Wednesday, April 11, 2007

Snoezing

For some years, Green Acres has asserted that it is a “Center of Excellence” which follows “best practices” and aspires to deliver “evidence-based care”. In my understanding, this means taking a hard-nosed look at scientific study of various treatments, to see how they will compare. Those without evidence are tossed out.

Recently, however, we seem to be going down a slightly different path. A decision was made, by someone upstairs, that one of our meeting rooms should be transformed into a “multisensory room”. You might ask (as I did) what this means. Well, a consultant from New York came in to tell us about it. The room is to be re-decorated according to a visionary , therapeutic concept called “snoezelen" (pronounced SNOOZ-eh-len). According to Wikipedia, “snoezelen” is an amalgam of the Dutch words "snuffelen" (to sniff, to snuffle) and "doezelen" (to doze, to snooze). In other words, it means “to sniff around and fall asleep.”

This is not exactly the outcome that I generally have in mind for my patients when they are admitted. But no matter, because from what I’ve seen, the term “snoezelen” more accurately translates to English as “tangible representation of a bad acid flashback, accompanied by objects you have not seen since your last visit to a Spencers Gifts back in 1981.” It might also translate to “Strange Euro-décor hand-picked to go with endless-loop tape recordings of ABBA.” Also, based on this map of an idealized "snoezelen room", it might translate as "the room I described in my 7th-grade essay entitled 'My Perfect Pre-Teen Bedroom'" I mean, just check out the mirror-ball and solar projector music system!


Now, here are a few photos of actual "snoezelen rooms" I pulled up at random on the web. As you can see, the only adjective really appropriate here is “trippy”. The idea, as best I can gather from "official" websites, is that providing intense, artificial poly-sensory stimulation to certain types of patients can help to “bring them out of their shells” and calm agitated behaviors. Generally the populations suggested for snoezelen are those with autism, developmental delay, and head injuries. I actually think it might be a good therapy for such people. However, it's hard to know for sure, because “There is no formal focus on therapeutic outcome”. Nor, not surprisingly, much in the way of scientific evidence that this therapy has any particular effect.




But what about our acutely psychotic, paranoid, delusional, agitated psychiatric patients? Should we prod them into the snoezelen room? I will keep an open mind, but daresay this environment may be disorienting to say the least. Peculiar bubbling potions? Weird, unidentifiable noises? Odd, wafting smells? And check out the glow-in-the-dark skeleton—- that’s got to be among the worst ideas I’ve ever seen for people in a mental hospital.


One snoezelen website even suggests constructing the floor of the snoezelen room somewhat off-kilter, so as to “stimulate the sense of balance”. Will this help with reality-testing? There is a fine line between “stimulate” and “freak out” which this whole idea crosses several times.

Also, lest you think this feel-good concept is entirely promulgated by selfless folks trying to help the afflicted, take a look at some of the official Snoezelen-room merchandise on offer by the people who have trademarked the word Snoezelen. Perhaps you need an “aquarium bubble tube” ($1,590)? In functional use, it strongly resembles the “orb of ecstasy” hoarded by Miles Monroe in Sleeper (see side-by-side comparison:)


If your hospital has deeper pockets, you might consider other cost-effective items such as the “Pediatric SUV (Sensory Ultimate Vehicle)” for only $5,350, the Musical Hopscotch Pad ($2,750), and the Ultraviolet Metalophone (which cannot be distinguished from a common toy xylophone except that it costs $1,275.) Finally, for the ultimate experience, there is the “Personal SNOEZELEN Sensory Satchel” at $999. Frankly, I find this a rip-off— we all have built-in “personal sensory satchels” which we can access anywhere, anytime, for free. I think maybe we should be promoting more of that, instead of stroking giant glowing plastic bubble sticks.

8 Comments:

Anonymous Anonymous said...

I work with street involve, drug addicted youth in Vancouver, Canada. We have VERY strict restriction on what colors we can paint the walls (mostly white, off white, and what can only be described as jaundice skin tone). Our housing authority would have a fit over those rooms, and we're considered to be "progressive" in drug treatment and harm reduction.
I'm off to the local thrift store to find some 70's memorobilia to decorate our teen lounge. I think I can do it for under $999.

CV

4/12/07, 2:28 AM  
Blogger Catherine said...

If I was ever placed in a room likeb that I would probably start screaming and never stop. Even the pictures gave me jitters.

4/12/07, 8:24 AM  
Anonymous Doug said...

Any idea who this new room is supposed to impress? It seems like a toy for someone showing off their discretionary spending authority.

4/12/07, 10:59 AM  
Anonymous Doug said...

An odd pattern in all of these sensory items is that the sensory stimulation they provide doesn't connect to any real thing, just a thing made to stimulate. You know? Opening a trunk in a dry attic, with the afternoon sun catching dust motes, smelling the mothballs, unwrapping yellowed newspaper to touch your grandfather's train set -- there each sense is telling you something. A light spray -- what does that connect you with? This seems a recipe for disconnectedness.

I quite agree about our personal sensory satchels.

4/12/07, 11:16 AM  
Anonymous Anonymous said...

Just for the other side of the picture, I've spent a bit of time in a Snoezelen room volunteering with young kids with complex needs (nonverbal, multiple physical disabilities, etc).

Snoezelen is a snazzy and safe playground for these kids who don't have the opportunity to play in the ways that other kids take for granted. These kids have very little control over their environment, so being able to touch a wall and have it change colour in response can be quite magical for them. Also, because the walls and floor are covered in soft foam blocks, kids who aren't safe outside of their wheelchairs in other environments can really explore.

I have no idea whether it is more therapeutic than anything else, and it doesn't sound like a particularly good idea for your clients. But, for some populations, it really is a fun place! And the adults working with the kids typically love it as well.

4/12/07, 1:43 PM  
Blogger jcat said...

As a non-autistic, bipolar adult,
put me in there for longer than ten seconds and it's going to feel like the worst drug trip I've ever been on! The thought of what it could do to someone who is psychotic is quite awful

4/12/07, 2:17 PM  
Anonymous Kaliki said...

You. Have. Got. To. Be. Kidding. Are they *paying* people to come up with this? It's very pretty but very disturbing.

4/12/07, 10:01 PM  
Blogger daedalus2u said...

As someone on the ASD spectrum (Asperger's), this does seem kind of relaxing and non-threatening. There are no people, just things. Wierd and strange things, but nothing anywhere near as wierd and strange as people.

In some sense, if it did make NTs uncomfortable and feel out of control, that would bring them closer to how I feel in a crowd.

Rergarding the comment on Canadian "harm reduction", if a room like this could allow someone to achieve a "trippy" experience without drugs (or even with lower or fewer doses), isn't that "harm reduction"?

4/25/07, 10:18 AM  

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