Treatments of Schizophrenia

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  • Created by: SarahBee
  • Created on: 14-06-15 13:16

Token Economy - A01

  • 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' 


  • 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
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Token Economy - A02

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

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Chemotherapy - Conventionals

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


  • 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
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Chemotherapy - Atypicals

  • 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


  • 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 
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Chemotherapy - Criticism

  • 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
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