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The influence of posttraumatic stress disorder, depression, and sensory processing patterns on occupational engagement: A case study
Abstract
The purpose of this article is to provide a brief overview of how Posttraumatic Stress Disorder (PTSD), Depression, and Sensory Processing patterns influence occupational engagement, including work performance. Interventions and outcomes of the Sensory Modulation Program and approaches from Cognitive Behavior Therapy (CBT) are reviewed through single case exploration with a 42 year-old woman in outpatient services. The marked increase in occupational engagement and improved work performance in this single case review demonstrates the need for more research on the use of the Sensory Modulation Program and approaches from CBT with populations with PTSD, Depression, and Sensory Processing disorder.
... People with schizophrenia have been reported to experience high rates of SM deficits when compared with the general population Brown et al., 2020), and these sensory processing problems impact on daily occupational and social functioning (Barbic et al., 2019;Champagne, 2011a;Champagne et al., 2015;Fleischhacker et al., 2014;Lipskaya-Velikovsky et al., 2015;Yakov et al., 2018). ...
... This manipulation of sensory input is achieved using activities, behavioural strategies, specific equipment, and modification of the physical and social environment to assist the regulation of an individual's sensory experience (Sutton & Nicholson, 2011). The use of SM interventions is an emerging practice in mental health driven by contemporary approaches such as the recovery approach, trauma informed care, and seclusion and restraint reduction (Champagne, 2011a;Lloyd et al., 2014). ...
... Another important issue is that not all clinically important outcomes have been addressed in previous studies. Most looked at distress tolerance but did not address functional outcomes (Champagne, 2011a;Lloyd et al., 2014;Sutton et al., 2013;Yakov et al., 2018). This study sought to measure and report on both levels of distress and functional outcomes to bridge this gap. ...
Introduction:
Current research evidence suggests that people with schizophrenia have sensory processing difficulties. Sensory modulation has growing evidence for use in this population. This study aimed to evaluate the extent to which health, social, cognitive, and occupational functioning outcomes were impacted by sensory modulation interventions for people with schizophrenia.
Methods:
A prospective observational cohort study using a waitlist control design was used in two large hospital and health services in Queensland, Australia. The study recruited patients who used sensory modulation (n = 30) across the two hospitals and those who did not use sensory modulation interventions as a control (n = 11). Results were analysed using a series of planned comparisons including independent and paired t-tests, and mixed ANOVA was used whenever statistically indicated. The analysed measures were pre- and post-intervention scores.
Results:
This study found no statically significant differences between the control and intervention groups at both pre- and post-intervention. However, analysis of results from within the intervention group showed statistically significant improvements between pre- and post-test scores on distress, occupational functioning, and health and social functioning but not on sensory processing and global cognitive processing. Further analysis of results from this study, compared with those from an earlier study on the general population showed significant differences in Low Registration and Sensation Avoiding, as measured by the Adult/Adolescent Sensory Profile, between participants with schizophrenia and those without schizophrenia.
Conclusion:
This study provides evidence to suggest that sensory modulation interventions can be complementary to standard care when utilised appropriately in clinical settings. Findings also suggest that the sensory profile of people with schizophrenia is different to that of the general population and this may have clinical implications. Further longitudinal research is needed with larger and randomised samples, using more targeted measures to better explore effectiveness of sensory modulation interventions.
... A number of studies provide evidence that people with mental health conditions experience sensory processing issues, including issues with the modulation of sensory input. Conditions associated with altered sensory processing include schizophrenia, anxiety disorders, personality disorders, autism spectrum disorder, post-traumatic stress disorder, and psychosis (Champagne, 2003(Champagne, , 2006(Champagne, , 2008(Champagne, , 2011Cusack, Frueh, Hiers, Keane, & Mueser, 2003;Moses, Reed, Mazelis, & D'Ambrosio, 2003;Mueser, Goodman, Trumbetta, Rosenberg, Osher, Vidaver, et al., 1998;Prescott, 2000;Rosenberg, Mueser, Friedman, Gorman, Drake, Vidaver, et al. 2001). For example, people with autism, schizophrenia, anxiety, and mood disorders are significantly more likely to avoid a high amount of sensory input (Dunn, 1997). ...
... In early 2000, due to increasing pressure to find ways of managing distress without coercion in acute services in the United States of America, Tina Champagne developed a sensory modulation programme and became a key proponent of sensory modulation in adult mental health. Champagne (2003Champagne ( , 2006Champagne ( , 2008Champagne ( , 2011 described her sensory modulation programme as involving the use of sensory approaches during both assessment and treatment for adolescent and adult populations to help manage distress and achieve their optimum well-being. This description is similar to that of O'Hagan et al. (2008) who proposed the use of sensory modulation across New Zealand inpatient services. ...
... Sensory modulation programmes can be used in a variety of settings, such as inpatient mental health units, school classrooms, and work environments. The sensory modulation programme developed by Champagne (2003Champagne ( , 2006Champagne ( , 2008Champagne ( , 2011 aims to increase individuals' self-awareness and promote selfregulation through skill development and habit stabilisation. Champagne's sensory modulation programme is an adaptation of sensory theories and principles of sensory integration. ...
Sensory modulation is an evidence-based, and people-centric approach used in mental health practice to support people to manage their distress. This e-training is open to DHB and government funded mental health practitioners who have received introductory training in sensory modulation and want to build their knowledge and skills in sensory modulation.
This e-training presents the science behind sensory processing, arousal and emotion. There will be good opportunity to engage with other participants in group activities and relaxed open discussions. It will give the participants:
• better understanding of sensory modulation in New Zealand’s mental health practice setting; and
• enhanced sensory modulation assessment, planning and treatment approach skills.
... It also includes proprioception (sense of movement and force in muscles and joints) and vestibular input (sense of balance and acceleration) [4]. There is considerable neuroscientific evidence that people with diagnoses such as Schizophrenia, Post Traumatic Stress Disorder and Anxiety Disorders may have associated sensory processing issues [5][6]. This includes difficulties in 'gating' or filtering out less important stimuli as well as hypersensitivity to specific input [7]. ...
... Furthermore, when acutely distressed, individuals with or without serious mental health issues may become over-sensitive to input such as noise or bright light, or under responsive to other input, such as visual cues [8]. Difficulties with sensory processing are presumed to significantly affect engagement in daily occupations, such as attending to work tasks and socialising with others [5,9]. However, there is currently limited published evidence exploring how atypical sensory processing is experienced in adults with mental illness and how it affects occupational participation [6]. ...
... It is an approach that focuses on assisting individuals to more effectively self-regulate their emotional and physiological arousal in order to optimise their wellbeing [13][14]. The ability to self-regulate sensory input has been shown to prevent distress and support social and occupational engagement for people with serious mental illness [5,[14][15][16]. Still, most studies are within clinical wards and no studies have been conducted exploring sensory modulation strategies in the context of daily occupations. ...
Background: There is growing evidence that people with serious mental illness have impaired capacity for processing sensory inputs which affects daily occupation. Although this is known, research regarding the target groups experiences of sensory inputs in daily occupations is lacking.
Aim: To investigate the experience of sensory input and strategies used in daily occupations among people with serious mental illness.
Material and methods: Fourteen people with serious mental illness were interviewed regarding their experiences of sensory processing and strategies for managing sensory inputs in daily occupations. Data were analysed using content analysis.
Results: Sensory processing issues affected occupational engagement and strategies to control inputs were intuitively used to cope with sensory challenges. Informants either ignored, reduced or avoided sensory inputs. Informants also enabled daily life through strategies such as creating a home that provides rest, finding a safe place, using nature and animals for relaxing and using effects of calming and alerting occupations.
Discussion: Specific sensory inputs were difficult to process, which was experienced as stressful and affected occupations negatively. The results imply a need for further research exploring the management of sensory input and the use of sensory modulation approaches to enable engagement in daily activities.
... A number of studies provide evidence that people with mental health conditions experience sensory processing issues, including issues with the modulation of sensory input. Conditions associated with altered sensory processing include schizophrenia, anxiety disorders, personality disorders, autism spectrum disorder, post-traumatic stress disorder, and psychosis (Champagne, 2003(Champagne, , 2006(Champagne, , 2008(Champagne, , 2011Cusack, Frueh, Hiers, Keane, & Mueser, 2003;Moses, Reed, Mazelis, & D'Ambrosio, 2003;Mueser, Goodman, Trumbetta, Rosenberg, Osher, Vidaver, et al., 1998;Prescott, 2000;Rosenberg, Mueser, Friedman, Gorman, Drake, Vidaver, et al. 2001). For example, people with autism, schizophrenia, anxiety, and mood disorders are significantly more likely to avoid a high amount of sensory input (Dunn, 1997). ...
... In early 2000, due to increasing pressure to find ways of managing distress without coercion in acute services in the United States of America, Tina Champagne developed a sensory modulation programme and became a key proponent of sensory modulation in adult mental health. Champagne (2003Champagne ( , 2006Champagne ( , 2008Champagne ( , 2011 described her sensory modulation programme as involving the use of sensory approaches during both assessment and treatment for adolescent and adult populations to help manage distress and achieve their optimum well-being. This description is similar to that of O'Hagan et al. (2008) who proposed the use of sensory modulation across New Zealand inpatient services. ...
... Sensory modulation programmes can be used in a variety of settings, such as inpatient mental health units, school classrooms, and work environments. The sensory modulation programme developed by Champagne (2003Champagne ( , 2006Champagne ( , 2008Champagne ( , 2011 aims to increase individuals' self-awareness and promote selfregulation through skill development and habit stabilisation. Champagne's sensory modulation programme is an adaptation of sensory theories and principles of sensory integration. ...
Sensory modulation is an evidence-based, and people-centric approach used in mental health and addiction practice to support people accessing services to manage their distress. This book is for mental health practitioners who have received introductory training in sensory modulation and want to build their knowledge and skills. This book presents the science behind sensory processing, arousal and emotion. It will give the participants: [1] a better understanding of sensory modulation in New Zealand’s mental health and addiction practice setting, [2] enhanced skills for sensory modulation assessment, planning and use. This book will help participants to develop their values, attitudes, knowledge and skills in advancing their practice in the application of sensory modulation. The book is comprised of six modules with specific learning objectives.
... It consisted of a device administering micro currents to alter electrical currents in the brain self-administered by the participants under the direction of an occupational therapist. Moore & Henry (2002) and Champagne (2011) reported on interventions based on the theory that traumatic experiences can lead to sensory distortion and sensory defensiveness (Kolb, 1987). They carried out single case studies with individuals with PTSD and the intervention mainly consisted of the prescription of a sensory diet of "sensory rich" activities, augmented in the case of Moore and Henry (2002) with deep pressure brushing of the skin. ...
... Moore and Henry (2002) used an unpublished questionnaire developed for the study called the Sensory Defensiveness Screening for Adults and reported that participants identified with fewer symptoms of sensory defensiveness following the treatment. Champagne (2011) reported that several baseline measures were carried out with the single participant with PTSD but no results are reported. Some personal goals are measured on a scale of 1-10 e.g. ...
... "paying bills on time". Both Champagne (2011) and Moore and Henry (2002) gathered outcome data in an informal way, sometimes over the phone and directly by the clinician delivering the intervention, introducing risk of reporting bias. These two interventions included scheduling many pleasant activities such as yoga and swimming so any positive results seen could have been due to increased participation in these health-promoting activities, rather than the sensory aspect of the intervention. ...
Anxiety and stress-related disorders are highly prevalent and impede participation in life activities. Occupational therapists work extensively with people diagnosed with these disorders but the effectiveness of their interventions is unclear. A systematic search strategy identified 19 papers describing 13 studies. Studies varied in methodology, intervention type, and theory base. The results show the potential for lifestyle approaches, occupational science-based programs, and skill-building to improve mental health. The variety of interventions and methodologies of many studies means that the effectiveness of occupational therapy interventions for this population is not yet determined. High-quality research is required to replicate interventions with emerging potential for effectiveness.
... Worldwide, there are increasing demands for consumer-centered humane approaches for people with schizophrenia or other mental illnesses. Sensory modulation is largely regarded as the profession of occupational therapy's response to that demand (Champagne and Stromberg 2004;Champagne 2011;Champagne and Koomar 2012). ...
... SM is the regulation and organization of the degree, intensity, and nature of one's responses to sensory input in a graded and adaptive manner (Champagne et al. 2010, Champagne 2011Lipskaya-Velikovsky et al. 2014). SM is an emerging approach in mental health spearheaded by new approaches such as the recovery approach, trauma-informed care, and seclusion and restraint reduction (Champagne 2011). ...
... SM is the regulation and organization of the degree, intensity, and nature of one's responses to sensory input in a graded and adaptive manner (Champagne et al. 2010, Champagne 2011Lipskaya-Velikovsky et al. 2014). SM is an emerging approach in mental health spearheaded by new approaches such as the recovery approach, trauma-informed care, and seclusion and restraint reduction (Champagne 2011). SM is an adaptation of sensory integration, an approach used in occupational therapy practice particularly with children (Ayres 1972;Champagne 2011). ...
Sensory modulation, as a treatment for sensory modulation disorders in adults with psychiatric conditions, has been implemented by occupational therapists for more than two decades. The purpose of this systematic literature review was to evaluate published research evidence relating to this intervention. The aim of the study was to determine if there was established evidence for the effectiveness of sensory modulation in treating sensory modulation disorder in adults with schizophrenia and to identify any gaps in knowledge to guide further research. We utilized Australia’s National Health and Medical Research Council (NHMRC)’s levels of evidence and recommendation grading and the Rosalind Franklin Research Appraisal Instrument (RF-QRA) to review selected articles. The results were then summarized and reported utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. A total of 17 studies were included in the study. We concluded that there is preliminary evidence for the existence of sensory modulation disorder in schizophrenia and the effectiveness of sensory modulation interventions for reducing distress. We recommended further studies on the effectiveness of sensory modulation with better rigor and advise that guidelines be developed for use in practice by clinicians.
... S ensory modulation is an overarching term given to a suite of tools used to assist mental health service users to moderate their responses when distressed (Brown et al, 2002;Champagne and Stromberg, 2004). Sensory tools can, for example, be used to help service users who are agitated to become calmer, those who are anxious to feel less so, or help activate service users who are depressed (Champagne, 2011). Clinicians also use sensory modulation to help some service users to lessen feelings of self-harm (Lee et al, 2010;Smith and Jones, 2014) or to manage violent situations (Sutton et al, 2013). ...
... Champagne et al (2010) and Champagne and Koomar (2012) recommend establishing sensory-based approaches in mental health occupational therapy practice. Sensory modulation is the profession of occupational therapy's response to the sociopolitical movement based on increasing demands from service users and governments for service user-centred humane approaches for adults with mental health conditions who present with behavioural issues associated with violent incidents (Champagne, 2011). ...
... The assessment process included implementation of a sensory screen tool developed by members of the SMWP by adapting the sensory preference screen (Champagne, 2011). The sensory preference screen starts out by looking at the top five calming strategies and the top five alerting strategies. ...
... Further, the present study indicates that the daily progress in EAT had a positive influence on the informants' ability to also engage in various occupations outside the EAT program such as work and social interaction. According to Champagne (2011) and Bejerholm and Eklund (2004), people who suffer from mental illness or trauma often have difficulties with engagement in daily activities. In the present study the informants described how different social activities and practical tasks, such as having the responsibility of performing different practical maintenance tasks for the horses, such as feeding and grooming, helped them to improve their occupational abilities. ...
... Further, in the current study the informants seemed to become more relaxed when riding and being with the horse. According to Champagne (2011) and Champagne and Stromberg (2004) people with mental health problems or trauma often experience difficulties with sensory modulation due to distortion in sensory processing. Research shows that many people with mental health problems also are sensitive to sensory inputs and use different sensory strategies to calm and alert themselves (Andersson et al., 2021;Champagne & Stromberg, 2004;Sutton et al., 2013). ...
Equine Assisted Therapy (EAT) has positive influence on health. However, research is scarce regarding how people with mental health problems experience EAT and if it influences occupational engagement. Eleven people with mental health problems were interviewed regarding this issue. Data was analyzed using a hermeneutic phenomenological approach. Results showed that EAT had a positive influence on personal development and occupational engagement in forms of a catalytic experience, taking control in daily life, and being active and building relationships in life. Although the study is small in size, the results indicate that EAT could be used to facilitate meaningful occupations.
... Specifically, occupational therapy is utilized in some psychiatric settings to address trauma with sensory-based interventions to decrease seclusion and restraint as well as improve overall engagement in everyday activities (Champagne, 2011a;Scanlan & Novak, 2015;Sutton et al., 2013;Warner et al., 2013). Treatment interventions may include use of sensory rooms for de-escalation (West et al., 2017), sensory-based activities such as soothing music and tactile mazes (Arnsten et al., 2015), and modifications to the environment to facilitate adaptive self-regulation skills (Sutton et al., 2013). ...
... Recognizing, labeling, and regulating one's emotions can be difficult for individuals with trauma histories (Champagne, 2011a;Chen et al., 2017) or mental health concerns (Logan-Greene et al., 2017). This study utilized a numerical approach with the Emotions Intervention Tool Likert scale to aid youth to recognize a change in emotion. ...
Previous studies have shown that experiences of childhood trauma disproportionally impact incarcerated youth and may decrease self-regulation skills including identification of emotions and ability to control behaviors.
Purpose: The current study aimed to investigate changes in emotional state identified by incarcerated youth after receiving sensory-based occupational therapy treatment.
Methods: A quasi-experimental retrospective chart review design was used in addition to surveys.
Results: Participants had an average ACE score of 5.91 traumatic experiences and at least three mental health diagnoses. Results showed a statistically significant change between pre-and post-session emotions via a Likert scale as well as a decrease in the frequency of negative words used to identify emotions. When surveyed, participants reported a calmer body state after occupational therapy and highlighted the importance of learning coping strategies.
Conclusion: Results suggest that sensory-based occupational therapy may be an effective, trauma-informed intervention to improve self-regulation and support daily function of these incarcerated youth.
... Champagne [27] 2011 ...
... The Relationships Among Sensory Processing Styles, Personality Traits, and Body Mass Index: A Pilot Study "Sensory modulation is the neurological process of balancing excitation and inhibition in reaction to the sensory environment for the purpose of maintaining appropriate arousal and supporting adaptive responses" (20, p. 73) Champagne [27] 2011 Sensory Modulation & Environment: Essential Elements of Occupation "The ability to self-organise and regulate reactions to sensory inputs in a graded and adaptive manner. The ability to self-organise inhibitory and excitatory sensory stimulation and adapt to environmental changes" (21, p. 252) Figure 2. Coding distribution for the definition of sensory modulation. ...
Background: Sensory interventions are prevalent amongst adult mental health practitioners and are supported by major stakeholders and policy makers across the world. The term commonly used by occupational therapists applying sensory practices is sensory modulation, however this term has evolved.
Aims: This paper aims to investigate and clarify the definition of ‘sensory modulation’ for application by occupational therapists.
Method: A framework guided this concept analysis on sensory modulation. A summative content analysis approach was employed to code results.
Results: Six conceptual themes for sensory modulation were identified. 81% of authors defined sensory modulation as consisting of more than one of these themes. 18% of authors defined sensory modulation as both a neurophysiological process and means to regulate behaviour.
Conclusion: The concept of sensory modulation has evolved in occupational therapy practice. The authors summarise with the following proposed definition of sensory modulation for contemporary occupational therapy practice: ‘Sensory modulation is considered a twofold process. It originates in the central nervous system as the neurological ability to regulate and process sensory stimuli; this subsequently offers the individual an opportunity to respond behaviourally to the stimulus’.
Significance: A contemporary definition of ‘sensory modulation’ has been identified for occupational therapy practice.
... This might apply to social environments in which participation is intended to be enhanced, to facilitate first the regulation and then the sensory selfregulation of the patient. In this sense, it has been indicated that the use of sensory modulation techniques can help people with schizophrenia to become aware of their sensory preferences and sensitivities, improving their emotional and behavioral self-regulation, so that they can apply it in their daily lives (Champagne & Stromberg, 2004;Champagne, 2011). Interestingly, some studies in the acute unit have reported that there are some hours when the patients could benefit more from sensory reduction strategies, especially in the afternoon until dinner, where a higher incidence of difficulties in social interaction among them has been observed. ...
The aim of this study was to explore the relationship between sensory profiles and the quality of life. Methods: A cross-sectional study was conducted with 99 participants, with a diagnosis of schizophrenia. Adolescent/Adult Sensory Profile, the WHOQOL-BREF and PANSS were administered. A stepwise linear regression analysis was performed, with those variables of the sensory profile and the dimensions of quality of life that showed a statistically significant correlation. Participants with lower quality of life (WHOQOL-Bref score ≤ 60) showed a higher score in Low Registration profile (t(97) = 2; p = .048; δ = .42). Physical Health showed a moderate negative correlation with Sensory Sensitivity profile (r = −.415; p < .01) and Sensation Avoiding (r = −.372; p < .05). Psychological Health showed a moderate negative correlation with Low Registration (r = −.354; p < .01), Sensory Sensitivity (r = −.307; p < .01) and auditory processing (r = −.343; p < .01). Sensory preference could be a key aspect of mental health rehabilitation programs. Sensory modulation issues seem to be related to the quality of life of patients with schizophrenia.
KEY POINTS
• Sensory preference could be a key aspect of mental health rehabilitation programs.
• Mental health services should consider the sensory profile of the patient in the evaluation and intervention.
• Sensory modulation approaches could be complementary interventions to improve the quality of life of people with schizophrenia.
... There are multiple approaches to treating sensory modulation dysfunction in the literature. Examples include promoting daily self-regulation through implementation of sensory strategies/experiences (i.e., fidget with stress ball, eat strong tasting mint, use weighted blanket, or pulling a resistance band) and training use of coping strategies such as progressive muscle relaxation, diaphragmatic breathing, and guided meditation (203,204). Incorporating these sensory-based interventions may enhance patient recovery when provided in combination with other available treatments. ...
Dystonia is a common movement disorder, involving sustained muscle contractions, often resulting in twisting and repetitive movements and abnormal postures. Dystonia may be primary, as the sole feature (isolated) or in combination with other movement disorders (combined dystonia), or as one feature of another neurological process (secondary dystonia). The current hypothesis is that dystonia is a disorder of distributed brain networks, including the basal ganglia, cerebellum, thalamus and the cortex resulting in abnormal neural motor programs. In comparison, functional dystonia (FD) may resemble other forms of dystonia (OD) but has a different pathophysiology, as a subtype of functional movement disorders (FMD). FD is the second most common FMD and amongst the most diagnostically challenging FMD subtypes. Therefore, distinguishing between FD and OD is important, as the management of these disorders is distinct. There are also different pathophysiological underpinnings in FD, with for example evidence of involvement of the right temporoparietal junction in functional movement disorders that is believed to serve as a general comparator of internal predictions/motor intentions with actual motor events resulting in disturbances in self-agency. In this article, we present a comprehensive review across the spectrum of FD, including oromandibular and vocal forms and discuss the history, clinical clues, evidence for adjunctive “laboratory-based” testing, pathophysiological research and prognosis data. We also provide the approach used at the Massachusetts General Hospital Dystonia Center toward the diagnosis, management and treatment of FD. A multidisciplinary approach, including neurology, psychiatry, physical, occupational therapy and speech therapy, and cognitive behavioral psychotherapy approaches are frequently required; pharmacological approaches, including possible targeted use of botulinum toxin injections and inpatient programs are considerations in some patients. Early diagnosis and treatment may help prevent unnecessary investigations and procedures, while facilitating the appropriate management of these highly complex patients, which may help to mitigate frequently poor clinical outcomes.
... This has thus implications for both staff and residents. The staff in SH services need to gain knowledge about environmental stimuli and their effect on the residents, while the residents may need to learn more about regulating their own reactions to stimuli, as described by Champagne [47] which might enhance their activity repertoire and reduce their loneliness. Furthermore, identifying significant others who can help bridge the fear of overstimulation [31] and be a safe supporter in a new environment can be important [38,39]. ...
Background
People with severe mental illness (SMI) living in supported housing (SH) struggle in everyday life and we currently lack a comprehensive body of knowledge concerning how the residents experience their day. This paper aimed to gain knowledge about how people with SMI describe a day in SH in Sweden, in particular the activities they most frequently engage in and how they experience what they do in or outside their home. Furthermore, it is important to gain knowledge of which activities motivate residents to leave the housing facility and to participate in the community. This new knowledge can help staff to encourage a recovery process among the residents.
Methods
One hundred thirty-three people living in SH completed a time-use diary and a mixed-methods approach was applied, including calculations of what activity that was most frequently performed and a manifest content analysis addressing experiences of activity.
Results
The residents had a low activity level and were often alone. Approximately one-half of the reported activities were performed in their own apartments, and generally unaccompanied. A quarter of the activities were performed in the common areas and a further quarter outside the SH. The most frequently performed activities were quiet and tranquil ones, e.g. listening to music and resting. Doing errands and group activities with staff and residents were the main activities that motivated leaving the facility. The participant experience of a day is presented in three categories: “Experiences of chosen and enforced togetherness and overcoming loneliness”, “Environmental change and emotional balance can generate activity”, and “Met and unmet needs for support, friendship and security”.
Conclusions
The residents were generally satisfied with their quiet and tranquil lifestyle and appeared to demand little of life, which may relate to previous experiences of institutional life and can constitute a challenge for staff. The findings highlight experiences that can help to improve SH. Services need to support individually adjusted contextual stimuli and individualize the support to help residents find a good balance and motivate them to be active in and outside SH, which can support a recovery process.
... In a case study examining the efficacy of the Sensory Modulation Program for an individual with PTSD and sensoryprocessing difficulties (i.e., elevated sensory sensitive, low registration, and sensation-avoiding tendencies), 1 month of outpatient treatment led to decreased PTSD symptoms and more adaptive sensory responses. 58 In addition to occupational therapy-based sensory modulation training, other psychotherapeutic modalities such as sensorimotor psychotherapy may also warrant consideration in patients with FND with abnormal sensory processing. For example, sensorimotor psychotherapy has been shown to address physiologic arousal, alexithymia, and emotional numbing in patients with PTSD, depression, and anxiety through techniques that help patients to modulate autonomic arousal and reinstate adaptive responses. ...
Background:
Functional neurological disorder (FND) is a prevalent neuropsychiatric condition characterized by sensorimotor difficulties. Patients with FND at times report that sensory experiences trigger and/or exacerbate their symptoms. Sensory processing difficulties are also commonly reported in other psychiatric disorders frequently comorbid in FND, suggesting that contextualizing sensory profiles in FND within a biopsychosocial model may be clinically relevant.
Objective:
To address this literature gap, we conducted a retrospective cohort study to examine sensory processing patterns and their relationship to other neuropsychiatric characteristics in patients with FND.
Methods:
A retrospective chart review design was used to investigate sensory processing patterns, established with the Adolescent/Adult Sensory Profile self-report questionnaire, in 44 patients with FND. Univariate analyses of cross-sectional screening tests followed by multivariate linear regression analyses were performed to identify clinical factors associated with sensory processing scores in the FND cohort.
Results:
Compared to normative data, most patients with FND reported sensory processing tendencies toward low registration, sensory sensitivity, and sensation avoiding. In multivariate regression analyses, the presence of a lifetime anxiety disorder independently predicted elevated low registration scores, while female gender and number of current medications independently predicted increased sensory sensitivity scores. In uncorrected univariate analyses only, individuals with psychogenic nonepileptic seizures were more likely to report increased sensory sensitivity and elevated low registration.
Conclusion:
These preliminary findings support sensory processing difficulties in some patients with FND. Prospective and large sample size studies are needed to investigate relationships between sensory processing profiles and neuropsychiatric comorbidities, FND subtypes, and treatment outcomes.
... Reviewers decided that although the intervention is "cranial electrotherapy stimulation", it is administered by an occupational therapist, and the author notes that CES is a physical agent modality that is legitimate for occupational therapists to use. (Champagne, 2011) (Beck et al., 2012) X *see decisionmaking process √ √ JF Excluded Population was broadly described in the paper as including people with PTSD, but no diagnoses were available on the participants of this study. The number of participants with a "behavioural health issue" was less than 50%. ...
This is a table of the included and excluded studies for this systematic review. It provides transparency about the exclusion process for some papers which almost met the criteria.
... Exponents of sensory approaches in clinical practice have reported them as generally effective (Champagne, 2004;Champagne and Stromberg, 2004;Champagne, 2011;Sutton and Nicholson, 2011;Chalmers et Scanlan and Novak, 2015). Sensory approaches are currently widely used in both inpatient and community mental health settings, particularly for decreasing distress during crisis situations. ...
... For individuals with PTSD specifically, several studies showed statistically significant improvements in PTSD symptoms, although the interventions varied from high-intensity sport (Rogers et al., 2014), to driving rehabilitation (Classen et al., 2014) to life-skills (Helfrich et al., 2011). Positive pre test -post test outcomes from some studies should be interpreted with caution due to limited description of the intervention (Kohn et al., 2012), limited discussion of the outcome measures used (Crouch, 2008) and a lack of independent assessment (Champagne, 2011) Discussion: Studies varied widely as to the quality of the methodology, content of the intervention, method of delivery, population included and assessments used. The review showed that occupational therapy-led interventions have potential for improving mental health and functioning for individuals with anxiety disorders, but a definitive conclusion about effectiveness was not reached. ...
... stres bozuklu?u ya?ayacaklard?r. Lopez, 2011). Travma sonras? ...
INTRODUCTION: This article presents a research-informed model of trauma responsive care for use in residential care practice social work settings with children and young people in Aotearoa New Zealand. The model was developed from a qualitative project which sought to address the research question “Does the quality of relationships with staff members have a positive impact on outcomes for children who reside in group home settings?”METHODS: Using semi-structured, in-depth interviews, eight children were interviewed regarding their experience of relationships while living within supervised group homes (SGHs). In order to gain multiple perspectives on this topic, six biological parents and two legal guardians of children were interviewed and focus group discussions were held with staff members from three SGHs. Thematic analysis was used to identify key themes identified from the findings.FINDINGS: Five dominant themes were identified from the children’s and parent’s interviews. The central theme was the importance of relationships; that relationship is the key when working with children who have experienced trauma. Children who have experienced trauma need to feel safe in the context of relationships and benefit from bottom-up interventions in order to heal from their traumatic experiences.CONCLUSION: A research-informed model of trauma responsive care was constructed from study findings informed by two principal bodies of knowledge: (1) attachment theory; and (2) neuroscience. The resultant trauma responsive care model provides a framework of strategies for anyone working with children in residential care settings who have experienced trauma and/ or attachment difficulties.
This paper is devoted to the investigations of the recording of 1-D and 2-D holographic gratings using thin films of polyepoxypropylcarbazole (PEPC) obtained by deposition from solutions and their use as registering media for. For the direct recording azopolymer films based on polyepoxypropylcarbazole: methyl red with magnetic particles of Fe2SO4 were used. Diffraction efficiency in transmission of the recorded gratings consisted ~34%. Morphology of films surface and obtained surface relief’s was investigated using AFM and good quality of films surfaces and obtained relief’s was shown. For the first time simultaneously surface and magnetic relief were directly recorded using PEPC thin films as registering media.
A review of published data sources, their synthesis analysis, a description of the developed approach in health-forming technologies, based on the use of natural physical environments of living, daily working and servicing activity, inducing adaptive plastic transformations, optimization of gas-energy exchange in the body, strengthening of sensorimotor integration. Strategically, the development is aimed at enhancement of the working and defense capability, rehabilitation of individuals, i.e. an approach to solving the modern social problem of the growing ‘‘disability of society’’.
Purpose
This paper aims to explore service-user perspectives of sensory approaches introduced and promoted by the trauma and self-injury service within the National High Secure Healthcare Service for Women (NHSHSW) at Rampton Hospital.
Design/methodology/approach
This cross-sectional descriptive study used a semi-structured questionnaire, which was devised for this evaluation and included both open and closed questions. The data collected were then analysed using descriptive statistics and thematic analysis.
Findings
The paper evaluates the current use of sensory approaches within the NHSHSW. Sensory approaches were widely used across the service, with essential oils being the most commonly used sensory approach. The use of sensory approaches can be understood according to the following three themes: independence, accessibility and self-regulation. The self-regulation theme contained three sub-themes as follows: safety-seeking, relaxation and reducing distress. The evaluation also highlighted barriers to using sensory approaches and sought service-user feedback as to how these may be overcome.
Practical implications
Participants’ feedback informed changes to practice, such as introducing sensory approaches to service-users earlier in their care pathway and increasing the accessibility of sensory items. These approaches may be of relevance to service provision in other forensic or inpatient settings.
Originality/value
This paper offers a unique contribution to the current literature with its focus on using sensory approaches to ameliorate trauma symptoms, in the context of a forensic setting.
Incarcerated youth have histories of high rates of childhood traumatic experiences which may correlate with sensory processing patterns and increased violent behavior. This mixed methods study explored the relationship between these variables as well as functional benefits of sensory-based occupational therapy treatment for incarcerated youth. Significant correlations were found between several pairs of variables and key-results showed youth who participated in occupational therapy had fewer violent behaviors. Client voices affirmed that occupational therapy reduced violence, provided support, and gave hope for the future. These findings suggest occupational therapy intervention help reduce violent behavior and promote safety in juvenile correctional facilities.
Increasing human interaction creates extra stress on individuals and organisations as well. The nature of such stress results in economic shocks and large societal and organisational traumas. Although recent social science is capable of addressing the complexity of international interplay such as culture, acts of multinational corporations or cross-cultural team management, little attention was paid on the cultural aspects of removing organisational trauma. Since the 1980s, social science has experienced lively development in cross-cultural studies via the work of Hofstede, the Globe Group, the World Value Survey initiative, Trompenaars, Schwartz and others. Although major models are sufficient for defining national culture, there is lack of work explaining the managerial implications for crisis management or mitigating trauma in organisations.The authors of this chapter intend to critically review the latest literature on national culture, while discussing the relevant models and introducing the theoretic framework applicable for crisis/ trauma management.
Importance:
When occupational therapists understand sensory processing preferences, they can create environments that promote participation.
Objective:
To determine the sensory processing preferences of people with a psychiatric condition as measured by the Adolescent/Adult Sensory Profile (A/ASP).
Data sources:
PubMed, PsycINFO, ERIC, CINAHL, and OTseeker were searched from 2002 through January 2018.
Study selection and data collection:
Studies that included people with psychiatric conditions and measured sensory processing preferences using the A/ASP were included. Studies had to report means and standard deviations for all four A/ASP subscales. The retrospective analysis involved extracting sensory processing quadrant scores from each study and comparing these scores with the A/ASP norms by means of independent-samples t tests.
Findings:
Five studies revealed a general pattern of greater sensory sensitivity, sensation avoiding, and low registration and less sensation seeking among people with a psychiatric condition. For each condition (schizophrenia, high risk for psychosis, bipolar disorder, major depressive disorder, posttraumatic stress, and obsessive-compulsive disorder), scores in at least two of the four sensory processing quadrants were significantly different from the normative scores, with some variability in sensory processing preferences across the psychiatric conditions.
Conclusions and relevance:
The sensory processing preferences of people with a psychiatric condition differ from those of the normative sample. This research can lead to condition-specific sensory-based interventions targeting a person's specific sensory needs in the context of occupational performance.
What this article adds:
This article provides new information that compares and contrasts the sensory processing preferences of people with different types of psychiatric conditions. This information can be useful in treatment planning.
Purpose
An emerging evidence base and increased awareness of the effects of trauma on the body, advocate a sensory-based approach to treatment with posttraumatic stress and complex trauma survivors. This paper aims to identify, analyse and summarise the empirical evidence for and the sensory-based interventions, which occupational therapists are using in the treatment of adult and adolescent trauma survivors.
Design/methodology/approach
An integrative review of the literature was undertaken. Both empirical and conceptual papers were included. An inductive approach and constant comparative method were used to understand and synthesise the research.
Findings
The literature search yielded 18 papers describing the types of sensory-based interventions used, sensory processing (SP) patterns and the context and evidence for sensory-based occupational therapy practice with trauma survivors. Nine of the studies were empirical and nine were conceptual and review papers. Themes identified included: atypical SP patterns; type of sensory-based intervention used with trauma survivors; and transdisciplinary treatment programmes can reduce the symptoms of trauma.
Practical implications
Sensory-based interventions with adult and adolescent trauma survivors are emerging as promising areas of practice and research in the literature. Although empirical data is limited, the sensory needs of the body in processing trauma experiences is becoming more recognised and are supported by the atypical SP patterns identified in survivors. A sensory-based, transdisciplinary approach to treatment has the potential to be effective in treating the trauma survivor.
Originality/value
With a skill base in sensory integration and occupational analysis, occupational therapists have much to offer the field of trauma studies. This review begins to address the gap in the literature, recommending more rigorous controlled outcome research with a larger sample sizes, person-centred studies focussing on the trauma survivor’s perspective and continuing professional development and mentorship for occupational therapists working with this population.
Anxiety is a common mental health issue involving cognitive and physiological hypersensitivity to threat. It negatively affects occupational participation. Sensory modulation intervention aims to use calming sensory input to manage the hypersensitivity and physiological arousal associated with anxiety. The empirical evidence for using sensory interventions for anxiety, however, is limited. This mixed methods single subject case design explored the effectiveness of a 6-week sensory modulation intervention for reducing anxiety and improving occupational participation. Results showed significant reduction in anxiety and improved participation, providing further evidence that sensory modulation is an effective approach for the self-management of anxiety.
Increasing human interaction creates extra stress on individuals and organisations as well. The nature of such stress results in economic shocks and large societal and organisational traumas. Although recent social science is capable of addressing the complexity of international interplay such as culture, acts of multinational corporations or cross-cultural team management, little attention was paid on the cultural aspects of removing organisational trauma. Since the 1980s, social science has experienced lively development in cross-cultural studies via the work of Hofstede, the Globe Group, the World Value Survey initiative, Trompenaars, Schwartz and others. Although major models are sufficient for defining national culture, there is lack of work explaining the managerial implications for crisis management or mitigating trauma in organisations. The authors of this chapter intend to critically review the latest literature on national culture, while discussing the relevant models and introducing the theoretic framework applicable for crisis/ trauma management.
Purpose:
Sensory approaches to mental illness are increasingly prominent in occupational therapy. Despite indicators of efficacy, a paucity of literature supports these approaches. This article provides a scoping review of research on the relationship between sensory processing and mental illness.
Method:
Using Arksey and O'Malley's (2005) framework, we mapped this area of research and identified gaps in the knowledge base. We searched PubMed, CINAHL Plus, PsycINFO, OTseeker, and the Cochrane Library using the terms sensory and mental health.
Results:
We found a growing body of neuroscientific research, primarily using electroencephalography and functional MRI, that links atypical neurosensory activity to mental illness. The occupational therapy literature has primarily focused on the efficacy of sensory rooms in psychiatric inpatient settings.
Conclusion:
Research on the efficacy of sensory approaches needs to be expanded, including on how atypical sensory processing in adults with mental illness affects meaningful occupational participation.
Deep pressure stimulation has been used in therapeutic practice because of the assumption that it changes physiological arousal. The purpose of this study was to test the effects of deep pressure stimulation, applied with a Vayu Vest (Therapeutic Systems), on both autonomic arousal and performance in a normative adult sample. A repeated-measures, repeated-baseline design was used with participants completing a performance test before and after deep pressure application. A convenience sample of 50 adults participated in the study. Results showed that wearing the Vayu Vest for even short periods of time reduced sympathetic arousal and non-stimulus-driven electrical occurrences. Concomitant increases in parasympathetic arousal were found. Performance improvements were noted after wearing the Vayu Vest, potentially because of changes in arousal. We conclude that deep pressure stimulation is capable of eliciting changes in autonomic arousal and may be a useful modality in diagnostic groups seen by occupational therapy practitioners.
Copyright © 2015 by the American Occupational Therapy Association, Inc.
In this paper we report the findings from an evaluation of the introduction of sensory modulation (SM) in an acute mental health inpatient unit. It was expected that SM could be used to help settle patients experiencing high levels of disturbance and that as a result, there would be less need for use of more restrictive seclusion practices. The evaluation took place in a hospital in south-east Queensland, Australia. SM was introduced in one acute unit while the other served as a control. The evaluation comprised two studies. In the first study we aimed to determine whether SM reduced the level of disturbance among patients given the opportunity to use it. In the second study we aimed to find out whether the introduction of SM reduced the frequency and duration of seclusion. In study 1, we found that most patients reported marked reduction in disturbance after using SM and there was a very large effect size for the group as a whole. In study 2, we found that frequency of seclusion dropped dramatically in the unit that introduced SM but rose slightly in the unit that did not have access to SM. The change in seclusion rate was highly significant (χ2 = 49.1, df = 1, p < 0.001). Results are discussed, having reference to the limitations inherent in a naturalistic study.
This article describes factors that contribute to the treatment needs of complexly traumatized children, lists the primary domains targeted by the described trauma intervention, and identifies sample interventions in each targeted domain. The role of traumatic stress in shaping early development and the issue that exposure to complex interpersonal trauma is qualitatively distinct from acute trauma in both experience and effect cannot be understated. Traumatized children need a flexible approach to intervention. ARC (Attachment, Self-Regulation, and Competency model) has been developed in response to this challenge as an intervention framework designed to address the array of developmental vulnerabilities experienced by the complexly traumatized child by building or restoring developmental competencies; identifying and enhancing internal, familial, and systemic resources; and providing a foundation for continued growth. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Occupational therapy focuses on complex dynamic relationships between people, occupations and environments. Therapists must clearly communicate their practices and how their practice influences outcomes. This paper explores applications of the Person-Environment-Occupation Model (Law et al., 1996) in occupational therapy practice, and delineates how this particular model helps therapists to conceptualize, plan, communicate and evaluate occupational performance interventions. Three case studies illustrate how the model can be used by occupational therapists to systematically approach analysis of occupational performance issues while considering the complexities of human functioning and experience. The ways in which the model facilitates communication within and outside occupational therapy are explained. The Person-Environment-Occupation Model is offered as a tool for therapists to use in client(s)-therapist alliances to enable clients to successfully engage in meaningful occupations in chosen environments.
The research showing how exposure to extreme stress affects brain function is making important contributions to understanding the nature of traumatic stress. This includes the notion that traumatized individuals are vulnerable to react to sensory information with subcortically initiated responses that are irrelevant, and often harmful, in the present. Reminders of traumatic experiences activate brain regions that support intense emotions, and decrease activation in the central nervous system (CNS) regions involved in (a) the integration of sensory input with motor output, (b) the modulation of physiological arousal, and (c) the capacity to communicate experience in words. Failures of attention and memory in posttraumatic stress disorder (PTSD) interfere with the capacity to engage in the present: traumatized individuals "lose their way in the world." This article discusses the implications of this research by suggesting that effective treatment needs to involve (a) learning to tolerate feelings and sensations by increasing the capacity for interoception, (b) learning to modulate arousal, and (c) learning that after confrontation with physical helplessness it is essential to engage in taking effective action.
There has been considerable interest recently in the relationship between depression and the workplace. This interest is driven by the growing recognition that depressive disorders are highly prevalent in the workplace and have an enormously negative impact on performance, productivity, absenteeism, and disability costs. A variety of clinical research with occupational-related samples has helped to define those at risk for depression and has led to a better understanding of the overlap of the construct of clinical depression with more longstanding occupational health and organizational psychology models such as stress, burnout, and job satisfaction. From an employer perspective, depression's impact remains largely unmitigated due to stigma, uncertainty about treatment's cost effectiveness, and lack of effective interventions delivered in a workplace setting. Progress in these areas is reviewed with suggestions for future directions.
The impact of sensory defensiveness on performance, behaviour and adjustment of children has been addressed in the literature, but little has been written concerning its impact on adults. The purpose of this study was to explore whether sensory-defensive adults had more symptoms of anxiety, depression and pain than adults without sensory defensiveness. Participants were 32 volunteers who were normal functioning adults aged 21 to 48 years, without physical or psychological diagnoses or history of abuse. They were screened to eliminate persons with undiagnosed psychological problems using the Forty-eight Item Counseling Evaluation. Participants were assigned to a sensory-defensive or non-sensory-defensive group based on their score on the ADULT-SI, a sensory history interview, which assesses sensory defensiveness in adults. The two groups were matched for age, gender and race. Participants were then administered the IPAT Anxiety Scale, the IPAT Depression Scale and the Pain Apperception Test. Differences were found between sensory-defensive and non-defensive adults in anxiety (p=0.014) and depression (p=0.019), but not in pain perception. Analysis of the screening scores of the Forty-eight Item Counseling Evaluation indicated an unexpected difference between groups in psychological adjustment (p=0.005). This study supports clinical impressions that sensory-defensive adults differ from non-defensive adults in some psychological parameters. A sequela of sensory defensiveness in adults may be a tendency towards increased symptoms of anxiety and depression. Further, investigation of sensory defensiveness and its sequelae in adults is recommended, using larger samples, more sensitive tools and various diagnostic categories. Exploration of the impact of sensory defensiveness on adult roles and performance and life satisfaction is also recommended. Copyright © 1999 Whurr Publishers Ltd.
Research has suggested that individuals who experience work related injuries may be at an increased risk for developing trauma symptoms or Posttraumatic Stress Disorder (PTSD). The purpose of this article is to provide a brief overview of PTSD from both a categorical and dimensional perspective and discuss implications for rehabilitation planning with workers with industrial injuries. The negative impact of trauma symptoms and PTSD is profiled according the following four areas that are important for effective career and vocational behavior: (a) making occupational adjustments, (b) adjusting performance to meet specific work demands, (c) utilizing appropriate social and interpersonal skills in the work setting, and (d) meeting the production and time requirements associated with the specific job. Recommendations are then offered to increase the effectiveness of rehabilitation professionals working with industrial injured workers who may be experiencing trauma symptoms or PTSD.
Eighty-three adults with severe mental disabilities participated in a study examining effects on life satisfaction of having nothing to do, receipt of a housing subsidy, and enrollment in an intensive case management program. The clients were divided into four groups receiving subsidized housing and intensive case management, subsidized housing and nonintensive case management, intensive case management and nonsubsidized housing, and nonintensive case management and nonsubsidized housing. Initially and at ten months, clients reported how much time they spent with nothing to do and their level of satisfaction with supported-living arrangements. A significant association was found between time spent with nothing to do and both satisfaction and change in satisfaction and between having a housing subsidy and satisfaction. Results suggest that getting clients involved in activities of their own choosing would result in much greater increases in satisfaction.
The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described.
A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life.
More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, > or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.
We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
Depression is one of the most prevalent and costly health issues affecting the American work force. Despite well established research demonstrating the association between employee depression and reduced on-the-job productivity, increased absenteeism, and higher health care use, most employers remain largely unresponsive to the need for company based depression initiatives. Organizational and individual barriers can prevent companies from effectively managing employee depression. Organizational barriers include information gaps, lack of data to justify increased investment in employee mental health programs, and employers' ambiguous roles in addressing depression. Individual barriers such as an inability to recognize signs and symptoms; stigma; confidentiality and privacy concerns; and unavailability of easily accessible, quality resources can keep employees who are depressed from seeking treatment. Many occupational health professionals may feel ill prepared or uncomfortable taking the lead in creating more aggressive worksite responses to depression, but they are, perhaps, in the best of all possible positions within an organization to succeed. Occupational health professionals have the credentials, credibility, training, and experience necessary to build a strong case for business leaders for why investing in workplace depression programs is so important. Occupational health professionals are the most qualified to design and deliver destigmatized, customer friendly programs and services for employees to access for help with depression, and to integrate their services with other departments such as benefits, health promotion, EAP, and human resources, to create an effective, organization-wide depression initiative.
The national initiative to decrease the use of seclusion and restraint in psychiatric inpatient settings requires innovative methods to facilitate the processes of consumer self-organization, self-care, and positive change. Sensory-based approaches and multisensory rooms are valuable resources as cultures of care shift to become more responsive and collaborative. This article explores the importance and efficacy of trauma-informed approaches that are sensory supportive, address the individual needs of the person, and strengthen the therapeutic relationship.
This study investigated predictors of quality of life among persons with schizophrenia and other psychoses. On the basis of previous research, it was hypothesised that objective life circumstances, self-variables, psychopathology, activity level, satisfaction with daily activities, and satisfaction with medical care would be determinants of quality of life. 134 persons were investigated, and the analysis was based on Structural Equation Modelling (SEM). A model with two quality of life variables, General quality of life and Security, fitted the data best. A self-variable, Sense of self, and Satisfaction with daily activities, Psychopathology, and Satisfaction with medical care served as mediators and explained the variation in the quality of life variables. External to the mediators, and related to these, were Activity level, Educational level, and Independent living. In conclusion, a self-variable showed the strongest association with quality of life, but two aspects that should be feasible to influence in mental health care, daily activity and medical care, contributed to the subjects' self-rated quality of life. These results render a somewhat optimistic view on how to accomplish a better self-perceived quality of life among people with severe mental illness.