Treatments of Schizophrenia

• Behavioural treatment
• Based on principles of Operant Conditioning
• Used in institutions in 1970s
• Tokens awarded for 'socially desirable' behaviour > exchanged for things patient desires
• Can be taken away for 'socially undesirable behaviour' 

Steps:

• Identify target beh. and beh. that needs to be punished (what the patient needs to do)
• Nature of token is identified (e.g. poker chip)
• Unconditioned reinforcers are identified (item the patient wants)
• Schedule of reinforcement is initially continuous, lessened over time to maintain beh. 
• No. of tokens needed for UR identified
• Time and place when a patient can exchange tokens is identified, so there is consistent structure

Allyon & Azrin > evidence to support short-term effectiveness; tokens given for completing chores > no. completed increased from 5 - 40 per day

Paul & Lentz > long term effectiveness > after 4 years, TE patients; 98% released from institutions as opposed to 71% of other therapies > helps them leave institutions

Could be argued that is not effective after > supported by McMonagle & Sultana > reviewed research and agreed we have no data to prove effectiveness of TE outside institutions

Not a cure > only afters beh. > mental illness remains

Ethics > way beh. is manipulated determined by institutions > removes free will > may not be acceptable to p.

Corrigan > found TE to be abusive and humiliating

Bind tight and long-lasting to D2 receptors, reducing the levels of dopamine on the brain

Effective in treating +ve symptoms > as these products of overactive dopamine system

A02:

• Side effects > due to blocking D2 for long period of time > tardive dyskinesia, parkinsons > could lead to patient drop-out due to embarassment or discomfort > therefore cannot be considered effective 
• Found to be effective by WHO (2001) > only 25% relapsed, as apposed to 55% of placebo group

• Newer
• Allows for normal dopamine transmission > temp. binding > fewer side effects
• Also acts on serontonin system & others > treats both +ve and some of the -ve

A02

• Davis et al > reviewed 123 trials, found atypical to be more effective
• Geddes et al > found no difference
• As there are fewer side effects, could be more appropriate if not effective > as decreased risk of patient drop out 

• Not an appropriate treatment
• Does not cure schizo, only alleviates the symptoms
• Patients remains on anti-psychotics for life 
• Side effects could lead to patient drop-out or spiral into depression
• Determinst nature of treatment > lack of control > could act as a stressor
• Could be linked to 5% of schizo patients take their own lives
• Not sure this is the case though