Token economy
Token economy is a form of therapy based on the use of selective positive reinforcement or rewards. This tends to be used with institutionalised patients, who are given tokens, for behaving in appropriate ways. These tokens can later be used to obtain various privileges. Paul and Lentz used a token economy with hospitalised patients with long-term schizophrenia. Patients developed various social and work-related skills, and their symptoms were reduced. There was also a substantial reduction in the number of drugs that were given to the patients. After 4 ½ years, 98% of patients in the token economy group had been released.
Token economies were among the first forms of hospital-based treatments to show clear evidence of reducing the symptoms of schizophrenia. Token economies have proved to be effective with institutionalised patients resistant to other forms of therapy. Dickerson et al. concluded that token economies are especially effective when used in combination with other psychology and/or drug therapy. However, beneficial effects are often greatly reduced when good behaviour is no longer followed by the rewards the patients have become used to receiving. Also token economies focus on only a few of the symptoms associated with schizophrenia. Token economies increase certain kinds of behaviour but do not address cognitive symptoms of schizophrenia.