The Effect of Sensory-Based Coping Strategies on Adolescents With Mental Illness

PURPOSE: Literature expounds upon the fact that multisensory interventions decrease psychiatric symptoms and maladaptive behaviors and increase attention and learning tasks for people with mental health diagnoses and cognitive limitations (Lotan & Gold, 2009; Worthen, 2010). There has been a lack of evidence indicating a connection between the use of multisensory interventions and overall occupational adaptation. The purpose of this study was to examine the effect of sensory-based coping strategies on adaptation of adolescents with chronic mental illness. Children and adolescents with hospitalizations due to chronic mental illness often display decreased participation in daily occupations such as school, after-school activities, and social interactions (Chung, Edgar-Smith, Palmer, Bartholomew, & Delambo, 2008).

METHOD: A multiple single-subject ABAB design was used for this 12-wk study. Participants were age 13–17 yr, with at least one Axis I diagnosis, who were patients at an adolescent mental health behavioral intensive residential treatment facility. Seven adolescents participated in an occupational therapy coping skills group with sensory-based coping strategies 2×/wk for 6 wk. Additionally, the Adolescent/Adult Sensory Profile (AASP) was administered to each participant. Results of the AASP combined with participant preferences and observations during group were used to develop individualized sensory kits that were used by each individual participant with daily activities during intervention phases.

The Adaptive Behavior Assessment System (ABAS–II) Teacher Questionnaire was administered as a pre- and posttest to identify adaptive skills in conceptual, social, and practical domains. The Child Occupational Satisfaction Assessment (COSA) was administered as a pre- and posttest to provide information about client self-perception of occupational performance. The daily number of PRN medications, number of hours spent in the classroom, and number of minutes spent in timeouts were measured on a daily basis. The binomial test, a common type of data analysis used with single-subject design data, was applied to the daily number of PRN medications and the number of hours spent in the classroom for each participant. Wilcoxon signed-rank test was used to compare pre- and posttest data from the ABAS–II Teacher Form and the pre- and posttest results of the COSA for each participant.

RESULTS: This study resulted in statistically significant data in several outcome areas, including the decreased use of daily number of PRN medications and the increased number of hours spent in the classroom. ABAS pretest and posttest scores were also significantly different in all subsections, indicating increased adaptive skills within the classroom. COSA scores had statistically significant changes as well, demonstrating improved occupational self-assessment by participants. The results of the study demonstrate that sensory-based coping strategies improved occupational adaptation of adolescents with chronic mental illness. Specifically, there was a decreased use of daily PRN medications, increased management of symptoms of mental illness, increased time spent in the classroom, and increased occupational participation in school, as well as improved communication, self-direction, and performance within the classroom.

CONCLUSION: Occupational therapy professionals are concerned with improving occupational function as well as areas of performance and performance skills; this study was a step toward expanding the literature in regard to the impact of sensory-based coping strategies on occupational adaptation.

IMPACT STATEMENT: The American Occupational Therapy Association and the American Occupational Therapy Foundation have identified research priorities, specifically for the efficacy of client-centered interventions for clients with mental illness. This research clearly adds to the needed body of knowledge regarding evidence-based research in the area of occupational therapy and mental health.

References

Chung, W., Edgar-Smith, S., Palmer, R. B., Bartholomew, E., & Delambo, D. (2008). Psychiatric rehospitalization of children and adolescents: Implications for social work intervention. Child and Adolescent Social Work Journal, 25, 483–496. https://doi.org/10.1007/s10560-008-0147-8

Lotan, M., & Gold, C. (2009). Meta-analysis of the effectiveness of individual intervention in the controlled multisensory environment (Snoezelen) for individuals with intellectual disability. Journal of Intellectual and Developmental Disability, 34, 207–215. https://doi.org/10.1080/13668250903080106

Worthen, E. (2010). Sensory-based interventions in the general education classroom: A critical appraisal of the topic. Journal of Occupational Therapy, Schools, and Early Intervention, 3, 76–94. https://doi.org/10.1080/19411241003684217