Mental Health inpatient units are increasingly using Sensory Modulation strategies to provide options for people to self soothe and self regulate. One strategy that many people find useful is the use of cold temperature items. This can include using ice sprays, disposable ice packs, zip lock bags with cold water, cold slushies, cold water in sinks, cold stress balls, and chill towels.

Cold temperature can be useful for several reasons:

·         It can cool the body when it is hot eg when anger flushes the face and hands.

·         Cool water used in conjunction with breath holding can invoke the mammalian dive reflex and reduce the heart rate. (this makes it unsuitable for people with heart conditions or anorexia nervosa without prior medical clearance).

·         as an intense sensation, it can be an alternative to self harm

·         the sensory input can feel grounding and reduce dissociation.

·         Some people who experience night sweats find that sleeping with a chill towel is very cooling and relaxing.

On an inpatient mental health unit, it can be useful to have a small fridge with cold items in it that can be used by people to self regulate. Another option is to have a sink that can be filled with icy cold water and used by distressed, angry or agitated clients to calm through placing the head in the cold water and breath holding. This technique is used within Dialectical Behaviour Therapy as a distress tolerance skill (TIP skill).

The cold water could be plumbed so that it does not overfill. A non-slip mat could be placed next to the sink to reduce the risk of falls. The sink would be useful in an area that is available to people when they need to use it.

Further suggestions on Sensory Modulation items for mental health inpatient units are in the Sensory Modulation Resource Manual.

References:

Sensory Modulation Resource Manual paperback: https://www.barnesandnoble.com/w/sensory-modulation-carolyn-fitzgibbon/1128221915

Sensory Modulation Resource Manual ebook: https://www.amazon.com.au/Sensory-Modulation-Carolyn-Fitzgibbon-Sullivan-ebook/dp/B0791WJZ5N

https://dailydbt.wordpress.com/2011/02/17/tip-skills/

DBT skills training handouts and worksheets (2014), Linehan

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