title: The Effectiveness of Sensory Modulation in Adults with Schizophrenia
Creators: name: Machingura, Tawanda
Publisher: name: Griffith University
Year: 2021
Subjects: subject: schizophrenia
subject: sensory interventions
subject: sensory modulation (SM)
subject: sensory processing

description: Despite advances in the medical management of schizophrenia with new generation antipsychotics, the overall quality of life and the number of years lived with disability for people with this condition has remained suboptimal. Non-pharmacological interventions that lead to improvements in psychosocial and occupational functioning of individuals with schizophrenia are therefore much needed. Previous research has linked sensory processing impairments in people with schizophrenia with a reduction in quality of life, and social and occupational functioning. Currently, sensory modulation is perceived by clinicians as a promising intervention to address this problem, but research evidence is lagging behind clinical practice. The aim of this PhD project was to investigate the effectiveness of sensory interventions for people with schizophrenia. The overarching research question for this project was: What is the effect of sensory modulation interventions on health, social and occupational functioning when used for people with schizophrenia? More specifically the researcher sought to answer the question: Are sensory interventions effective in reducing distress/regulating arousal/ and improving function for people with schizophrenia? The hypothesis was that sensory interventions are effective for people with schizophrenia based on practice-based evidence. The research project was made up of four studies. The first study aimed to evaluate published research evidence relating to the effectiveness of sensory modulation (SM) in adults with schizophrenia and to identify any gaps in knowledge to guide further research This study was conducted in 2017 and findings were that there was a paucity of studies and those available had several methodological limitations. The review of 17 papers meeting the inclusion criteria concluded that practitioners were already using this intervention in practice and were reporting positive outcomes using low quality descriptive studies. There was a clear need for further research that has higher methodological rigor. The second study aimed to ascertain local normative data on sensory processing in adults and investigate socio-demographic factors that might influence sensory processing. In Study 2, members of the general population without schizophrenia completed measures including sensory processing (n = 71). Results indicated that mean scores were similar to most people as measured by the Adult / Adolescent Sensory Profile and comparable to established norms. The third study aimed to examine the effectiveness of sensory interventions in people with schizophrenia using quantitative methods and this was Study 3 of this research project. The objectives of Study 3 were two-fold: the first being to establish a sensory processing pattern profile for people with schizophrenia and the second being to measure the efficacy of sensory modulation interventions for people with schizophrenia. This study established that people with schizophrenia (n = 41) had different sensory processing profiles on average, compared to individuals in the general population. It also established that patients receiving sensory modulation improved on some measures, but to no greater extent than patients who received treatment as usual. The fourth study aimed to explore experiences, provide explanations, and develop new ideas from the lived experience of those using SM. Study 4 used a qualitative study design. using semi-structured interviews with users of sensory modulation who were occupational therapists working in mental health (n = 11) and patients diagnosed with schizophrenia (n = 13). Five themes were identified: Service user education on the sensory approach is the key; A variety of tools should be tried; Sensory modulation provides a valued treatment option; There are challenges of managing perceived risk at an organisational level; and There is a shortage of accessible and effective training. These findings suggest that sensory modulation can be a beneficial addition to treatment options for people with schizophrenia. This multisite research project used a mixed methods research design to investigate the effectiveness of sensory modulation interventions when used with people with schizophrenia. The project design incorporated a systematic literature review followed by a convergent parallel mixed methods design (qualitative and quantitative) for later stages of the research project.Overall, the findings of this research project have enhanced current understanding of sensory processing and sensory modulation intervention effectiveness when used for people with schizophrenia. The mixed method approach provided new evidence regarding the use of sensory interventions with people with schizophrenia and the results of this project can inform practice guidelines for this intervention. The research also highlights to practitioners that there are benefits to using the intervention however a cautious approach is required as the evidence is still emerging and there is still limited generalisabity of the findings. The findings of this project suggests that practitioners should exercise their ethical responsibility of considering available evidence when using sensory modulation and apply shared decision-making principles when using it. This cautious approach is an important addition to safe and ethical practice which can lead to better patient outcomes.