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Sensory Modulation in Eating Disorders (call for help)

 
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Melissa Davis
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Joined: 20 Jul 2010
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I work in an inpatient psychiatric unit, and as part of this role am part of a team working with client's with eating disorders. I would really like to utilize some sensory modulation approaches to help these client's manage anxiety during refeeding process (particularly around meal times). Additionally have proposed a project for fourth year Occupational Therapy students to look for evidence for use of sensory modulations with adults with Eating disorders and hopefully contact other units using sensory modulation approaches, and units treating clients with eating disorders.

Is there anyone out there working in inpatient settings using sensory modulation approaches for anxiety management?

Do you work with clients with eating disorders? What techniques to you use to manage anxiety?

Would you be willing to have correspondence/fill in a survey about use of sensory modulation in your setting?
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Occupational Therapist, Brisbane Australia
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melbot
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hi there
i work in a similar setting at least that is part of my role. At the moment I can't say I have any ideas on this one but would be good to chat and bounce ideas off one another ito experiences and what you have learnt.
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Amanda
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Eating disorder treatment via sensory approaches is a personal area of interest and I am currently in the process of reviewing the literature. Without hard and fast information, my first inclination is to approach the ED from a trauma informed perspective. The interest in this topic has reignited my passion for research in this domain; as I find evidence of best practice, I will share.

This may be a place to start: http://uspra.info/Education/Conference2011/HANDOUTS/605MHSIS_June_2010.pdf
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Amanda M. Rodriguez, OTS
Bay Path College
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Tina Champagne
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I have worked with individuals with eating disorders on inpatient units and also in the community. My biggest recommendation is to #1 realize that most eating "disorders" are classified (generally) as a type of self-injurious behavior (SIB) and that all SIBs have a function(s). All too often professionals get overly focused on getting the person to "eat" rather than helping the individual become more self-aware and to identify and address the source of the "problem". I realize that this sounds easier said than done but too often I have seen this happen on inpatient units (people hyper focus on just getting the person to eat).

Some of what I have done over the years: assuming the "problem" is getting in the way of the person's ability to engage in meaningful roles/occupations and wanted my help...

In terms of a sensory approach - I would first assess whether or not the person has any sensory processing issues that may be part of the problem (e.g., oral defensiveness, overall problems with hyper-sensitivities/overresponsivity, etc.). If so, there are therapeutic ways to work on this. I would also help to target anxiety if the person was having that symptom as well. You can of course help the individual to identify sensory approaches to help do this, in addition to any other tools/approaches.

Once the nervous system is out of the fight/flight or freeze response it easier to help them explore the function(s) of the eating disorder. For example, for one person there may be incredible self-loathing and perfectionism and with another it may be that there is so much anxiety they cannot eat much, or that hypersensitivity to a large variety of foods leaves them feeling like they cannot eat...especially hospital foods/when given few choices (have them consult the dietician for more food options they feel they can eat more comfortably).

Using sensory modulation means you are working on the regulatory component of sensory processing. In this way, you are looking at sensory overresponsivity, underresponsivity, seeking and/or avoiding patterns (Miller, et al.,; Dunn). You may also use this approach to work with individuals who do not have problems with sensory modulation but want to try sensory-based alternatives for stress and anxiety management as well as health and wellness goals.

In addition, sensory tools can be used to help people engage in mindfulness activities with a sensory cue and coupled with DBT and expanded when adding the proprioception and vestibular options as well.

I created the "sensory modulation program" to help serve as a guide to how to introduce sensory modulation interventions to adults. This is also something that can be used with people with eating disorders. This is published in my book and also there are some resources on this topic on this website.

Increased self awareness is key to helping people to be able to be more aware of how they feel and to use tools to self-regulate and feel more grounded in their bodies. However, if this is too triggering (to feel grounded) then this is another important thing to consider. It is not uncommon for people with trauma histories to develop SIB's. Therefore it is important to also educate yourself in how to work with individuals with trauma histories as well.

If a person has trouble with body image or if their trauma response is triggered by being more "grounded" (e.g., flooding, flashbacks, physical discomfort) this must be respected and carefully worked with at the person's pace and collaboratively to identify ways to engage without the person feeling overwhelmed.

There has been one study that I know of that looked at sensory approaches and eating disorders that was presented at AOTA's annual conference several years ago - but it was not published. It looked at different types of eating disorders and sensory profile patterns but I have not been able to get this person's contact info to inquire about her results. Either way that sounds like a nice little study to be done and published at some point...but it would also be important to look at trauma history and occupational performance barriers/changes post treatment as well in my opinion.

Hope this helps some!
Tina
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waleeedijaz
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Is there anyone out there working in inpatient settings using sensory modulation approaches for anxiety management?

Do you work with clients with eating disorders? What techniques to you use to manage anxiety?
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