A Leader in Sensory Room Approaches
Submitted by Tatiana Gregor, Ed.D.
Riverview Psychiatric Center has been actively engaged in efforts to improve the therapeutic environment. Innovative work began several years ago when hospital administrators approached the civil admissions unit with an objective: create a room that will enable clients to relax and possibly reduce the use of coercive measures. Dr. Tatiana Gregor, psychologist, and Diane Pearson, Assistant Director of Nursing, began the quest toward what was to become a multisensory room. It formally opened in May of 2007. Since that time, more development has taken place, with the goal of a sensory room to be available on each of the four units.
Gregor and Pearson, researched various ideas for developing a room that would be comforting to clients. One idea that had particular appeal was the multisensory environment which originated in the 1970’s from two Dutch therapists, Jan Hulsegge and Ad Verheul. This occurred at the De Hartenberg Institute in Holland, a center for people with intellectual disabilities. They named their concept ”Snoezelen,” a combination of the Dutch verbs ”snuffelen” (to seek out or explore) and ”doezelen” (to relax). Although the Snoezelen approach had been primarily used with children with developmental disabilities and adults with dementia, it has expanded to applications with those with traumatic brain injury and chronic pain.
Although little was found in the application of multisensory environments in inpatient psychiatric settings, Gregor was particularly interested in a study which found that the multisensory environment could improve mood and reduce agitation. Although this research looked at patients with dementia, agitation or distress is something that everyone can relate to and finding ways to reduce it can be applied to a variety of people and settings. Dr. Gregor contacted one of the researchers, Jason Staal, Psy.D., a psychologist at Department of Psychiatry at Beth Israel Medical Center in New York and assistant professor of psychiatry at the Albert Einstein College of Medicine, who provided initial consultation and expressed enthusiasm over the application of this approach to an inpatient psychiatric hospital, noting that the work would be ”cutting edge.” From that point, Gregor, Pearson, and Terry Hayward, the treatment team coordinator on the admissions unit, integrated the information and developed a plan for a sensory room on their unit.
The development of the sensory room involved collaboration from numerous departments
in the hospital. In
addition to the clinical direction provided by Psychology and Nursing, the expertise of Facilities
headed by the team of Rick Levesque and Joseph Silva, Safety, lead by Robert Patenaude, and
Information Technology, headed by Anthony Tassinari and Ronald Moores, was essential to
the successful completion of the project.
Taking into account the importance of having a time and place to regroup or recharge, the sensory room offers clients a non-threatening environment to foster relaxation, interest, and improve mood. It is a place that is failure-free since it does not involve any performance expectations. Within the sensory room, clients can explore different sensory experiences, including relaxing music, nature scenes, colored lights, a bubble tube, weighted blanket, tactile objects, and aromatherapy. There is an interpersonal component as staff interact with clients to learn more about their preferences. In so doing, they become more responsive to client needs. In this way, there is an emphasis on collaboration and empowerment of the client. The focus is on staff being proactive and offering options early to avoid coercive measures.
Over a period of 15 months, Gregor collected the results of questionnaires completed by clients to assess the effectiveness of the sensory room. The data are based on 259 uses of the room by 70 different clients. The majority of clients experienced increased relaxation, increased feelings of being in control, and decreased distress levels after sensory room use. The incorporation of such proactive approaches, including the sensory room, and a commitment to a culture of caring vs. coercion have contributed to positive results. For example, the civil admissions unit has avoided the use of restrictive restraints for almost 2 years.
The work at Riverview has come to the attention of other hospitals both within Maine and out of state.