Discuss token economies as a method used in management of schizophrenia. (8
marks)
Token economies are a behaviourist approach to the management of schizophrenia,
where tokens are rewarded for desired behavioural change.
Long-term hospitalized patients may be set simple, daily tasks, such as brushing their
hair or chatting to a friend, to improve their engagement in activities. Tokens are
awarded when such tasks are completed, and they can be used to exchange for rewards
later, such as sweets. Tokens themselves are neutral to begin with, but after they are
repeatedly presented alongside rewards, patients will comply to achieve desired
rewards. Thus, patients will engage more often with the desirable behaviour because
the behaviour becomes associated with these rewards and privileges. This is a result of
classical conditioning, where their behaviour has been gradually shaped through positive
reinforcement.
One advantage is that patients become more independent and active, which has a
knock-on effect of nurses’ increased respect for patients, leading them to be more
motivated and develop positive self-esteem. This shows that token economies are an
effective way of helping patients in institutions, and thus creating a safer and more
stable environment in general.
However, positive effects of the treatment are short term ones only. Token economies
works to change the behaviour of the patient on a low level of compliance only, and it
does not change the mentality of the patient. They also do not appreciate the logic
behind such forms of treatment. Thus, upon release into the community, the
reinforcement ends which leads to high re-admittance rates, as there are no
professionals to monitor the patient to award them with tokens, which shows that token
economies may work inside a hospital but are not able to help patients in the long run.
marks)
Token economies are a behaviourist approach to the management of schizophrenia,
where tokens are rewarded for desired behavioural change.
Long-term hospitalized patients may be set simple, daily tasks, such as brushing their
hair or chatting to a friend, to improve their engagement in activities. Tokens are
awarded when such tasks are completed, and they can be used to exchange for rewards
later, such as sweets. Tokens themselves are neutral to begin with, but after they are
repeatedly presented alongside rewards, patients will comply to achieve desired
rewards. Thus, patients will engage more often with the desirable behaviour because
the behaviour becomes associated with these rewards and privileges. This is a result of
classical conditioning, where their behaviour has been gradually shaped through positive
reinforcement.
One advantage is that patients become more independent and active, which has a
knock-on effect of nurses’ increased respect for patients, leading them to be more
motivated and develop positive self-esteem. This shows that token economies are an
effective way of helping patients in institutions, and thus creating a safer and more
stable environment in general.
However, positive effects of the treatment are short term ones only. Token economies
works to change the behaviour of the patient on a low level of compliance only, and it
does not change the mentality of the patient. They also do not appreciate the logic
behind such forms of treatment. Thus, upon release into the community, the
reinforcement ends which leads to high re-admittance rates, as there are no
professionals to monitor the patient to award them with tokens, which shows that token
economies may work inside a hospital but are not able to help patients in the long run.
