Outline and Evaluate Token Economy as a Way of Managing Schizophrenia PDF

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ESSAY ON WAYS OF MANAGING SCHIZOPHRENIA WITH TOKEN ECONOMY...

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Outline and Evaluate Token Economy as a Way of Managing Schizophrenia Token economy is based on operant conditioning and is therefore called the behavior modification technique, used for easier management of patients and preparing them for communties. It aims to modify directly observable behaviours, such as brushing your hair, using a reward system. It involves first identifying undesirable or maladaptive behaviour in an individual, and then identifying reinforcers that maintain such behavior. From this there is a restructuring of the environment, so the undesirable behavior is no longer reinforced. As a result, reinforcers are removed, meaning the behavior is less likely to be repeated, and the punishment will also decrease the chance. This works as tokens are often exchanged for privileges, such as watching a film, and consequently undesirable behavior results in the lack of such. The use of consistent rewarding results in continuous reinforcement. There is evidence to support the effectiveness of this treatment. Dickerson reviewed studies which used the method and found the majority of them had reported beneficial effects that were the direct result of the system. They concluded that this evidence provides support for the effectiveness of the method, increasing adaptive behaviours of patients with schizophrenia. Thus, this suggests the treatment can be beneficial. However, there have been few trials done to try to support this evidence, and thus the lack of support means researchers are cautious of using token economy in the real world. This therefore leaves the unanswered question of whether the method does actually work. Furthermore, there are number of ethical concerns regarding the method in psychiatric settings. In order to make some aspects of the theory effective, such as reinforcement, clinicians need access to necessities such as food. It is a basic human right to have access to these, and as such it is not allowed for patients to exchange tokens for them. Thus, regardless of the potential benefit of the method, these rights cannot be violated, limiting the use of the system, and raising ethical questions. Furthermore, the use of this method with severely ill patients may pose issues around their ability to provide full consent. They may also be too ill to comply to methods used in this therapy, resulting in distress or a lack of rewarding. Thus, the treatment is limited to use on less severe patients, who have the ability to understand the treatment and consent to its use. In addition, token economy is limited by is lack of usefulness for patients who live in the community. Although it has been shown to reduce negative symptoms in schizophrenics, it has only been shown in a hospital setting. Corrigan argues that there are problems with the method when patients live in the community; within a ward there is 24-hour care and consequently staff can control, monitor and reward patients appropriately. However, when they live in the community, and only receive treatment for a couple of hours a day, the token method can only be used minimally. As a result, there may be a lack of application of the method in the real world, with it not producing the same effects. Similarly, when used in a prison environment it may lead to them relying on the reinforcers for privileges, and thus disadvantage them when released into the community. This could lead to reoffending in order to regain the system they had previously, which raises issues surrounding how effective the treatment is in the long term....