1. Ian Murphy Occupational Therapist, Kilmallock Day Hospital, Co. Limerick.
Edel Feury 1st Year Occupational Therapy Student, University of Limerick.
Colin Jones 1st Year Occupational Therapy Student , University of Limerick.
26th June 2014
2. Sensory Rooms (Where, What & How?)
Sensory Regulation
Literature Review
Equipment
How to use the room
Practicalities
Case Study
Recommendations
Summary & Questions
3. Mental Illness is ‘a medical condition that disrupts a
persons thinking, feeling, mood, ability to relate to
others and daily functioning’ (NAMI 2014).
Sensory-based interventions expand the range of
therapeutic interventions available and are useful in
avoiding or resolving crisis situations that could lead
to seclusion and restraint (Champagne & Stromberg,
2004).
Recovery: Empowering the client. Productive coping
methods.
5. 1975: Holland.
Snoezelen rooms for
people with
intellectual
disabilities.
Since 1999:
Inpatient adult
psychiatric
programmes
developing sensory
rooms.
Multi-sensory
environments now
used in a variety of
settings
• Baillon et al (2002).
• Champagne &
Stromberg (2004).
8. http://www.youtube.com/w
atch?v=78b67l_yxUc
Ability to maintain
homeostasis while taking
interest in the world and
regulating arousal and
response to sensory input.
Building block to other
functional capacities.
• DeGangi, 2000; Greenspan, 1992; Lachmann & Beebe, 1997.
• Greenspan & Wieder, 2007, Siegel, 1999.
9. Positive Findings:
Baillon et al (2002) – How multi-
sensory therapy works.
Chalmers et al (2012) – Mental
health inpatients. Decreased
distress levels. Nursing conducted
most sessions.
Reddon et al (2004) – Adult
psychiatric setting. Positive
effects for patients and staff.
Sutton & Nicholson (2011) –
Positive findings.
Gardner et al (2012) – Successful
use of WRAP and sensory-based
approach in mental health.
Limitations:
Limited research in
area of mental health.
Focus on intellectual
disabilities, dementia.
Positive change
ascribed to interaction
between participant
and enabler (Martin et
al, 1998).
10. Reduced distress levels in patients reported following use
of sensory room (Chalmers et al, 2014).
Use of a sensory room and sensory-based treatment
approaches by skilled and/or educated staff has significant
positive effects among clients of varied ages and diagnoses.
89% reported positive change. Used Allen Cognitive Levels.
(Champagne & Sayer, 2003).
Therapeutic relationship with staff strengthened.
Individual’s health and recovery promoted (Champagne &
Stromberg, 2004).
11.
12. Build a record of client’s responses to various stimulation
Collaboratively complete mood questionnaire (post-session)
Observe client’s response and grade stimulus appropriately to
regulate mood
In room, select one piece of equipment for calming/alerting
patient as appropriate
OT/client collaboratively complete mood assessment
questionnaire (pre-session)
Select patient(s) for sensory session
Receive list of appropriate referrals for room from 5B staff
13. Up to date risk assessment completed for all clients
Sensory room must remain locked when not in use
Electrical equipment must be regularly checked
Equipment must be kept clean using antiseptic wipes in
keeping with infection control guidelines.
Clients must be supervised at all times in room
Education and training should be provided for all staff
• Sensory Room Policy Document
(2010).
14. Michael is a 37 year
old male diagnosed
with bi polar disorder
since the age of 22,
having previous
hospital admissions
when ill
Michael is
employed as a
mechanic, has not
worked in three
months due to his
illness
Michael lives with his
girlfriend, his social
supports include his
family, friends and
work colleagues
Michael experienced
periods of a natural high
in his 20’s needing little
sleep for several weeks.
Had persistent
enthusiasm and took on
new projects for which he
was ill suited
Michael recently
experienced an elevation
in his mood where he
was seen shouting at
friends. He had also
taken on too much at
work
This affected his
ability to concentrate,
problem solve, make
decisions and his
judgement in his
employment
Michaels
interpersonal and
social relationships,
vocational
functioning, leisure
participation, self
care and
independence were
affected
16. Step 1
•Initiate sensory room session with Michael to help regulate mood
Step 2
•Complete mood questionnaire (pre-session) collaboratively
Step 3
•If client needs alerting, use projector to raise mood (visual)
•If client needs calming, seat client in beanbag, using deep pressure to
regulate arousal
Step 4
•Observe client’s response to the stimulus and grade appropriately to
regulate mood
Step 5
•Complete questionnaire again (post-session) and use to build record of
client’s responses to various stimulation
17. • MIDI invisible
keyboard.
• Encourages and
rewards movement.
• Anyone can operate.
• Weighted Blanket/Shawl.
• Deep pressure to regulate
arousal.
• Champagne & Stromberg
(2004).
18. Aim to regulate client’s senses in the ‘optimal zone of
engagement’.
Sensory rooms can be used for both calming and
alerting patients in mental health.
This can improve function in areas of self-care,
productivity and leisure.
Long-term, the aim should be self-regulation as part
of a recovery focus.
19.
20. Anzalone, M. E., & Ritchey, M. (2013). Developmental and Dyadic Implications of Challenges
With Sensory Processing, Physical Functioning, and Sensory-Based Self-Regulation. Infant and
Early Childhood Mental Health: Core Concepts and Clinical Practice, 209.
Baillon, S., van Diepen, E., & Prettyman, R. (2002). Multi-sensory therapy in psychiatric care.
Advances in psychiatric treatment, 8(6), 444-450.
Chalmers, A., Harrison, S., Mollison, K., Molloy, N., & Gray, K. (2012). Establishing sensory-
based approaches in mental health inpatient care: a multidisciplinary approach. Australasian
Psychiatry, 20(1), 35-39.
Champagne, T., & Sayer, E. (2003). The effects of the use of the sensory room in psychiatry.
Copyright by Tina Champagne.
Champagne, T., & Stromberg, N. (2004). Sensory approaches in inpatient psychiatric settings:
innovative alternatives to seclusion & restraint. Journal of psychosocial nursing and mental
health services, 42(9), 34-44.
DeGangi, G. A., Breinbauer, C., Roosevelt, J. D., Porges, S., & Greenspan, S. (2000). Prediction of
childhood problems at three years in children experiencing disorders of regulation during
infancy. Infant Mental Health Journal, 21(3), 156-175.
Gardner, J., Dong-Olson, V., Castronovo, A., Hess, M., & Lawless, K. (2012). Using Wellness
Recovery Action Plan and Sensory-Based Intervention: A Case Example. Occupational therapy
in health care, 26(2-3), 163-173.
21. Greenspan, S. I. (1992). Infancy and early childhood: The practice of clinical
assessment and intervention with emotional and developmental challenges.
International Universities Press, Inc.
Greenspan, S. I., & Wieder, S. (2007). Infant and early childhood mental health: A
comprehensive developmental approach to assessment and intervention. American
Psychiatric Pub.
Lachmann, F. M., & Beebe, B. (1997). Trauma, interpretation, and self-state
transformations. Psychoanalysis and Contemporary Thought, 20(2), 269-291.
Martin, N. T., Gaffan, E. A., & Williams, T. (1998). Behavioural effects of long‐term
multi‐sensory stimulation. British Journal of Clinical Psychology, 37(1), 69-82.
National Alliance of mental health (NAMI) (2014) What is Mental health [online]
available: http://www.nami.org/ accessed 06th June 2014
Reddon, J. R., Hoang, T., Sehgal, S., & Marjanovic, Z. (2004). Immediate effects of
Snoezelen® treatment on adult psychiatric patients and community controls. Current
Psychology, 23(3), 225-237
22. Sensory Room Policy (2010) [online] available:
http://www.nepft.nhs.uk/_uploads/documents/trust-policies-and-procedures/sensory-room-
policy-2010.pdf accessed 6th June 2014
Siegel, D.J. (1999). The developing mind: Toward a neurobiology of interpersonal experience.
New York: Guilford.
Sutton, D., and Nicholson, E. (2011). Sensory modulation in acute mental health wards: A
qualitative study of staff and service user perspectives. Auckland, New Zealand: Te Pou o Te
Whakaaro Nui.
23. AOTI (2011) Mental health advisory group. [Online] available:
http://www.aoti.ie/ [accessed 02 June 2014.
Brown, C. (2002). What is the best environment for me? A sensory processing
perspective. Occupational Therapy in Mental Health, 17(3-4), 115-125.
Champagne, T. (2011). The influence of posttraumatic stress disorder,
depression, and sensory processing patterns on occupational engagement: A
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38(1), 67-75.
Champagne, T., & Koomar, J. (2011, March). Expanding the focus: Addressing
sensory discrimination concerns in mental health. Mental Health Special Interest
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Hill, L., Trusler, K., Furniss, F., & Lancioni, G. (2012). Effects of Multisensory
Environments on Stereotyped Behaviours Assessed as Maintained by
Automatic Reinforcement. Journal of Applied Research in Intellectual
Disabilities, 25(6), 509-521.
Hope, K. W., Easby, R., & Waterman, H. (2004). ‘Finding the person the
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http://www.mentalhealthireland.ie/information/what-is-mental-health.html
accessed 06th June 2014
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http://www.sensoryconnectionprogram.com/sensory_room.php accessed 02 June
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Editor's Notes
Mental Health can be about how we feel about others, how we feel about ourselves and how we are able to meet the demands of life.
Mental Ill-Health for example, work pressures can cause us to experience poor concentration, mood swings and sleep disturbance. These are temporary in nature as all of us suffer from mental health problems at times, but this dose not necessarily lead to mental illness.
Mental Illness can lead to anxiety, depressed mood, obsessional thinking, delusions and hallucinations.
Core OT Concepts
Recovery
Productivity, Self-Care, and Leisure (Aim for better engagement in these areas)
Zone of Optimal Engagement/Function
Regulation
Timeline:
During the 1960s, A. Jean Ayres pioneered the sensory integration framework within the field of occupational therapy (Ayres, 1974, 1979). By the 1970s, occupational therapists began creating treatment spaces filled with equipment necessary for implementing a combination of directive and nondirective sensory-based therapeutic exchanges. The first multisensory room was developed in 1975 by Jan Hulsegge and Ad Verheul at the Hartenburg Institute in the Netherlands (Hulsegge & Verheul, 1987). These environments were initially created for people with intellectual disabilities and were referred to as “Snoezelen” (Hulsegge & Verheul, 1987). Multisensory environments are currently being used in a variety of psychiatric facilities with different age groups and populations and are frequently referred to as “sensory rooms” or “sensory-modulation rooms” (Champagne, 2003). Since 1999, in collaboration with occupational therapists, many adult inpatient psychiatric programs have begun developing sensory rooms, and currently, use of these rooms is a growing trend nationwide (Champagne, 2003). These rooms are used for individual and group sessions and offer a combination of sensorimotor activities, with calming and alerting options for each of the sensory areas. In South Florida, a nurse and consumer activist developed “comfort rooms” as a place of respite on busy 50-bed units within a 350- bed psychiatric hospital (Bluebird, 2004). Optimally, consumers and staff are involved in painting the walls, decorating, selecting furniture and artwork, and developing policies and procedures for use of the room and equipment (Bluebird, 2004; Champagne, 2003). Although few published research studies have evaluated the effectiveness of multisensory treatment rooms, one study demonstrated that the therapeutic exchanges occurring within these rooms were effective in reducing maladaptive or stereo-typical behaviours (Hutchinson & Haggar, 1991). A second study reported that, among certain individuals, the therapeutic use of multisensory environments appears to facilitate an improvement in the ability to concentrate during task performance (Ashby et al., 1995).
Children:
In 2002, the majority of inpatient child and adolescent programs in Massachusetts began to develop sensory rooms in response to an initiative led by the Commonwealth of Massachusetts Department of Mental Health aimed at preventing the use of S/R (LeBel et al., 2004). With occupational therapy consultation or oversight, a variety of programs developed sensory spaces for children and adolescents with names such as the “Zen Room,” “Cool Room,” “Peace Room,” and “Chillville.” Each program made the commitment to have a supportive place for children and adolescents to draw, bounce, play, and use weighted blankets, indoor tunnels, and climbing structures, depending on their needs, in physically appealing environments. These interventions pro- mote self-organization through physical outlet, self-expression, and/or containment, thus reducing the need for S/R.
MSE provide sensory stimulation.
Auditory = nice music, chimes.
Visual = lighting effects.
Tactile = different textures.
Olfactory = smell.
Proprioception = sensory information that contributes to the sense of position of self and movement.
This is a flood of sensory stimulation that activates a number of senses together. There is control and choice.
Proprioception = Sensory information that contributes to the sense of position of self and movement.
Gustatory
Core OT Concepts
Recovery
Productivity, Self-Care, and Leisure (Aim for better engagement in these areas)
Zone of Optimal Engagement/Function
Regulation
