For some, it will be the small rubber balls that beckon, with their bright colors and squeezable textures. For others, it will be the rainbow coils, the pointy hedgehog balls or the small beanbag dog. It may soothe them to feel the gentle pressure as they squeeze. It may help focus their minds.
Or perhaps they’ll choose music, a piano solo or a drum composition, or decide to watch an IMAX movie on the high-definition TV, with lots of bright colors and spectacular scenery.
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Others may find it helps to sink into a big beanbag chair and huddle under a lightly weighted blanket – that might make them feel safer, self-contained.
Butler Hospital’s “sensory modulation room” is so new, no one knows for sure just how many patients it will help, what kinds of patients, or with which tools. Nationwide, in fact, the use of sensory modulation with adults is relatively new, though it’s been used for about two decades with children, people with developmental disabilities and elderly patients.
“This is really new,” said Joanne Matthew, nurse manager for Butler’s intensive treatment unit, where the room was set up. “But I’m glad they’re letting us try it.”
Sensory modulation therapy is based on the notion that, when you’re seriously mentally ill, your sensory perception may be distorted, or you may be hypersensitive or numb. The purpose of the therapy is to soothe, stimulate or focus the patient as needed, and hopefully, provide tools the patient can replicate at home after being discharged.
A person who is disoriented and agitated, for example, might find it helpful to focus on a single item – a rubber ball, or a tube filled with shimmering stars and snow. A patient who is feeling the self-destructive urges of borderline personality disorder might benefit from the sharp cinnamon bite of a Fireball candy – a safe way to get the intense stimulus she craves.
“Sensory modulation plays an extremely large role,” said Meghan Franklin, an occupational therapist who was involved in setting up the room. “We, as healthy people, do it all the time.” For example, she noted, “if the room is too bright, we might turn the lights down.”
We do things to cheer ourselves up or to soothe ourselves.
“Our ideal is for the patient to be able to come into the room and say, ‘This is what I need right now,’ but many of our patients are too ill to be able to do that,” Franklin said. “So what we’ll do is suggest options. … One of the wonderful things about everything in that room is, in some form, everything in there can be carried out by patients outside the hospital.”
The sensory modulation room is part of Butler’s brand-new, 20-bed intensive treatment unit. Patients moved out of the old ITU, which had 17 beds, in late December.
“In the older unit, the environment itself was much more institutional,” Franklin said. “If you looked at it, it had concrete walls, much blander colors, a much colder feeling.” The new unit is “much more patient centered,” she said, and it is decorated to be more homey.
The room was put here, Butler spokesman James Hallan Jr. said, because it was a new space.
It is the first such room in Rhode Island, according to Butler officials – though Rowland Barrett, director of the Center for Autism & Developmental Disabilities at Bradley Hospital, said the center has long used such strategies to help autistic children better manage their sensory processing, and there’s “a lot of anecdotal evidence” that they work, but little hard science.
At Butler, the clinicians have found that some elderly patients like holding weighted dolls, and patients in the child and adolescent programs like weighted items, as well as the “body sock,” which they can step into and stretch into different shapes.
In Massachusetts, sensory modulation has gained such credence that in April, the state Department of Mental Health mandated that hospital psychiatric units must offer such therapies along with their other treatments, Franklin said.
At Butler, “I think going forward, there’s a lot of interest in incorporating this into all of the units,” Hallan said.
Placing the first such room in the hospital’s intensive treatment unit has its pros and cons.
Dr. Martin J. Furman, chief of the unit, noted that this is where the most ill patients are treated, many of whom require heavy medication and other measures to contain their aggression, self-destructive impulses or other serious problems.
Sensory modulation can’t replace those measures, Furman said, and it’s unlikely to be helpful at all to a patient who’s in the midst of a severe manic state or some other crisis.
But patients in the ITU also stay longer than most at Butler, Matthew noted – typically, eight to 10 days. So although in the first few days of their stay, they may be too sick to benefit from the new therapies, as they improve a bit and start preparing to return to the outside world, this could help.
Furman said sensory modulation also could help a patient avert a crisis, through early intervention, and it could also reduce, to a limited extent, the need for medication.
“It certainly can make it more manageable and more pleasant for the patients,” he said.
“It’s a kind of room that I think could be valuable in many levels of care at the hospital and even in non-hospital settings.”
Franklin, whose job entails helping patients to reengage with what’s important to them – whether it’s just getting up in the morning when they’re extremely depressed, or eating well, or taking an active role in managing their illness – is enthusiastic about the room’s potential.
“On the first day, I was in there with three patients, and they were in there for about an hour,” she said. “Their comments were wonderful. They said they were going to set up a room like this in their house, because they understood the concept and they wanted to have a place where they could practice these techniques.”
