Token Economy

what is the aim of a token economy?

when are they awarded?

the patient will engage more often with desirable behaviours

what is the approach to token economy?

how are target behviours reinforced?

why do target behaviours need to be reinforced?

how does token economy work?

what are the primary and secondary reinforcers?

research support

difficulties assessing success

less useful for patients in the community

ethical concerns

does it actually work?

dickerson et al (2005): reviewed 13 studies of the use of token economy systems; 11 had reported beneficial effects directly attributable to token economies. ths provides evidence of the effectiveness of TE in increasing the adaptive behaviours of patients with sz; however, studies had significant methodological shortcomings that limited their impact in the overall assessment of TE

corner(2013): studies of their use tend to be uncontrolled; when a programme is introduced into a psychotic ward, all patients brought into the programme and there is no control group that does not. therefore, patient’s improvements can only be compared to with their past behaviours rather than a control group/ could be misleading as other factors could be causing patients’ improvement

TE has only been shown to work when in a hospital setting. corrigan (1991): there are problems with administering TE with outpatients who live in the community; outpatients only receive day treatment for hours a day(token method could only be used for that part of the day).

the use of TE causes clinicians to exercise control over important primary reinforcers, which violates the basic human rights

very few randomised trials have been carried out to support the claims made for the effectiveness of token economies in the management of sz. mcmonagle and sultana(2000) suggest TE may still be imprtant if such trials could be carried out. this is only likely to be possible in developing countries where some form of TE is still practiced