Token economy

Reinforcement

Primary reinforcers -reward that they are able to choose

Secondary reinforcers-tokens - initially had no value

Token provided when

tokens are provided when patient engages in target behaviour- they can then exchange theese for a reward

based on operant conditioning

Decrease in effectiveness

If there is a gap between behaviour and reward

Shaping

Making target behaviour more complex overtime to increase the behaviours and make them a habit

Sran and Brrero

Patients prefer when there is variety of reward available rather than just one highly preferred reward-choice

Alloy and Azin

Token economy on female SZ ward

Given the tokens (gift) for doing chores such as making bed -rewards included privileges such as watching a movie

This increases desirable behaviours performed by SZ patients

Difficulties of assessing success of token economy

Usually studies have no control group or use of random allocation results can only be compared to their own past behaviour

Could be other factors that increase the behaviour such as staff attention

Less useful for patients living in the community

Carrigan-can’t administer to outpatients as you cannot monitor their behaviour 24 hrs a day -no control for staff and providing reward

Could be used for part of the day attend hospital

Ethical issue

Clinicians may exercise control over basic human rights as primary reinforcers

Eg- food , privacy

But basic human rights should not be seen as a privilege and token economy can be harmful and manipulating

Alternative therapy treatment options

Token economy instils positive habits but this does not target underlying issues and can be seen as a superficial(focus on overlying symptoms not the underlying causes )treatment

Treatment such as CBTp may be more effective as it likely to have long lasting impact on SZ eg- if patient leaves the hospital, they will revert back to usual behaviours