer)

What are Token Economies?

A behaviourist therapeutic approach to the management of Schizophrenia, based on the principles of operant conditioning

Where has Token Economies been used to manage people with Schizophrenia?

Psychiatric hospitals

Which symptoms of Schizophrenia do token economies improve?

Negative symptoms of Schizophrenia (Such as avolition)

What is the difference between a primary and secondary reinforcer?

Primary reinforcer → Gives direct pleasure

Secondary reinforcer → Doesn’t give direct pleasure, but lead to something that does give direct pleasure

How does Ayllon and Azrin’s study support the effectiveness of Token Economies to manage Schizophrenia?

Procedure:

• Hospitalised female schizophrenic patients were rewarded with tokens for behaviours such as brushing hair and making bed

• Tokens could be exchanged for viewing a film or visiting a canteen

Findings:

• Ayllon and Azrin found that the average number of chores completed rose from 5 to 42

Why is token economy not effective outside of an institution?

• Tokens lose value if the reward (primary reinforcer) that can be exchanged for them stops

• It is harder to provide consistent rewards to exchange tokens for outside of an institution

• When reward stops, so does the behaviour

What are the ethical issues with using token economy in the management of Schizophrenia?

• Patronizing → Reduces patient’s dignity and autonomy

• So no longer used as treatment for Schizophrenia