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A treatment for schizophrenia from the learning approach:
Token economy programme.
Description of the approach:
· TEP are based on the principles of operant conditioning. These are:
· positive reinforcement: A reward is given in response to a desired behaviour shown to encourage
the reproduction of the behaviour. If the desired behaviour is not completely shown immediately,
shaping can be used which is rewarding the behaviour that gradually moves near to the desired
behaviour. e.g If a schizophrenic is set a complex task like bathing themselves, they could be
rewarded step by step.
Negative reinforcement: is when a person wants to remove something unpleasant so they behave
in such a way to remove it. e.g it a person had panic attacks when they go to the shop they stay in
their home instead. This is a negative way of dealing with the the problem.
Punishment: is really used, it models negative behaviour and doesn't help to develop
required behaviour though it may stop the undesired behaviour.
· The idea of TEP's are to reward required behaviour with tokens which then are exchanged for
rewards that are in return wanted by the individual. These paid tokens are the economy part of
· In consequence to undesired behaviour a token reward is not given.
· Shaping can be used by rewarding desired behaviour stepbystep.
· This method is called a programme because there is a plan of what will be rewarded, when, by,
whom and for what.
How the treatment works:
· TEP's are implemented in 8 steps:
1. Identifying the behaviours to be changed, positive ones are usually chosen. E.g. putting the dished
away rather then leaving them out.
2. The nature of the tokens are decided E.g. points or plastic counters
3. A decision it then made on the rewards available which are to brought with the tokens which are
4. Achievable goals are set that can be met by the individual.
5. The individual must be fully briefed about the nature of the programme.
6. Feedback on the progress of the individual must be given on how they doing, where they might be
going wrong. Response cost can be used where tokens are taken away or withheld for showing
7. Arrangements must be made to decide for when the tokens can be exchanged. Criticisms must
NEVER be made of someone who isn't 'earning taken'.
8. Review if the programme. Goals should be reviewed, as well as how often tokens are given and
how often the exchange of them takes place.
Which mental illness is it suitable for:
· The use for treating schizophrenia.
The effectiveness of this treatment for schizophrenia:
In 2008 a PET was carried out and evaluated in Sweden with 12 chronic (longterm) schizophrenic
patients. Patients undesired activity levels were changed in the required direction during the treatment.
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Activities chosen to be changed for 2 of the patients included lip biting and aggressive acts. The
treatment was then stopped as part of the study, which resulted in them reverting back to their undesired
activity levels. Finally the treament was reintroduced and their activity levels went back to the desired
As a result it was concluded that the treatment programme worked to improve patients undesired activity