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Deep Pressure & The Therapeutic Application of Weight

 
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T Champagne
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Are there other OTs in acute psychiatry using the therapeutic application of weight? I have been using weighted blankets, wrist/ankle weights, weighted lap pads, weighted balls, vests and so on forth many years.

I must say that out of all the weighted items I have used with people, the weighted blanket has been the most helpful/used most often on our unit. The nurses and psychiatrists I work with have really noticed the positive influence this can facilitate re: the process of self-organization. Particularly among some people in crisis states!

Other forms of deep pressure and also "heavy work" activities are generally effective. Theraband use, blanket wraps, bean bag tapping, hand hugs, massage, etc... just the beginning! On our unit we have built heavy work activities into the daily schedule/milieu activities. It really seems to have made a difference.

It would be fun to compile and online list of ideas! Anyone interested in doing this please post some ideas.

Tina
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KLS
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Joined: 01 Jun 2004
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We have a great ball filled duvet (ball blanket ex ROMPA) that we have put in a duvet cover...it is a firm favourite of 2 clients who like the weight of it, especially if a heavy blanket is put over it as well. It can be a bit alerting to those who have auditory defensiveness, as the ball make a clicking sound.....

We are lucky in our hospital to have a gym where the rowing machine and bike all provide exercise against resistance ie heavy work.. We also have a set of dumbells and some ankle weights. 2 years ago we made a sand filled u shaped shoulder hugger - it is easy to clean and several clients really like it especially when distressed, they describe it as a heavy hug-very grounding!

I have also made a sewn together sandbag(beanbagsized sandbags like patchwork) quilt for a young lad who had behaviour difficulties - it was the size of a small travel rug.
I used sand sterilised for children's sandpits, and his Mum hoses it off and lets it dry outside in the sun.....
We covered the bags in lots of different comforting touchy feely textures......
Wink
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Hi Kath!

Nothing like exercise for heavy work with those who can engage in it! For those who are in really acute states we often begin with offering a trial of the weighted blanket & also try hallway walks with staff while the others are in groups. (This again is for those who are extremely manic/depressed/psychotic/unsafe in the general milieu & are having difficulty engaging in meaningful and purposeful activities). It has been my experience that at that point assistance with facilitating the grounding/self-organization of the system is very meaningful/very important to the person. Of course this does not work for everyone who is in crisis and those who like weight at one point in treatment may or may not like it at others, but it has been very helpful to many clients across age levels and populations. Also interesting to report that it also crosses cultures! Other things that have worked with some people in really acute states have been brushing protocols/use of certain aromas/push & pull activities/doing isometrics with the person whenever possible/use of clay/art/etc...

When a bit more stable, many psych OTs in the USA have groups where clients create, decorate & fill "safety" or "self-soothing" kits. I know from our conversations you are also doing this in your setting. We also offer sewing projects. Clients can make any variety of things to keep in their safety kits to take home with them. We have ages 16-100+ and sewing projects (although assistance may be needed for some) is often enjoyed for many reasons. Neck warmers, bean bags for self massage/tapping/aromatherapy & sachets are just a few ideas. I agree it is important to have many material choices as well as "filler" choices. Different types of beans, sterile sand, rice, corn starch - just to name a few. If clients make their own then take them home it also reduces infection control/laundering problems that may arise with the sharing of these items on inpatient units. Most important - they can completely individualize them!

I am also really glad to see this emerging with adults in a way that is not juvenile, since some of these techniques were initiated in SI work with kids. There is a book available re: making weighted blankets with patterns and suggestions available. Although created with primarily an SI twist, I will have to post that resource on the website. We have used it - it is a great resource, especially since many of our clients can not afford the prices of the weighted blankets offered through rehab vendors. Many families also have relatives who sew and therefore to offer a pattern and directions is often much appriciated. I am trying to see if our volunteers who make the booties and hats for our maternity ward might consider making some weighted items. My aunt made us a few weighted vests out of a soft denim and I was able to then give one to a client with autism who had an extremely positive resonse to it. His staff from his residence were amazed at his response to it, as was he.

Thanks for talking and sharing ideas! Hopefully others will join in with us!
This is what this site is all about...it takes a village!

Any other ideas re: the therapeutic use of weight &/or heavy work from other OTs?

Talk soon,
Tina Wink
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KLS
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As well as all of those others that clients can make for themseloves....... Idea , one client has just made some lavender bags......another has suggested other herb bags too, and one client recently said she made a herb bath bag, drape it over the taps, and the bathroom is filled with amazing aroma as hot water runs over the bag!!!
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Tina Champagne
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Joined: 03 Jun 2003
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Any OTs with creative ideas regarding ways to create weighted items since so many of our patients can not afford them? I would love to see us devise a long list of ideas - putting all of our heads together!

Tina Idea
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Tina Champagne
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Location: MA

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In MA state the use of weighted blankets (& sensory rooms) in psych is not just emerging but is actually exploding. This is wonderful except there are not always OTs around consulting regarding the use of weight, etc. This is of course very concerning although I think it is getting quite a bit better. I think this is partially due to all the advocating that has been happening by organizations such as NASMHPD & DMH, demonstrating the importance of these techniques - but also the safe use and importance of OT collaboration! This in addition to many OTs now being more & more empowered to take the leadership role in such initiatives seems to have really helped.

Although, in MANY settings across the nation and beyond this is all very new to psych OTs and I am hoping some of you who are in this position will take the opprtunity to talk about your questions and concerns here. There are several OTs that use this forum who have been using these modalities for quite sometime now who can be of lots of help. You are not alone and any question you may have is most likely one many others are wondering about as well.

Hope to see a lot more discussion on this subject. The weighted blanket is one of the few modalities we can use (although all modalities need to be supervised) when an individual is in a very acute state. There are not many things safe enough to offer people when they are extremely distressed and this has been one of the most helpful items we have found to date. Not to say there are not a HOST of others, but really it has been amazingly helpful to many of our consumers. Our staff have gotten to the point that the thought of being without one is just not even an option!

Tina
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Working in an inpatient unit in a state prison leaves me envious of the items you all have to work with. I am in the process of trying to get a used lead apron from the dentistry department.

At the moment, I am using a large therapy ball in a group called "Get a Grip". The opportunity to bounce the ball, throw it and experiment with moving it around the group appears to be accepted. I have some men who don't do any other groups come to this one.
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I seem to have forgotten my username: I just posted a reply and realized it was anonymous. Very Happy
Any help on the hygiene front would be helpful! So many of the men just don't do showers. There are other barriers also, but I think I have a handle on them. I just have to convince the department of corrections that they need to help too. Suzanne Lawrence
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TERRY
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Joined: 04 Jul 2005
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While I was in OT school my granddaughter was diagnosed with autism and a seizure disorder. In some way I believe God directed me into OT because of her. She loved to go out to dinner on Friday nights but would become over simulated half way through the meal. By accident I discovered that when I brought her to the ladies bathroom, took her arms and placed them around my waist and applied pressure to the trunk of her body against mine she immediately calmed down and was able to communicate what was troubling her. When I started studying SI in school, I immediately realized how the deep pressure helped to ground and calm her. Deep pressure continues to soothe her, I use weighted vest and place weights in her lap to help her focus when trying to learn a new skill in school. I have used it extensively on peds units. My granddaughter is very verbal and I truly believe it is because of the vestibular stimulation she got from swinging because for a long time that was the only outside activity I could get her to perform and we did it a lot. I have used a bolster swing with non verbal children with autism and within two weeks they suddenly find their voices and become little parrots.

I am very interested in trying it out on a geripsych unit. Can anyone offer a pattern for a weighted blanket. I often wonder if swinging would help geriatric patients with expressive aphasia, it won't solve the problem with a progressive organic brain disorder but may give them more time to be able to express themselves. Just a thought.

Temple Grandin is one of my heroes and she continues to use her squeeze machine to soothe herself. Her invention of her squeeze machine is evidence based. She studied the effects that deep pressure had on cattle to calm them before going to be slaughtered to help design her own squeeze machine. Temple Grandin is evidence in her own right when she demonstrates her squeeze machine.

Because of my granddaughter I tend to look at the similiar symptoms of autism and alzheimers disease. In autism you are still able to make new connections in the brain. I believe you can tap into the unused and undamaged portions of the brain of a person diagnosed with alzheimers if you are willing to try and help them try something new they have never done before, like painting, sculpture, etc. The disease will eventually progress but you have enhanced the patients quality of life longer if you didn't try anything. In patients with autism they continue to grow and bloom into incredible lovable individuals with a purpose for their life who can share what works and what doesn't. They are a great wealth of evidence if we choose to use it.

The seizure disorder my granddaugher has is temporal lobe seizures. After experiencing several temporal lobe seizures with her I witnessed sundowning for the first time with a patient in a nursing home. I was amazed at the similiar symptoms and hallucinations. I often wondered and have asked several psychiatrist if sundowning could actually be seizures. Alzheimers disease begins in the temporal lobe and is viewed as a temporal/parietal lobe disorder. None of the psychiatrist have expressed any real interest in my hypothesis but they do prescribe anti-convulsants for alzheimers and other mental disorders. Many patient with temporal lobe seizures where placed on psych units because of their behavior before being diagnosed with a seizure disorder. Maybe I should consult a neurologist or a neuropsychiatrist?

I always look at the similiar patterns patients exhibit to see if something I have tried and has worked with one patient may work with another patient with similiar symptoms. I have found my passion in Occupational Therapy and truly try to make a difference in the lives of the individuals I treat as all of us who become Occupational Therapist. OT definitely requires a person with compassion, understanding, insight, drive and love in our hearts which is essential to our role and that I believe many other disciplines lack which makes us so much more special and needed.

Any patterns for weighted blankets would be greatly appreciated.

Terry
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Tina Champagne
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Joined: 03 Jun 2003
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Hi Terry,
There is a book called The Weighted Blanket (more info about it is on the sensory modulation page) that offers both information about weighted blankets and a pattern to make a weighted blanket.

However, they can be easily made by sewing 2 blankets or comforters together with sections evenly distrubuted in squares or strips throughout to be filled with bean bags filled with either uncooked beans, uncooked popcorn, aromatherapy blends or whatever combination appeals! If used in hospitals, LLTC settings or so forth (and not for family or friends) you will want want to create something really durable and safe and without the aromatherapy unless you are a certified aromatherapy clinician.

Just some ideas! Welcome to our forum!

Sincerely,
Tina
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Pagea
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Hi KLS,

I am looking for a travel rug. Can you please let me know which website did you get this? Are you in Australia...I checked IKEA but unsuccessful!
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