Health provider and service-user experiences of sensory modulation rooms in an acute inpatient psychiatry setting

Autoři: Skye P. Barbic aff001;  Nicole Chan aff001;  Amanpreet Rangi aff001;  James Bradley aff003;  Rachal Pattison aff001;  Kerri Brockmeyer aff003;  Sandy Leznoff aff003;  Yojo Smolski aff003;  Gagan Toor aff003;  Blaine Bray aff003;  Adelena Leon aff001;  Malcolm Jenkins aff003;  Steve Mathias aff003
Působiště autorů: Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada aff001;  Department of Occupational Science and Occupational Therapy, UBC, Vancouver, British Columbia, Canada aff002;  Providence Health Care, Vancouver, British Columbia, Canada aff003;  Department of Psychiatry, UBC, Vancouver, British Columbia, Canada aff004;  Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada aff005;  Foundry, Vancouver, British Columbia, Canada aff006;  Department of Psychiatry, St. Paul’s Hospital, Vancouver, British Columbia, Canada aff007
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225238



Sensory modulation rooms (SMRs) are therapeutic spaces that use sensory modulation concepts and strategies to assist service users to self-regulate and modulate arousal levels. SMRs are increasingly being explored as strength-based and person-centered adjuncts to care for people receiving inpatient psychiatry services. The aim of this study is to understand health provider and inpatient service user perceptions on the use of SMRs on acute psychiatric units.


We conducted semi-structured interviews with ten service users and nine health providers (four occupational therapists and five nurses) regarding their experiences of the SMRs located on three acute inpatient units in a large urban tertiary care hospital. We audio recorded and transcribed the focus groups and used thematic analysis to analyze the data.


Our results suggested four common themes amongst health provider and service user experiences of sensory modulation rooms: (1) service user empowerment through self-management, (2) emotional regulation, (3) an alternative to current practices, and (4) health provider and service user education.


Our study supports the ecological utility of SMRs as person-centred adjunct therapeutic space viewed positively by both service users and health providers. This understanding of SMRs is critical for future service design, research and policy aimed at improving the service user experience and care for this population. Future research is needed to validate the experience of the SMRs with other patient groups and health providers.

Klíčová slova:

Behavior – Emotions – Health services research – Health systems strengthening – Inpatients – Learning – Mental health and psychiatry – Nurses


1. Barton SA, Johnson MR, Price LV. Achieving restraint-free on an inpatient behavioral health unit. J Psychosoc Nurs Ment Health Serv. 2009;47(1):34–40. Epub 2009/02/21. doi: 10.3928/02793695-20090101-01 19227108.

2. Colaizzi J. Seclusion & restraint: a historical perspective. J Psychosoc Nurs Ment Health Serv. 2005;43(2):31–7. Epub 2005/03/05. doi: 10.3928/02793695-20050201-07 15745238.

3. Scanlan JN, Novak T. Sensory approaches in mental health: A scoping review. Australian occupational therapy journal. 2015;62(5):277–85. Epub 2015/09/12. doi: 10.1111/1440-1630.12224 26358506.

4. Huckshorn KA, LeBel J, Jacobs HE. An organizational approach to reducing and preventing restraint and seclusion use with people with acquired brain injury. NeuroRehabilitation. 2014;34(4):671–80. Epub 2014/05/07. doi: 10.3233/NRE-141073 24796437.

5. Huckshorn KA. Reducing seclusion restraint in mental health use settings: core strategies for prevention. J Psychosoc Nurs Ment Health Serv. 2004;42(9):22–33. Epub 2004/10/21. 15493493.

6. Erickson MH. Psychological significance of physical restraint to mental patients. The American journal of psychiatry. 1949;105(8):612–4. Epub 1949/02/01. doi: 10.1176/ajp.105.8.612 18108321.

7. Szasz TS. Commitment of the mentally ill: treatment or social restraint. J Nerv Ment Dis. 1957;125(2):293–307. Epub 1957/04/01. doi: 10.1097/00005053-195704000-00017 13481728.

8. Kontio R, Joffe G, Putkonen H, Kuosmanen L, Hane K, Holi M, et al. Seclusion and restraint in psychiatry: patients’ experiences and practical suggestions on how to improve practices and use alternatives. Perspect Psychiatr Care. 2012;48(1):16–24. Epub 2011/12/23. doi: 10.1111/j.1744-6163.2010.00301.x 22188043.

9. Lee S, Cox A, Whitecross F, Williams P. Sensory assessment and therapy to help reduce seclusion use with service users needing psychiatric intensive care. Journal of Psychiatric Intensive Care. 2010;6(2):83–90. doi: 10.1017/S1742646410000014

10. Bjorkdahl A, Perseius KI, Samuelsson M, Lindberg MH. Sensory rooms in psychiatric inpatient care: Staff experiences. Int J Ment Health Nurs. 2016;25(5):472–9. Epub 2016/02/16. doi: 10.1111/inm.12205 26875931.

11. Gardner J. Sensory Modulation Treatment on a Psychiatric Inpatient Unit: Results of a Pilot Program. Journal of psychosocial nursing and mental health services. 2016;54(4):44–51. Epub 2016/04/05. doi: 10.3928/02793695-20160318-06 27042928.

12. Lipskaya-Velikovsky L, Bar-Shalita T, Bart O. Sensory modulation and daily-life participation in people with schizophrenia. Comprehensive psychiatry. 2015;58:130–7. Epub 2015/01/17. doi: 10.1016/j.comppsych.2014.12.009 25591905.

13. Sutton D, Nicholson E. Sensory modulation in Acute Mental Health wards: a qualitative study of staff and service user perspectives New Zealand2017 [June 8th, 2018].

14. Sutton D, Wilson M, Van Kessel K, Vanderpyl J. Optimizing arousal to manage aggression: a pilot study of sensory modulation. International journal of mental health nursing. 2013;22(6):500–11. Epub 2013/02/05. doi: 10.1111/inm.12010 23374543.

15. Oxford University Press.; 2017. A Dictionary of Occupational Science and Occupational Therapy.

16. Brown A, Tse T, Fortune T. Defining sensory modulation: A review of the concept and a contemporary definition for application by occupational therapists. Scandinavian journal of occupational therapy. 2018:1–9. Epub 2018/11/21. doi: 10.1080/11038128.2018.1509370 30457401.

17. Champagne J, Fortin C. Attention sharing during timing: modulation by processing demands of an expected stimulus. Percept Psychophys. 2008;70(4):630–9. Epub 2008/06/18. doi: 10.3758/pp.70.4.630 18556924.

18. Champagne T, Stromberg N. Sensory approaches in inpatient psychiatric settings: innovative alternatives to seclusion & restraint. J Psychosoc Nurs Ment Health Serv. 2004;42(9):34–44. Epub 2004/10/21. 15493494.

19. MacDaniel M, Van Bramer J, Hogan M. omfort rooms: A preventative tool to reduce the use of restraint and seclusion in facilities that serve individuals with mental illness. New York: New York State Office of Mental Health; 2009.

20. West M, Melvin G, McNamara F, Gordon M. An evaluation of the use and efficacy of a sensory room within an adolescent psychiatric inpatient unit. Australian occupational therapy journal. 2017;64(3):253–63. Epub 2017/02/01. doi: 10.1111/1440-1630.12358 28138979.

21. Meredith P, Yeates H, Greaves A, Taylor M, Slattery M, Charters M, et al. Preparing mental health professionals for new directions in mental health practice: Evaluating the sensory approaches e-learning training package. Int J Ment Health Nurs. 2018;27(1):106–15. Epub 2017/01/04. doi: 10.1111/inm.12299 28042908.

22. Blair EW, Woolley S, Szarek BL, Mucha TF, Dutka O, Schwartz HI, et al. Reduction of Seclusion and Restraint in an Inpatient Psychiatric Setting: A Pilot Study. The Psychiatric quarterly. 2017;88(1):1–7. Epub 2016/02/22. doi: 10.1007/s11126-016-9428-0 26897657.

23. Novak T, Scanlan J, McCaul D, MacDonald N, Clarke T. Pilot study of a sensory room in an acute inpatient psychiatric unit. Australas Psychiatry. 2012;20(5):401–6. Epub 2012/09/28. doi: 10.1177/1039856212459585 23014117.

24. Cummings KS, Grandfield SA, Coldwell CM. Caring with comfort rooms. Reducing seclusion and restraint use in psychiatric facilities. J Psychosoc Nurs Ment Health Serv. 2010;48(6):26–30. Epub 2010/03/31. doi: 10.3928/02793695-20100303-02 20349887.

25. Sivak K. Implementation of comfort rooms to reduce seclusion, restraint use, and acting-out behaviors. J Psychosoc Nurs Ment Health Serv. 2012;50(2):24–34. Epub 2012/03/23. 22439145.

26. Lin CY, Yang AL, Su CT. Objective measurement of weekly physical activity and sensory modulation problems in children with attention deficit hyperactivity disorder. Res Dev Disabil. 2013;34(10):3477–86. Epub 2013/08/10. doi: 10.1016/j.ridd.2013.07.021 23927990.

27. Chalmers A, Harrison S, Mollison K, Molloy N, Gray K. Establishing sensory-based approaches in mental health inpatient care: a multidisciplinary approach. Australasian psychiatry: bulletin of Royal Australian and New Zealand College of Psychiatrists. 2012;20(1):35–9. Epub 2012/02/24. doi: 10.1177/1039856211430146 22357673.

28. Smith S, Jones J. Use of a sensory room on an intensive care unit. J Psychosoc Nurs Ment Health Serv. 2014;52(5):22–30. Epub 2013/12/07. doi: 10.3928/02793695-20131126-06 24305908.

29. Barbic SP, Jones AA, Woodward M, Piercy M, Mathias S, Vila-Rodriguez F, et al. Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study. Canadian journal of public health = Revue canadienne de sante publique. 2018;109(2):204–14. Epub 2018/07/08. doi: 10.17269/s41997-018-0087-9 29981045.

30. Vila-Rodriguez F, Panenka WJ, Lang DJ, Thornton AE, Vertinsky T, Wong H, et al. The hotel study: multimorbidity in a community sample living in marginal housing. The American journal of psychiatry. 2013;170(12):1413–22. Epub 2013/08/10. doi: 10.1176/appi.ajp.2013.12111439 23929175.

31. Adepoju O, Lin SH, Mileski M, Kruse CS, Mask A. Mental health status and healthcare utilization among community dwelling older adults. Journal of mental health (Abingdon, England). 2018:1–9. Epub 2018/04/28. doi: 10.1080/09638237.2018.1466030 29701495.

32. Chiu M, Gatov E, Vigod SN, Amartey A, Saunders NR, Yao Z, et al. Temporal Trends in Mental Health Service Utilization across Outpatient and Acute Care Sectors: A Population-Based Study from 2006 to 2014. Canadian journal of psychiatry Revue canadienne de psychiatrie. 2018;63(2):94–102. Epub 2018/01/03. doi: 10.1177/0706743717748926 29291622.

33. Baker R. New addiction and mental health facilities coming St. Paul’s hospital 2017 [May 7th, 2017].

34. Braun V, Clarke V. What can "thematic analysis" offer health and wellbeing researchers? International journal of qualitative studies on health and well-being. 2014;9:26152. Epub 2014/10/19. doi: 10.3402/qhw.v9.26152 25326092.

35. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3.

36. Waldemar AK, Arnfred SM, Petersen L, Korsbek L. Recovery-Oriented Practice in Mental Health Inpatient Settings: A Literature Review. Psychiatric services (Washington, DC). 2016;67(6):596–602. Epub 2016/03/02. doi: 10.1176/ 26927572.

37. Waldemar AK, Esbensen BA, Korsbek L, Petersen L, Arnfred S. Recovery orientation in mental health inpatient settings: Inpatient experiences? International journal of mental health nursing. 2018;27(3):1177–87. Epub 2018/01/24. doi: 10.1111/inm.12434 29359397.

38. Waldemar AK, Esbensen BA, Korsbek L, Petersen L, Arnfred S. Recovery-oriented practice: Participant observations of the interactions between patients and health professionals in mental health inpatient settings. International journal of mental health nursing. 2019;28(1):318–29. Epub 2018/08/29. doi: 10.1111/inm.12537 30151987.

39. McEvedy S, Maguire T, Furness T, McKenna B. Sensory modulation and trauma-informed-care knowledge transfer and translation in mental health services in Victoria: Evaluation of a statewide train-the-trainer intervention. Nurse education in practice. 2017;25:36–42. Epub 2017/05/10. doi: 10.1016/j.nepr.2017.04.012 28477581.

40. Andersen C, Kolmos A, Andersen K, Sippel V, Stenager E. Applying sensory modulation to mental health inpatient care to reduce seclusion and restraint: a case control study. Nordic journal of psychiatry. 2017;71(7):525–8. Epub 2017/07/19. doi: 10.1080/08039488.2017.1346142 28719249.

41. Hetrick SE, Bailey AP, Smith KE, Malla A, Mathias S, Singh SP, et al. Integrated (one-stop shop) youth health care: best available evidence and future directions. The Medical journal of Australia. 2017;207(10):S5–s18. Epub 2017/11/14. doi: 10.5694/mja17.00694 29129182.

42. Cheng T, Kerr T, Small W, Nguyen P, Wood E, DeBeck K. High prevalence of risky income generation among street-involved youth in a Canadian setting. The International journal on drug policy. 2016;28:91–7. Epub 2016/01/26. doi: 10.1016/j.drugpo.2015.12.022 26806639.

43. Wood E. Strategies for Reducing Opioid-Overdose Deaths—Lessons from Canada. The New England journal of medicine. 2018;378(17):1565–7. Epub 2018/04/26. doi: 10.1056/NEJMp1800216 29694813.

44. British Columbia Ministry of Health. Secure Rooms and Seclusion Standards and Guidelines: A Literature and Evidence Review. 2012.

45. Mental Health Commission of Canada. Strengthening the Case for Investing in Canada’s Mental Health System: Economic Considerations. Ottawa: 2017.

46. Mental Health Commission of Canada. Recovery-orientated guidelines. Calgary: Mental Health Commission, 2015.

47. Mental Health Commission of Canada, editor Making transitions a priority. Concensus Conference on the mental health of emerging adults; 2015; Ottawa.

48. St. Paul’s Hospital Foundation. The New St. Paul’s. 2015.

Článek vyšel v časopise


2019 Číslo 11