Therapy rooms and waiting rooms: designing for sensory needs

Therapy room with grey lounge, green cushions, a white blanket and a plant on a small table. We would remove the aromatherapy sticks though!

At Sensory Modulation Brisbane, we have been advocating for Universal Design in Mental Health Units for Sensory Sensitivities and we also recommend this for therapy rooms, waiting rooms and all health care spaces.

Many people who attend Therapy practices have sensory processing patterns that are more sensitive, more avoiding, or more seeking or more missing of sensations than others and this can vary between different senses. This includes:

·         Autistics have sensory processing differences recognised as a diagnostic criteria. (DSM5)

·         People with PTSD often have reactivity and hypervigilance to certain sensations

·         People with schizophrenia often have auditory processing  and visual perception challenges.

·         ADHDers frequently have sensory processing differences (Schulze 2020)

·         A high percentage of people with mental illness have interoceptive difficulties

It can be useful to design for people with sensory sensitivities as it is easier to add sensory input if needed rather than take it away.

Lighting

·         Ideally a dimmable light that is set at the preference level of an individual client

·         Curtains or Blinds to block out light

·         If there is a florescent light, turn it off and use lamps instead.

Sound

·         Improving office acoustics can be very beneficial for everyone in terms of privacy and also reducing distractions and sensory sensitivities and overload.

·         It is preferable to not use music in a waiting room environment as people who want music can usually access this on their phone.

Scent

·         Scents can be a trauma trigger, allergy trigger or lead to sensory sensitivity and overload. So having a low scent therapy room and waiting room can be very important. For this reason, we do not recommend diffusers in public spaces.

·         Sometimes it may be necessary to neutralise odours. Try nil odour drops.

Interoception needs

Sometimes therapy is the place where people relax a little and notice that they need to go to the toilet, drink some water or have some snacks. They may not have noticed these interoceptive needs earlier.  Close proximity to toilets, water and food can be useful.

Comfortable Seating

There are many people in pain or who have hypermobility and are attending therapy offices. Comfortable seating can make a big difference.

Calming tools

At Sensory Modulation Brisbane, our favourite sensory tools for offices including a weighted cushion, a box of fidgets,  icy water or ice packs and invitations to reduce the lighting or turn on or off the pink/brown/white noise machine.

Visual Movement

Ideally design waiting rooms so that there is not a lot of visual movement eg people walking past, traffic etc.  Or provide options to be able to not face this visual movement.

Clear Pathways

It is useful for pathways to be clear and obvious and for signage to be clear. It can also be useful to take pictures of landmarks  and have this available on website or new starter information .

Personal preferences

It can be useful to invite individuals to use their preferred fidgets, earplugs, sunglasses, back cushion etc so that they are comfortable

 Nature

Access to nature can be calming. A plant or a picture of nature can be good additions to an office

Previous blog posts have discussed changing sensory input within a psychiatric hospital:

http://sensory-modulation-brisbane.com/sensory-modulation-blog/replace-the-torch-light-mental-health-unit-design

http://sensory-modulation-brisbane.com/sensory-modulation-blog/auditory-sensitivities-mental-health-unit

Training:

https://sensorymodulationbrisbane.ticketspice.com/sensory-modulation-using-a-sensory-lens-with-clients

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Marcel Schulze, Silke Lux, Alexandra Philipsen et al. Sensory Processing in Adult ADHD – A Systematic Review, 10 September 2020, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-71514/v1]
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Sugiyama, S., et al(2021). The Auditory Steady-State Response: Electrophysiological Index for Sensory Processing Dysfunction in Psychiatric Disorders. Frontiers in psychiatry, 12, 644541.

Sensory Modulation Resource Manual

Sensory Preferences in the Work Environment (Office)

Working from home/ changes to work locations have been one of the many challenges facing individuals during COVID-19. Some people have absolutely loved this change, while others cannot wait to return to the office environment. Are these differences all to do with personality traits? Or the trend towards open office spaces? Occupational therapists would suggest that it may also reflect our diverse sensory preferences.

What are Sensory Preferences?

Sensory Preferences are the unique likes and dislikes for different types and intensities of sensations in our day to day life. This can include what we see, hear, smell, taste, touch and our body movement. For example, some people like the feeling of strong muscle exercise, prefer music to be played loudly and enjoy intense flavours in their cooking. Other people may prefer gentle movement, lower noise volumes and predictable, familiar tastes. Most people have a variety of sensory preferences which illustrates just how diverse and unique our sensory systems and thus sensory needs really are.

Opportunities to better understand and accommodate our and other people’s sensory preferences can improve quality of life, enhance our performance in everyday activities (including self-care, work and leisure) and improve our relationships.

Sensory Preferences in the Workplace

Sensory preferences can have a significant impact on our experience of the workplace, with respect to the type of work we are drawn to do, the environments where we work best, and our stress levels in the workplace. We have improved work performance and wellbeing when there is a better match between our sensory preferences, our work duties and activities, and the environment in which we work. Less of a match between these elements can diminish feelings of wellbeing and performance in the workplace. Humans have a tendency to try to create a better match for themselves, which can be problematic when people working together have diverse sensory needs. How many times have we all been witness to or involved in drawn out battles over the office air conditioning controls?

To further illustrate, Afina works in an open plan office, but prefers to sit in the section up the back that is more quiet and less busy. A neat, tidy, clutter free desk helps her to feel more organised, less stressed and work more efficiently through her day.  However due to staff changes, Afina’s desk was relocated from the back of the office to right near the main entrance and close to the staff kitchen. She found the increased noise and movement around her unsettling and made it harder to focus. She also felt distracted by the noise of people chatting, preparing their lunch and smells from the kitchen. She is now sitting next to her colleague Tony, whom she gets on well with socially, but Tony tends to move around, gets up & down from his desk frequently and chats a lot with staff who pass by. Tony likes the hustle and bustle of this section of the office and is even known to create noise (humming to radio, whistling) when things are ‘too quiet’! While this sensory input seems to help Tony feel more energised and alert throughout the workday, for Afina this input is too overwhelming and impacts negatively on her stress levels and work performance.

Afina understands that she is not just being picky, that her sensory preferences are part of her unique physiology, and that she can apply strategies to assist her to focus in the workplace.

Strategies to Better Meet Sensory Needs in the Workplace

1.       Get to know your own sensory preferences

Are you sensitive to certain noises, temperature or visual movement? Do you find it harder to focus when certain sensory input (unexpected sound, certain smell) is present in the environment? Do you find your energy levels really dip if you stay seated at your desk for too long?

The Sensory Preferences Screen (The Office) helps identify:

•         Different preferences for sensory input commonly experienced in an office environment

•         Sensory input that is ‘too much’, not noticed, sought out or avoided. This is based on Winnie Dunn’s Sensory Profiles.

Building awareness of sensory patterns can then help us develop potential strategies and modulation techniques to better accommodate/address our sensory needs within the workplace.

2.       Turning up sensory input

For those who need increased levels of sensory input for optimum health and to feel regulated, ways of increasing or dialling up sensory input in the workday might include:

•      Bright lamp or lighting around desk

•        Colourful screen saver on computer – change at regular intervals

•        Listen to music with earphones/buds

•       Water bottle with cold water to sip

•        Move body at regular intervals - photocopy or fax items, take lunch break outside

•         Chew on mints/hot lollies

•         Fan near desk to increase air flow

•          Desk can be located near busier/louder office areas

It may also be useful to build in additional activities involving strong sensory input around work hours and during leisure time. Different examples include -

•   Listening to preferred music on the way home/while cooking dinner

•         Exercise or intense physical activities/pursuits in spare time

•         Playing with pet dog

•         Planning social activities with friends

3.       Turning down sensory input

For people who are more sensitive to and register sensory input more easily than others, reducing sensory input in the work environment (turning it down) can be helpful. Examples may include:

•          Sitting in a quieter/ less busy section of the office

•          Being closer to natural light sources (ie- a window)

•          Reduced clutter in the immediate environment and on desk

•          Turn down telephone volume

•          Wear headphones with quiet music.  

•          Desk located away from the kitchen or scent diffusers

•         Use product like Nil-Odor to reduce smells in environment

•          Take breaks away from office environment/in quieter space if possible

•          Small pot plant on desk or item that represents something familiar and comforting (photo of partner, picture of favourite nature scene etc)

 If you are interested in finding out more on Sensory Approaches, you could

read the Sensory Modulation Resource Manual or attend Sensory Modulation Brisbane Online Training

Resources:

Dunn, W (2014). The Model of Sensory Processing, Sensory Profile 2 (updated)

Lombard, A (2014). Sensory Intelligence: why it matters more than IQ and EQ. Metz Press, South Africa

O’Sullivan, J & Fitzgibbon, C (2018) Sensory Modulation Resource Manual

O’Sullivan, J & Fitzgibbon, C (2020) Sensory Preferences Screen (The Office)

Image Description: Crowded office space. A man sitting in a wheelchair is having a conversation with a co-worker. The office looks like it is busy and distracting and has lots of people talking . This office would be hard for people with sensory sensitivities to sound and visual input.