Auckland University of Technology (AUT) Senior Lecturer Dr Daniel Sutton has recently received a Health Research Council grant for research into sensory modulation as an approach for people experiencing anxiety.
Dr Sutton has been a Senior Lecturer in the Department of Occupational Science and Therapy since 2005. He also teaches the New Entry to Specialist Practice Programme at AUT for allied health new graduates.
Sensory modulation is one of his main research interests and he believes the approach can be used to help people manage a range of distressing symptoms, including anxiety. Anxiety disorders are very common, affecting a quarter of New Zealanders at some point in their lives. However, many people do not receive adequate treatment for it.
Sensory modulation helps people manage both their physiological arousal and emotional distress using calming sensory input through doing activities or changing their environment. Specific sensory tools such as: weighted blankets; rocking or massage chairs; music; or the smell of lavender are commonly used in the approach.
“Helping people regain a sense of control over their minds, bodies and environment is a key aspect of using the sensory tools,” Dr Sutton says.
“And then the aim is that they have some tools that they can take away in terms of self-management of their anxiety.”
He says sensory modulation is also important because it is increasingly being used as a tool to help reduce instances of seclusion and restraint. People learn to self soothe before their distress creates problems or challenging behaviour and coercive approaches are used.

The research

The first stage of the research is a feasibility study, which will trial aspects of a potential full study’s design. It will look at issues around recruitment, effectiveness, cost of resources and sample size. The full study would then evaluate the effectiveness of sensory modulation compared with Cognitive Behavioural Therapy (CBT) for people accessing primary care. 
There will be thirty participants in the feasibility study and each will be given six training sessions so they can develop skills and strategies to use sensory modulation to manage their anxiety and also to improve their function. 
“We’re very interested in how anxiety is affecting participants’ quality of life, so it’s not just about managing crisis, but also their anxiety levels throughout the day,” he says.

Building an evidence-base

Dr Sutton says we must have good evidence behind any approach we use in health services.
“Sensory modulation is a fairly new approach in mental health, especially with adults, so its evidence-base is only just emerging. We have some anecdotal and qualitative evidence, but we need more experimental evidence, clinical trials etc.
“However, it’s quite challenging to run clinical trials within inpatient services because of the acuity of people’s experiences and there are so many variables. That’s why we’re looking to work in primary care. It’s easier to manage the research process while meeting an unmet need for many people at the same time.”
It is hoped the study will contribute to that evidence-base and thus help sensory modulation become an affordable and promising approach for people to use to manage anxiety through primary care.
“The aim would be for those working with people experiencing anxiety to have another option because medication and CBT don’t work for every individual. It is an option that helps people to actively take control over some of the physical symptoms associated with their anxiety,” Dr Sutton says. 
It should be noted that one of the compelling things about sensory modulation is that it is only ever about what actually works for the individual and is driven by them. It restores a sense of autonomy and confidence about how they manage and respond to themselves.

The future of sensory modulation

Interest in sensory modulation has grown significantly both here and overseas and Dr Sutton says most district health boards use it at least to some extent in their mental health services – so its future is looking good. 
“There’s now a process in place to introduce it within prisons, and sensory rooms are being introduced to places like emergency departments. I think the range of settings in which it is used will keep expanding into places like schools.
“I think interdisciplinary use of sensory modulation will also expand. People in different disciplines will pick up its principles and use them in different ways. In fact that’s already happening. We also need to develop training options, including university-based studies in this area.”
He says the future needs to include research on the underlying mechanisms of sensory modulation – what happens in the brain when sensory input is introduced and how that affects the autonomic nervous system.
“In mental health there has always been a focus on the brain-body connection but the focus here is on the body-brain connection. We’ve neglected the body in mental health and this work will help fill that gap as we learn more about how much influence our bodily sensations have on our emotions and arousal.”