title: [Multisensory environmental intervention (snoezelen) as a preventive alternative to seclusion and restraint in closed psychiatric wards].
abstract: Seclusion and restraint, unfortunately, still remain a routine practice in closed psychiatric wards worldwide and in Israel. These practices often lead to distress, traumatized patients, and further increase the negative view and stigmatization of psychiatric treatment and, most especially, psychiatric hospitalization. Multisensory environmental intervention, Snoezelen, combines sensory integration theory with a client-oriented approach. Snoezelen treatment calms and relaxes agitative patients giving them a feeling of dignity, initiative and freedom of choice. The Snoezelen room is a high-tech, multisensory environment that includes music, light of fiber optic strands, calming image projections, vibrations of bubbles tubes, and soothing smells. After 30 to 40 minutes of exposure to Snoezelen, agitative patients in our closed ward reported substantial reduction of their distress level and, outwardly, appeared less agitated and displayed less aggressive and hostile behavior. Foremost, since the beginning of the multisensory environmental interventions in the closed wards, a statistically significant reduction in the number of restraints and seclusions has occurred in the closed male section in comparison to the closed female section, where snoezelen has not been administered (P < 0.05).
  
  
  CONCLUSIONS
  Snoezelen is an innovative and preventative alternative to seclusion and restraint in closed psychiatric settings. It produces a calming effect on agitative patients, reduces the length of time and number of seclusions and restraints, and diminishes the stigma against psychiatric treatment and hospitalization.
authors.affiliation: The Jerusalem Mental Health Center, Kfar Shaul Psychiatric Hospital, affiliated with the Hadassah Faculty of Medicine, Hebrew University.
authors.forename: Alexander
authors.initials: A
authors.lastname: Teitelbaum
authors.forename: Sarit
authors.initials: S
authors.lastname: Volpo
authors.forename: Rachel
authors.initials: R
authors.lastname: Paran
authors.forename: J
authors.initials: J
authors.lastname: Zislin
authors.forename: Dov
authors.initials: D
authors.lastname: Drumer
authors.forename: Sergey
authors.initials: S
authors.lastname: Raskin
authors.forename: Gregory
authors.initials: G
authors.lastname: Katz
authors.forename: Michael
authors.initials: M
authors.lastname: Shlafman
authors.forename: Amran
authors.initials: A
authors.lastname: Gaber
authors.forename: Rimona
authors.initials: R
authors.lastname: Durst
mesh_terms: D004779:Environment Design; D004780:Environment, Controlled; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000534:rehabilitation / Q000628:therapy*; D012149:Restraint, Physical; D012934:Social Isolation; D016896:Treatment Outcome