Sensory Rooms in Mental Health Print E-mail

Sensory Room: An Umbrella Term

“Sensory Room” is an umbrella term used to categorize a broad variety of therapeutic spaces specifically designed and utilized to promote self-organization and positive change. There are multiple types of sensory rooms and purposes for use that have been created and implemented in different practice areas to date. When used appropriately, sensory rooms:
  • Help to create a safe space
  • Facilitate the therapeutic alliance
  • Provide opportunities for engagement in prevention and crisis de-escalation strategies, as well as a host of other therapeutic exchanges (to teach skills, offer a variety of therapeutic activities, etc.)
  • Promote self-care/self-nurturance, resilience & recovery 
Generally, to help guide conceptualization, there are a variety of therapeutic spaces that may be categorized under the sensory room umbrella: sensory modulation rooms, sensory integration rooms and snoezelen rooms are examples.

The Sensory Room Umbrella

sensory_room_chart
© Champagne, 2008

In mental health settings, there may be one or more sensory rooms created, which typically fall under the sensory modulation room category. For example, on an acute or long-term care unit, there may be converted quiet room spaces that are designed to be more sensory supportive and used primarily for the purposes of crisis de-escalation and/or prevention. However, other kinds of sensory rooms in mental health care also include any additional therapeutic spaces that have been enhanced or developed for sensory supportive, therapeutic purposes. In this way, all of these sensory room spaces are used primarily to promote sensory modulation. Whereas, sensory integration rooms are created and used specifically by occupational therapists who are trained in sensory integration techniques and these spaces contain very specific types of equipment and intervention processes. Snoezelen rooms are generally used with people with moderate to profound cognitive impairment (e.g., people with pervasive developmental disabilities or dementia), and are often used to promote relaxation, social interaction and/or to provide activities affording intense stimulation. In most cases, all but sensory integration rooms are used by inter-disciplinary staff with training or certification specific to the kinds of equipment and approaches offered within the space.

However, it is important to point out that a mixture of sensory modulation and snoezelen approaches may be combined if it is beneficial for the specific consumer population and practice setting. Additionally, sensory integration equipment and techniques may be utilized in either a sensory modulation or snoezelen room by a skilled occupational therapist. Further, therapeutic exchanges in sensory integration rooms may also focus on sensory modulation. Therefore, this sensory room categorization is meant to be flexible and is to be used only as a guide.

The enhancement of the physical environment, including the use of sensory rooms, affords a more nurturing and recovery-oriented therapeutic environment. Skilled nursing facilities, day treatment centers, schools, long-term care facilities, respite care homes, hospitals, emergency rooms and hospice care settings are just some of the organizations utilizing sensory rooms.

Creating & Naming the Sensory Room

The development of sensory rooms requires a collaborative process, evolving over time. Consumers and staff who are going to be using the space must be involved in the development process, as much as possible. Given the varied populations sensory rooms may be used with and purposes of use, naming a sensory room should also be a collaborative decision and reflective of the specific goals of use. For more information on the development and naming of sensory rooms refer to the section on setting up a sensory room on this web page.

Sensory Rooms in Mental Health?
The idea to expand the use of sensory rooms to acute inpatient mental health care settings with varied populations is a more recent application, incorporating a variety of sensory modulation approaches and modalities. Hence, the use of sensory rooms in mental health settings often falls under the sensory modulation category. An essential part of this mission is to maintain an emphasis on engaging in meaningful therapeutic activities and in recognizing the inter-relatedness and importance of the therapeutic use of self and physical environment. Offering humane and self-nurturing choices for prevention and crisis de-escalation is essential and afforded in an organized and safe manner through therapeutic exchanges in sensory modulation rooms.

Two recent articles demonstrate the purpose of the incorporation of the use of sensory rooms and additional sensory-related approaches into mental health inpatient practice (Champagne & Stromberg, 2004) and provide a guideline to assist in the evolutionary process (Champagne, 2006). Champagne’s book, available through this website’s product page, is another valuable resource available to assist in the process of developing and integrating sensory rooms and other sensory approaches into mental health care practice settings.


The skilled and responsible use of sensory rooms has become readily endorsed by the MA State Department of Mental Health (DMH) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and has become a focal point in hospital surveys and re-licensing visits. It is also being promoted by the National Technical Assistance Center, a division of the National Association for State Mental Health Program Directors (NASMHPD), as one of the instrumental interventions influencing the reduction of restraint and seclusion in mental health care settings. For more information on the restraint and seclusion reduction initiative click here to visit the restraint reduction section of this website.

There is limited literature and research available regarding the use of sensory rooms in acute care inpatient mental health settings with pediatric, adolescent, and adult populations. However, the following is an article regarding a quality improvement study conducted on the use of the sensory room at Cooley-Dickinson Hospital's acute care psychiatric unit:

pdf The Effects of the Use of the Sensory Room in Psychiatry
 A Quality Improvement Study

By: Tina Champagne, M.Ed. OTR/L & Edward Sayer, Psy.D

This quality improvement study was replicated on this unit in 2004 with astonishingly similar results. Among the patients who utilized the sensory room during group or individual sessions, most report having had a positive response and a decrease in perceptions of distress.

In 2006, Champagne published an article on creating sensory rooms for the American Occupational Therapy Association's Mental Health Special Interest Section. The reference information for this article is:

Champagne, T. (2006). Creating sensory rooms: Environmental enhancements for acute inpatient mental health settings. Mental Health Special Interest Section Quarterly, 29(4), 1-4.

AOTA members may download this article at: http://www.aota.org/Pubs/SISQs.aspx

The sensory room's purpose also corresponds with the purpose of the Safety Tool developed and promoted by the Department of Mental Health in the state of Massachusetts. The Safety Tool was developed in an attempt to facilitate trauma-informed care and to help to reduce the occurrences of seclusion and restraint by learning about each person's early warning signs, triggers and what helps each individual early in the therapeutic process. The safety tool is typically administered by nursing staff during the initial assessment. The information obtained through the use of the safety tool has been helpful to occupational therapists during the information-gathering period prior to initial therapeutic exchanges with each consumer.

Taking A Leadership Role


Occupational therapists are taking a leadership role in the planning and implementation of the use of sensory approaches across mental healthcare settings, including the focus on environmental modifications and enhancements, such as sensory rooms. As in other areas of practice, the education and knowledge base of occupational therapists helps to justify the unique role of the OT as the qualified professional to supervise the development and implementation of the "sensory room" and other sensory approaches. Currently, occupational therapists are also collaborating with administrators and other disciplines to ensure staff trainings and competencies are developed, implemented and maintained. Program evaluation is another important component of any new program initiative, and occupational therapists are also playing a key role in this area as well.

The first adult acute inpatient mental healthcare setting to develop a sensory room was Berkshire Medical Center (BMC) in Pittsfield, MA. With the help of consumers and staff, Tina Champagne, OTR/L initiated and coordinated the development and implementation of this sensory room for adult acute care psychiatry after receiving administrative approval in 1999. She used interviews and questionnaires with staff and consumers to collect the following types of information: what people wanted the purpose of the room to be, ideas for ways to utilize the space, ideas for what to have available in the room, how people wanted the space to be decorated, etc. At this time, there are many such rooms in existence within acute care mental health settings with varied themes and purposes.

The development and implementation of sensory rooms and sensory enhancements across settings is a process that typically evolves over time. This affords the ability to get staff and consumer involvement and assistance throughout the entire process. Thus, it is possible to start a room on a very low budget and to slowly develop the space. One of the differences between the types of sensory rooms Champagne promotes and the more traditional "Snoezelen" style rooms, is in the shift from spaces filled with expensive technical equipment, to a more normalizing and replicable environment. Safety considerations within locked acute care settings as well as the need to offer options that the consumers can replicate outside of the hospital setting are some of the other reasons behind the differences in both approach and décor. Snoezelen rooms and the kinds of sensory rooms Champagne promotes are also different from the sensory integration style treatment rooms used specifically by occupational therapists that are trained, certified and competent to use such specialized equipment and techniques. Hence, it is necessary to understand these distinctions due to the very different purposes of each of these sensory-related therapeutic environments.

An International Initiative

Lesley Pinkney is an occupational therapist that helped to pioneer the bringing together of "Snoezelen" and occupational therapy approaches with older adults with cognitive impairments, performing some of the initial studies with this population in the United Kingdom. Occupational therapists in China have used sensory rooms and gardens for older adult long-term residential settings for many years. Katherine Smith and Angie Turner are occupational therapists in Cornwall, England (UK). They have been instrumental within the Cornwall Partnership Trust's planning and re-modeling projects to create and offer more "sensory-friendly" environments. In 2003, they contracted Tina Champagne to come to Cornwall and hosted a sensory conference specifically for OT's in mental healthcare services across the Cornwall Partnership Trust. This international partnership continues today as they collaborate on different initiatives and projects.


 tina_and_katherine
Tina Champagne (left) & Katherine Smith (right) together on the shore of the Helford River, at Trebah Garden in the UK (2003).


Ultimately, the use of sensory approaches and sensory rooms has increased the focus on each individual's unique system's tendencies, patterns and preferences. Thus, the skilled use of sensory approaches has brought a host of more humane and recovery-focused therapeutic tools to mental healthcare services, which appears to have significantly influenced the quality of therapeutic exchanges occurring in mental healthcare service delivery across the world. Providing such skilled and supportive options empowers staff and consumers and embodies a person-centered approach to care. This is a significant culture shift and it is important to recognize that any significant change in the culture of care takes time, an interdisciplinary team effort, a lot of work and dedication.

Setting Up A Sensory Room


Involving both staff & consumers!

It is essential to involve both staff and consumers in each step of this process. Meaningful items and themes for rooms can only be determined through actively involving staff & consumers who will be using the treatment space. Therefore, no sensory rooms are ever the same because this is not a cookbook process. The information and lists provided on this web site are provided to assist with starting up a room, are not all-inclusive and the ideas presented may not be suitable for all settings or populations. Clinical reasoning and brainstorming sessions with staff and consumers are essential in order to individualize your sensory space, from the ground up. In this way, it will surely become a unique and meaningful therapeutic space!

Ideas for involving staff & consumers in the process:
  • Post a flyer on your unit stating the plan to create a sensory room, sensory area, sensory cart, sensory bins, bags or baskets.
  • Ask for any suggestions and/or donations of time to help with the organizing of the whole project.
  • Post sign up sheets to determine who is interested in helping to plan and create the room.
  • Circulate a unit survey to staff and consumers for ideas regarding how to decorate the room, what to offer in the space, on the cart, theme ideas, what to call the room, etc.
  • Include everyone in the process of creating and decorating.
  • Ask for volunteers to help you provide educational in-services to assure staff are qualified to utilize the space and the items in a manner that is appropriate each person's cognitive/emotional/physical status and that things get washed as per policy.
  • Ask for ideas when creating the policies and procedures for use of the space and the items in the space.
  • Provide opportunities for staff to explore their own sensory tendencies, preferences and to think about how these tendencies influence their daily routines and work habits.

Naming your sensory room

Sensory rooms go by many different names and are often related to the purpose of the space within each specific setting. Some examples of names of sensory rooms include:
  • The Sensory Modulation Room
  • The Sensory Room
  • The Zen Room
  • Chillville
  • The Serenity Room
  • The Comfort Room
Developing the policy & procedure

Sensory rooms all must have a policy and procedure for use. It is important to create a policy and procedure specific to the purpose and kinds of equipment in your sensory room.  The following is a sample of a general
sensory room policy:

pdf Sample sensory room policy and procedure

Sensory Equipment Suggestions


General "Sensory Room" Ideas

For adolescent and adult sensory rooms (29 KB)

General "Sensory Cart" Ideas

For adolescents & adults with moderate levels of cognitive impairment (27 KB)
For adolescents & adults with low levels of cognitive impairment (19 KB)  


adl_basket02
  Sensory Diet: ADL Basket


A Few Ideas for Sensory Baskets, Buckets, or Bins


• Keep a bucket, bin, or basket of fresh nature items for use during each season (things to sort through, smell, touch, etc.)
◦ For the fall season (pumpkins, gourds, larger-sized cinnamon sticks, fall flowers, Indian corn, etc.)
• A basket with assorted items for each of the sensory areas
• Create a men's grooming basket
• Create a women's skin & nail care basket
• Create a bin of beading supplies for jewelry making
• Create a craft basket
• Create a reminiscence basket


General Considerations Prior to Purchasing Equipment:

• One good rule of thumb before purchasing equipment is not to buy it if it can't be washed in the washing machine or in hot soapy water.
• Anything electrical always needs to go through your facility's inspections prior to being brought onto or used on the unit.
• Most units require rugs, curtains, beanbag chairs, and similar items to be made with fire resistant materials. Request this information prior to ordering, Certificates are often available upon request from companies who assure products are fire resistant.

How to keep track of what you have & where things are:

• Use of a dry erase board, checklist or clipboard for signing items in & out helps things from walking away or vanishing altogether!

General treatment precautions:

• Be aware of those consumers who have allergies and seizure disorders. Do not use items with people if there is any possibility they may be hypersensitive to it.
• Always ask the person if they have any hypersensitivies to what you are planning to use PRIOR to use.
• Be aware of any respiratory or cardiac precautions

Sensory Room Slide Shows

Community Integration


It is essential for consumers to leave hospital settings with discharge "packets" (an occupational portfolio) to share with out patient providers, family members and caregivers. This should be organized and contain worksheets and information regarding the variety of techniques learned and practiced, and plans for incorporating these skills and ideas into daily schedules and home, school and/or work environments. This is an essential part of the discharge planning process. This provides one of the necessary links between hospital and discharge environments to support success with the transition from inpatient to community level of care.

With this increased support, many consumers have created sensory spaces within their group homes with the assistance of staff. Others have created various types of "sensory spaces" within their own homes. Residential educational settings often request occupational therapy consultation services to create more "sensory-friendly" spaces and sensory rooms within classrooms and living quarters. Recommendations and planning for the transition from hospital to the community typically requires assistance to adapt what was helpful in the hospital for use at home and in community levels of care.

Sensory Room and Snoezelen References

The following is a growing listing of many of the articles and studies published about the use of sensory rooms available in the literature to date. If you are aware of any others please email those references to: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it . This will assist in keeping this resource list as up to date as possible for worldwide networking!


Sensory Room and Snoezelen References


Links to vendors of sensory room equipment
Last Updated ( Sunday, 27 April 2008 )
 
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Attendee Comments

Comment from the January 2006 conference:
A Nonlinear Dynamics Approach to Sensory Modulation

Tina Champagne blew me away! She made me proud to be an OT and inspired to get back into psych OT! - Hollie Marron, OTR/L