SCHIZOPHRENIA - Behavioural approach to treating schizophrenia (token economy)
- Created by: EmilyEther
- Created on: 13-02-19 09:11
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- Token economy and the management of schizophrenia
- Token economy
- a form of therapy where desirable behavs are encouraged by the use of selective reinforcements. Rewards (tokens) are given as 2ndry.reins when individs engagein correct / socially desirable behaviours. Tokens can be exchanged for prim.reins (eg. food or privileges)
- to be effective, the reinforcer needs to be given immediately after performance of the target behaviour
- if token is given too late, another behaviour may been reinforced instead of target one (eg. arguing with another patient)
- form of behavioural therapy
- modification of patients behaviour to engage with target behaviours - associated with rewards
- target behaviours = social interaction, reducing aggression
- sch symptoms = speech poverty, lack of social interact, affective flattening
- more items / rewards that the token can be exchanged for, the more valuable it becomes
- rewards (the prim reins) could be: food, day out, internet
- 2ndrary reins - tokens become valuable and as exchange for a reward. Associate token with reward
- generalised reinforcers - rather than 1 reward, with tokens there are options
- Research
- SRAN - PPs had higher rates of responding in sessions where they were allowed to trade tokens in for choice between variety of edible items rather than a choice of one
- How does it work?
- 1. tokens are associated with rewarding stimuli (2ndry reins)
- 2. patient engages in desirable (target) behavs or reduces inappropriate ones
- 3. patient given tokens for engaging in target behavs (eg. tidying up after meal)
- 4. patient trades these tokens for desirable items or privileges
- 3. patient given tokens for engaging in target behavs (eg. tidying up after meal)
- 2. patient engages in desirable (target) behavs or reduces inappropriate ones
- 1. tokens are associated with rewarding stimuli (2ndry reins)
- Evaluation (A03)
- research support
- DICKERSON - meta 13 studies - 11 studies showed beneficial effects BUT many studies showed methodological shortcomings
- difficulties assessing the success of T.E
- COMER - uncontrolled studies - no control group. Improvements can only be compared with prev behavs.
- other factors may be involved in improvement eg. increased staff attention
- less useful for patients in community
- effects only shown to work in hospital setting
- difficult to administer tokens in community
- in wards, patients get 24 hr care, so easier to monitor rewards etc
- ethics
- argued that all humans have a right to some rewards (food, privacy etc)
- does it work?
- very few trials carried out to support claims
- SULTANA - t.e may still be a good treatment if trials are carried out
- research support
- Conditioning
- operant conditioning most important
- learning through reinforcements
- patient rewarded if behaviour is shown
- positive rein = food, behav will be repeated
- neg rein = avoid bad feelings, getting rewards taken away
- classical
- tokens become associated with the rewards
- operant conditioning most important
- Token economy
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