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Research update: Forest design for mental health promotion—Using perceived sensory dimensions to elicit restorative responses

Forest design for mental health promotion—Using perceived sensory dimensions to elicit restorative responses, research into the qualities of the natural environment which promote restoration

forest design for mental health promotion - research update

download full article – open access pdf here  

 

gray bridge and trees

 

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Workshop: Ayres’ Sensory Integration for Health and Wellbeing

Our two day workshop is a “great opportunity to reflect on clinical practice and learn new skills”. Find out more about the application of Ayres’ Sensory Integration beyond childhood to support health and wellbeing.

We can also offer 2 or 3 day onsite bespoke training and consultation for your organisation to support the development of sensory integration informed care pathways.

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Trauma and development of the brain.

Watch this amazing TED about trauma…here’s a taster of what Nadine Burke Harris will share with you in her presentation, which explores the underlying neuroscience.

close up photography of grizzly bear

Well, imagine you’re walking in the forest and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland that says, “Release stress hormones! Adrenaline! Cortisol!”

And so your heart starts to pound, Your pupils dilate, your airways open up, and you are ready to either fight that bear or run from the bear. And that is wonderful if you’re in a forest and there’s a bear. (Laughter) But the problem is what happens when the bear comes home every night,and this system is activated over and over and over again, and it goes from being adaptive, or life-saving, to maladaptive, or health-damaging.

Children are especially sensitive to this repeated stress activation, because their brains and bodies are just developing. High doses of adversity not only affect brain structure and function, they affect the developing immune system, developing hormonal systems, and even the way our DNA is read and transcribed.”

<div style=”max-width:854px”><div style=”position:relative;height:0;padding-bottom:56.25%”><iframe src=”https://embed.ted.com/talks/lang/en/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime” width=”854″ height=”480″ style=”position:absolute;left:0;top:0;width:100%;height:100%” frameborder=”0″ scrolling=”no” allowfullscreen></iframe></div></div>

 

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Please don’t say… “She seems fine to me…”

Submitted by guest blogger, Ruth OT.

In my time as a special needs parent, I’ve had a variety of responses to telling people my child has special needs. Some responses have been great, others have left me crying all the way home. Literally. Some have opened up conversations, others have shut them down. I know that those people who have not been so helpful have just been looking for the right thing to say and found the wrong one. So here are some cues to think about what you’re saying. Remember when the parent says the “we think (s)he might have….” Or “(s)he’s got…” they are very vulnerable. They will have cried and fretted and lost sleep over the information they are giving you and they will be at some stage of processing that information. If they are giving you that information, they either need you to change the way you are interacting with their child, or they need to talk about it. Choose your words carefully to open up the conversation and hear what they’re trying to tell you.

three-signs-in-male-fists-saying-stop-wait-and-go-isolated-on-a-white-C1ECPD

Please don’t say: “(s)he seems fine to me”. I know you’re trying to be reassuring, but by saying this, you imply that you are more able to identify the child’s developmental needs than the parents and the professionals working with the child. It pretty much shuts the conversation down, but if it continues, you force the parent into the role of pointing out their child’s deficits while you defend them. This is not a natural way of things, the parent spends enough time pointing out their child’s deficits with professionals, you need to enable them to big their child up and point out what a wonderful person they are.

Say instead: “I hadn’t noticed. What’s going on?” By saying “I hadn’t noticed”, you can reassure the parent that it isn’t that obvious, but also put yourself not the parent in the position of the person who needs educating about the child. You open up the conversation, and you give the parent the choice about how much information to give you, they might just tell you a load of assessments and appointments or they might tell you what the child is struggling with. It’s up to them.

Please don’t say “I couldn’t do it” the truth is you could. Of course, you could and a whole lot more, if that was what your child needed. Don’t point out how lucky you are that you don’t have to. The parent might well be wondering whether they can do it, and how long they can keep doing it for, they need you to reassure them that they can keep going.

Say instead “I really admire the way you’re doing it” This way, you’re complimenting the parent, you’re recognising how hard they’re working but you’re not sowing that seed of doubt that they might not be able to keep going.

Also, say “how can I help you do it?” they probably won’t know, but they’ll really appreciate being asked. It might be as simple as “watch my child while I have a pee in peace”. Do that. Then offer to do that again, don’t wait to be asked.

Please don’t say “(s)he’ll catch up” (s)he might well not. People were telling me this when the doctors were telling me she might well steadily regress. It wasn’t reassuring, it was frustrating. Again, it puts you in the position of the expert over the parent and professionals and the parent in the role of pointing out the deficits. Parents do not want to point out their child’s deficits, please don’t make them do it. Please don’t encourage the parent to compare their child to typically developing children, the only person a child needs comparing to, to track their learning is themselves.

Say instead “what does (s)he really love doing?” Give the parent a chance to gush about their kid, what they love, how much fun they are etc. Most parents will leap at this chance, it’s so refreshing after appointment after appointment telling professionals what their child can’t do.

Please don’t say “is there a cure?” The child may well not need a cure, they’re probably not ill. If the child is ill and there is no cure, they really won’t want to keep repeating that and if they know there is a cure, they’ll be doing it. Trust me, they will have researched treatment options very thoroughly.

Say instead “what are you thinking about for the future?” Again, keep it open. The parent might be trying really hard not to think about the future, they might well be taking one day at a time or they might be able to think of nothing else. They can choose how to interpret “the future” in your question and might tell you about getting them to eat just one more type of food or school support options, or they might be racing ahead to adulthood prospects.

Please don’t say “have you tried…?” again, you’re putting yourself in the role of expert with this one and the parent in the role of person to be taught how to raise their child. Unless you’re really actually a professional expert in what you’re suggesting, and you’ve spent time really interacting with the child, please just don’t.

Say instead “what do you think might help?” A parent who thinks their child has some additional needs will have done very thorough research, trust me. Give them time to talk about what they’ve learned. They might say “nothing” and then you’ll feel really awkward. Live with that, they feel awkward a lot of the time. They’ll probably tell you things that have been suggested and why they think/ don’t think that’s any good. Listen.

Please don’t say “you won’t want to come” Don’t presume, parenting a child with additional needs is isolating and exhausting. They might say no. Don’t be offended if they do but give them that option.

Say instead “I know (s)he finds this difficult, but I wanted to invite you in case you think they’d like it” Invite the child, acknowledge that it might be hard for them and they might want to say “no” and that’s OK, but make sure they know you want them there and you value time with them.

Please don’t say too much in front of the child. Remember they may well understand more than they can say and for any child seeing their parent upset is confusing and frightening.

Say instead “how am I best to communicate with him/her?” Then get down on the floor and do it. Playing with a child, talking with them on their level and really getting to know them is the biggest compliment you can pay the child and the parent.

My biggest advice if someone is telling you their child seems to have additional needs or a developmental difficulty is to listen to them, make them feel validated, treat them as the expert on their own child and don’t belittle their experiences. Your role is not to fix the child, you can’t do that. Your role is to support the parent, build their confidence and to be their friend.

black and white boys children curiosity

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Resources for Practice in Mental Health and Trauma-Informed Care: improving self-regulation to eliminate control and restraint aka TMAV

On our courses, we teach staff from CAMHS and adult/older adult mental health services how to use Ayres’ Sensory Integration to inform care including for those who have had early trauma.

On our in-house courses, we regularly teach mixed staff teams including Mental Health Nurses and Healthcare Assistants, CPN’s, OT’s, PT’s, SLT’s and Therapy Support Staff, Complementary Therapists, Psychologists and Psychiatrists. Working with staff teams from forensic, secure, acute and longer stay units, our lecturers help teams to develop and implement sensory informed care pathways. This includes working with sensory providers to develop secure safe sensory rooms for safe self-regulation and sensory-rich movement activities suitable for secure and forensic environments, where ligature risks mean traditional swings and other equipment cannot be used.

The use of Ayres’ Sensory Integration to support health and well-being has grown across the UK and Ireland.

The research and evidence base is expanding across the globe, with more clinical audits and studies being published that report that Ayres’ Sensory Integration is

  • improving self-awareness
  • improving self-regulation
  • promoting participation in everyday life
  • increasing clients ability to engage with others, with therapy

this means that there are significant reductions in

  • days in secure or acute care
  • deliberate self-harm
  • the use of PRN medication
  • the need for the use of physical support aka TMAV

We’d like to thank Tina Champagne for pointing us in the direction of this resource which fits so neatly alongside the resources and tools we teach on our courses.

Tina ChampagneTina is a colleague and critical friend of ASI WISE – having started her journey into sensory integration in parallel to our journey here in the UK where we were focussing on improving participation in care and daily life, addressing development of skills and occupations including self care to reduce self harm and use of PRN medication. We finally met in 2004 at a first conference about ASI in MH in Cornwall, UK.

Her work in addressing the use of chemical (mace) and mechanical (cuffs) restraints in the US helped transform their mental health care and she wrote several chapters in this free online resource about developmental trauma and practical ways to institute trauma-informed care.

Resources for Eliminating Control and Restraint aka Therapeutic Manage of Aggression and Violence 

https://www.mass.gov/files/documents/2016/07/vq/restraint-resources.pdf