Discuss the use of token economies to manage schizophrenia

Token economies are a form of behaviour modification based on the principle of operant conditioning. Patients are given tokens for demonstrating good behaviours such as personal hygiene. These tokens act as secondary reinforcers because they can be exchanged for primary reinforcers such as privileges like smoking. These systems can therefore help to treat avolition, which is a common negative symptom of schizophrenia.A strength of token economies is that they help to create a safer environment for patients and staff. This is because, due to their lack of reinforcement, behaviours such as aggression should eventually cease to continue within the establishment. However, an issue with token economy systems is that patients may become dependent on reward and therefore only behave well to receive a token. This can lead to low transference to real life because when patients leave the institution they no longer receive immediate reinforcement. For example, they may struggle to hold down a job with monthly pay as they expect to be rewarded immediately. Therefore, it could be argued that token economies are helpful for the short term management of schizophrenia but can actually be detrimental to schizophrenics in the long term.