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HIT and suicidal patients
Published in Jack A. Jenner, Hallucination-focused Integrative Therapy, 2015
Hearing voices is a double-edged sword: it is both disturbing and rewarding. Normally, the therapist spends more time on problematic than on normal behaviour. In other words the therapy may unknowingly reinforce problematic behaviour, including symptoms. Unfortunately, many relatives as well as mental health-care workers are not well informed about the rewarding side of symptoms that evoke reactions in others. Hence, psychoeducation about selective reinforcement is mandatory before a change can occur from rewarding (e.g. talking about) symptoms towards reinforcement of coping with symptoms and symptom-free behaviour. The effectiveness of operant conditioning with contingent tokens has been proved in intellectually disabled persons. In addition, the token economy has been developed for these patients. Patients may win tokens by cooperation and successes, and lose tokens when non-cooperative. Flashcards may be used as reinforcers, with x cards being changed for y favours. The choice of favours will depend on personal circumstances and preferences.
The principles of behaviourist psychology
Published in Devinder Rana, Dominic Upton, Psychology for Nurses, 2013
The token economy works in line with positive reinforcement whereby you are rewarded or recognised for desired behaviour; behaviour that is not desired is not rewarded. The opening case study documented how the nurse gave patient Buba a gold reward sticker after he displayed calmness when having the injection administered. This exemplifies how the token economy can be applied to patients.
Pre-Vocational Programming in a Pediatric Skilled Care Facility
Published in Jerry A. Johnson, David A. Ethridge, Developmental Disabilities: A Handbook for Occupational Therapists, 2013
After one year of operation, the STP still appears to be functioning at its initial level. The token economy is just being implemented, although the participants have not experienced the challenges of a work program. Work samples have just recently been upgraded. The suggested half-day schedule for the program has not yet occurred, and with the present two hours per week that the participants do spend in the STP, it would be unrealistic to use this session to evaluate their work adjustment abilities.
Use of technology in facilitating remote caregiver training for token systems
Published in International Journal of Developmental Disabilities, 2020
Cheryl Davis, Faith Hendon, Kendra McDonald, Sam Blanco
Results from this study were consistent with prior telehealth and caregiver training results within autism and behavioral treatment (Bearss et al. 2018, Boisvert and Hall 2014, Ingersoll and Berger 2015, Suess et al. 2014, Vismara et al. 2013). Despite variability in the level of change from baseline to treatment, both participants responded with definitive increases in accuracy for implementing the token economy through the treatment phase. The accuracy in implementation was maintained once the training role-play and review components were removed; however, minor fluctuation in accuracy through this maintenance phase indicate that further observation would be needed to conclude that results would continue at treatment levels over extended periods. These initial results, however, do indicate that the telehealth medium is feasible for teaching caretakers how to implement a token economy for at-home use.
Motivation in rehabilitation and acquired brain injury: can theory help us understand it?
Published in Disability and Rehabilitation, 2019
Andrea Kusec, Diana Velikonja, Carol DeMatteo, Jocelyn E. Harris
Formal rehabilitation is often a new experience for many. It is likely that individuals will not know what it entails and what is expected, making it difficult to know if they will find it intrinsically motivating. This leaves extrinsic factors as important determinants of motivation. The stress associated with recovering from a life-altering injury such as an ABI may also become a barrier to engagement in rehabilitation; therefore, focussing on extrinsic incentives/factors is an efficient method to improve motivation. Token economy interventions (i.e., receiving tokens to exchange for privileges/certain items, such as a pass off the unit) have shown efficacy in promoting desirable behaviours such as enhanced rehabilitation compliance, and have successfully altered client perceptions of inpatient units as a friendly environment [49]. The role of environment on motivation is essential in fostering motivation to engage in rehabilitation [1] and as such extrinsic aspects cannot be ignored. Assessing both intrinsic and extrinsic motivation would provide a greater insight into which factor may be more motivating for a person.
Modifying a behavior intervention plan according to classroom aides acceptability ratings: effects on treatment integrity and challenging behavior
Published in International Journal of Developmental Disabilities, 2019
Benjamin R. Thomas, Michael Lafasakis
During this phase, participants were instructed to use a three-component BIP selected by a behavior analyst (BA-selected BIP) during teaching sessions with Bart. The BA-selected BIP components were verified as effective in promoting on-task behavior and reducing challenging behavior through brief treatment and component analyses following Bart’s FBA. The first component involved showing Bart a visual schedule that included pictures of his instructional tasks, followed by a picture indicating access to free time in the play area (e.g. Bryan and Gast 2000). The second component allowed Bart to hold small, preferred items in his hand during the teaching sessions (i.e. noncontingent reinforcement; e.g. Lalli et al.1997). Items included a small stuffed bear and a toy train engine. The third component used a token economy to reinforce appropriate and on-task behavior (e.g. Tarbox et al.2006). Accumulating five tokens resulted in an immediate exchange for free-play away from the desk.