Token economy for SZ

Token economies

Behaviorist technique based on Skinner’s operant conditioning. This is learning through reinforcement of desired behaviors.

Tokens are used as a type of positive reinforcement. They are an immediate reward for when the patient shows pre-defined target behavior. Tokens are then exchanged for something else they want.

Behavior shaping

Behaviors are progressively changed, with tokens first given for small changes in behavior towards the ideal.

Treatment is designed to manage behavior within the hospital, or to prepare long stay patients for transfer into the community.

Symptoms

Treatments should only be used for patients with mild symptoms, as patients with severe symptoms would be unwilling to engage.

FOR AO3: Dickerson (2005)

When reviewing the findings of 13 studies, token economies can be effective in improving the adaptive behavior of people with SZ.

AGAINST AO3: Weakness

Token economies do not directly treat SZ symptoms. They only attempt to manage negative symptoms such as poor motivation, poor attention, and social withdrawal.

AGAINST AO3: Effectiveness

Not effective with severely unresponsive patients such as those with very strong negative symptoms

AGAINST AO3: Ethics

Using Skinnerian principles could be seen as degrading to patients, effectively manipulating them can be seen as ethically problematic.