What are the active components of sensory rooms in psychiatric care?

Transcription

1 What are the active components of sensory rooms in psychiatric care? Anna Björkdahl, PhD RMN Karolinska Institutet Psychiatry Stockholm South, SLSO Sweden

2 What is a sensory room? Different terminology used Focus on the use of the environment, sensory tools and activities to regulate a person s sensory experience (Te Pou o te Whakaaro Nui) Sight, hearing, smell, touch, taste

3 What is the purpose? Primary prevention - proactive o Well-being o Stress prevention Secondary prevention - reactive o Regulate arousal o Stress management

4 What are the effects? Emotions: It s so good, hope everyone will try it, to be here and now, incredibly calming, gives peace of mind. Works better than pills for me. Physical relaxation: By far the most wonderful thing I have ever done, totally relaxed in my body, amazing ball blanket, great alternative. Cognitive functioning: A fantastic tool. From a feeling of total chaos in my brain I went into a state where I could collect my thoughts. The evening went really well after that. Empowerment, emotional self care: If I panic, I need someone to help me at once, hopefully before I go totally crazy. But when I went into that room, I felt, no, it wasn t needed, I could deal with it later if I didn t feel any better after the room. But I really wanted to try it first, on my own, and most of the time it actually worked.

5 Self rated effect on well-being Stockholm 3% Total (n=440) 14% Positiv effekt Ingen effekt Negativ effekt 83% "F3 Mood disorders" (n=154) 5% 5% 13% "F2 Schizophrenia" (n=93) 1% 4% 10% "F4 Neurotic, stress disorders" (n=55) 0% 5% 11% 77% 85% 84%

6 What are the effects? Staff Better relationships with patients Can offer more than medication Proud of ward

7 What are the effects? Ward Image Atmosphere Rates of restrictive practices (?)

8 Clinically, we can see it works - but why? Different types of rooms with different implementation strategies seem to work equally well

9 Individual sensory profile? Occupational therapist expert area Patient is sensory assessed Tailor made selection of items

10 Alone in the room or not?

11 Activating items or not? Jigsaws Games Painting, drawing, knitting Videogames, films

12 Patient skills training or not? Mindfulness training Yoga DBT

13 Possible active components? What unite the different rooms?

14 Possible active components Brain response to stimulus of different senses Old brain communication Sensory input gets the fast lane to the brain (like pain distraction) Brain sends out pleasure signals Pharmacological effects?

15 Possible active components Placebo We say to the patient and each other that it works, so it does

16 Possible active components The sanctuary

17 Possible active components Patient empowerment Distraction, anti-boredom

18 Possible active components Change in staff attitudes and ward atmosphere

19 Way forward Keep on offering sensory rooms Step up the research It does a lot of good Low risks Listen to patients Explore new active components Focus on primary prevention for restraint reduction Larger samples More controlled research designs Include physiological variables Measure both patients and staff Include experts by experience when designing research

20 Way forward Keep on offering sensory rooms Step up the research It does a lot of good Low risks Listen to patients Explore new active components Focus on primary prevention for restraint reduction Larger samples More controlled research designs Include physiological variables Measure both patients and staff Include experts by experience when designing research contact: anna.bjorkdahl@sll.se