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Replacing Seclusion  
and Restraint Practices 
in Psychiatry With 
Sensory Rooms
EMMA COSTAIN



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INSPIRATION
My inspiration for this paper stems from both personal and professional 
experiences. The idea to replace seclusion and restraint (S/R) practices 
first took shape during my generalist year practicum at a behavioral 
health hospital. Drawing on my background working with individuals 
with Autism Spectrum Disorder and my expertise in behavioral health, I 
developed the concept of implementing Sensory Rooms as a humane and 
therapeutic alternative to S/R.

I firmly believe that patients should have agency in their treatment and 
leave the hospital with transferable coping skills rather than traumatic 
memories. My work is grounded in advocating for patient rights and 
ensuring that individuals in acute psychiatric care are active participants 
in their own recovery. Through this paper, I hope to highlight the urgent 
need for non-coercive interventions in mental health treatment and 
contribute to a shift toward more compassionate, patient-centered care.

Emma Costain is a 2025 graduate of the Columbia School of Social 
Work, specializing in policy practice and mental health. As a social 
worker, she is passionate about research and policy advising in the 
mental health field, with a particular focus on acute psychiatric inpatient 
care. Having grown up in a military family, she embraces the idea that 
home is wherever the heart is.EMMA 

COSTAIN



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REPLACING SECLUSION AND RESTRAINT

ABSTRACT
The use of seclusion and restraint (S/R) in acute psychiatric inpatient 
settings persists as a controversial practice, causing significant harm 
to patients and stress to staff. This policy brief examines the ethical, 
financial, and systemic implications of S/R and advocates for replacing 
S/R with sensory rooms—an evidence-based approach fostering emotion 
regulation, patient autonomy, and trauma-informed care. Recognizing 
that eliminating S/R may not be immediately feasible, this brief proposes 
an incremental approach through a hypothetical pilot program at Jackson 
Behavioral Health Hospital: converting an isolation room, or a room 
where a patient receives intervention separately from other patients, on 
each psychiatric inpatient unit into a sensory room, alongside incentives 
to reduce overall S/R usage. Sensory rooms can then be evaluated as 
a humane and cost-effective alternative to S/R practices. This policy 
brief aims to advance knowledge on patient-centered interventions in 
mental health care and underscores the ethical imperatives and financial 
incentives for legislative and organizational policy reform in psychiatric 
care. 

Keywords: seclusion, restraint, sensory rooms, psychiatric inpatient care, 
policy reform, trauma-informed care, social justice

EMMA COSTAIN

REPLACING SECLUSION AND RESTRAINT 
PRACTICES IN PSYCHIATRY WITH  
SENSORY ROOMS
The field of mental health has progressed in many regards. However, 
the archaic practice of seclusion and restraint (S/R) still dominates acute 
psychiatric inpatient care, causing unnecessary trauma and distress for 
both patients and providers. The Code of Federal Regulations (CFR) 
define seclusion and restraint as follows:

• Seclusion is “the involuntary confinement of a person alone in a 
room or area from which the person is physically prevented from 
leaving” (Condition of participation: Patient’s rights, 42 CFR 
482.13(e)(1)(ii)).

• Restraint is “any manual method, physical or mechanical device, 
material, or equipment that immobilizes or reduces the ability 
of a person to move his or her arms, legs, body, or head freely” 
(Condition of participation: Patient’s rights, 42 CFR 482.13(e)(1)(i)
(A)).

This policy brief will not only exhibit the ethical and financial costs of 
S/R in psychiatric settings, but will also shed light on potential policy 
interventions that can significantly reduce the prevalence of S/R. By 
applying the concept of emotion regulation, often used for individuals 
with autism spectrum disorder, and integrating it with the principles 
of patient autonomy, acute psychiatric inpatient hospitals can replace 
seclusion rooms with designated sensory rooms (Recovery Ways, 2022). 
As discussed later in this brief, sensory rooms are spaces that provide 
patients with efficient, transferrable, and relevant distress tolerance skills 
that can be used both within the hospital and in their daily lives.

BACKGROUND AND HISTORICAL CONTEXT
The use of S/R in Western psychiatric medicine has a long and troubling 
history, with its inhumane and traumatizing use dating back to the 
1700s. While historically rooted in the control and segregation of those 



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deemed “unmanageable,” these practices persist today, often justified 
as necessary for safety despite growing evidence of their harm and the 
availability of alternative interventions (Weiss, 1998).

EUGENICS

In the late 19th and early 20th centuries, psychiatric practices were 
significantly influenced by the rise of eugenics theory—a discredited 
form of scientific racism that posited human beings could be perfected 
and social ills eliminated through genetics (e.g., National Human 
Genome Research Institute, n.d.). Psychiatrists, frustrated by the 
lack of effective treatment for mental illness, turned to experimental 
interventions aimed at controlling and segregating individuals deemed 
“unfit” by societal standards (Turda, 2022). 

One such intervention was the lobotomy, introduced in the 1930s 
as a means to manage patients with severe mental disorders. This 
procedure involved severing connections in the brain’s frontal lobe and 
was often performed without patient consent (Mashour et al., 2005). 
Electroconvulsive therapy (ECT; also known as “shock therapy”) 
also emerged during this period, initially administered under coercive 
circumstances and without adequate evidence of its effects, further 
exemplifying the era’s inhumane treatment approaches (Scull, 2022). 

Similarly, S/R also originated as a means of controlling and isolating 
those deemed undesirable. Though lobotomies were eventually 
discredited and abandoned due to their devastating consequences, ECT 
and S/R persisted and were frequently misused as a means of social 
control rather than medical necessity, reflecting the broader pattern of 
psychiatric interventions being wielded as tools of oppression (Larson, 
2018). 

Marginalized populations—including immigrant populations, people 
of color, impoverished people, and those who were mentally or 
physically disabled—disproportionately became the victims of eugenics 
experimentation by psychiatrists, often under the guise of medical 

advancement (e.g., Larson, 2018; Mashour et al., 2005). This targeting 
extended to the widespread and unchecked use of S/R, which was 
implemented as a means of control rather than care (Larson, 2018).

PSYCHIATRIC CARE TODAY

Decades later, S/R remains deeply entrenched in psychiatric treatment, 
disproportionately impacting the same marginalized communities that 
were historically subjected to these practices. Studies have found that 
Black patients are significantly more likely to be subjected to S/R than 
their white counterparts, in both emergency departments and inpatient 
psychiatric settings (Eswaran et al., 2023; Hawkins et al., 2022). This 
pattern is not incidental; it reflects the persistent biases and systemic 
inequities that continue to shape psychiatric care. The case of Orville 
Blackwood in 1991 serves as a tragic example: Blackwood, a Black 
psychiatric patient, died after being subjected to excessive restraint 
and medication. The case led to a national inquiry that revealed Black 
patients were more likely to be misdiagnosed, overmedicated, and 
subjected to coercive psychiatric interventions (Prins et al., 1993). These 
findings reinforce what many mental health professionals and advocates 
have long argued: S/R is not only a failure of psychiatric care but a 
practice that also reflects deeper patterns of racism, ableism, and classism 
embedded in the mental health system.

According to international standards (UN General Assembly, 1992), 
the use of seclusion rooms and restraints are permitted exclusively in 
instances where the patient is in imminent danger of harming or killing 
themselves, another patient, or a staff member. However, research has 
shown that seclusion rooms are more often used as a form of punishment 
in response to a patient being loud, disruptive, or noncompliant 
with medications (Substance Abuse and Mental Health Services 
Administration [SAMHSA], 2010, p. 1). This misuse is not random: It 
reflects the same systemic biases and discriminatory patterns described 
earlier in this section, where marginalized patients are disproportionately 
subjected to control and punishment under the guise of care. The 

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widespread practice of S/R demonstrates persistent systemic biases 
within psychiatric care, and is in direct violation of encouraging patient 
autonomy, providing trauma-informed care, and respecting the human 
dignity of every patient (e.g., National Association of Social Workers, 
2021). Research also shows that patients subjected to S/R face increased 
risk of extended lengths of stay in psychiatric facilities and reduced 
likelihood of returning home upon discharge.

Despite its persistence, S/R is neither therapeutic nor necessary—rather, 
it is a remnant of outdated and oppressive psychiatric models that have 
disproportionately harmed vulnerable populations for centuries. 

WHAT THE RESEARCH ON SECLUSION AND 
RESTRAINT SHOWS
In addition to the well-documented evidence of bias in its application, 
S/R has ethical and financial consequences as well. This section 
highlights not only the devastating impact of S/R on patient well-being 
but also the significant costs it imposes on hospitals. These consequences 
further reinforce the urgent need to adopt more humane, evidence-based 
alternatives that prioritize patient dignity, safety, and autonomy.

Research illustrates how S/R practices, shaped by the systemic biases 
and inequities outlined in the previous section, can result in devastating 
consequences for patients and the healthcare system as a whole. These 
harms are reflected in ethical failures, clinical outcomes, patient mortality 
rates, and financial costs, as explored in the rest of this section (Recovery 
Ways, 2022). 

S/R: PATIENT TREATMENT AND 
CONSEQUENCES

S/R can be applied to a wide range of psychiatric conditions, placing 
nearly any patient admitted for inpatient psychiatric care at risk 
regardless of their specific diagnosis. The diagnoses most commonly 
associated with the use of S/R include schizophrenia, schizoaffective 

disorder, and bipolar disorder; however, the application is not limited to 
those conditions (Georgieva et al., 2020). Research indicates that patients 
subjected to S/R face significantly worse clinical and systemic outcomes 
compared to those who are not restrained. 

The use of S/R in psychiatric settings is not only harmful but can also 
have fatal consequences. The Substance Abuse and Mental Health 
Services Administration (SAMHSA) (2010) has reported that “an 
estimated 50 to 150 individuals die each year as a result of seclusion 
and restraint practices in facilities, and countless others are injured or 
traumatized” (p. 1). Other patients die from cardiac arrest triggered 
by the severe physiological stress of being forcibly restrained—a risk 
heightened for individuals with underlying medical conditions (LeBel 
& Goldstein, 2005). Some patients have also died due to neglect, when 
they were placed in seclusion rooms without proper monitoring and 
experienced life-threatening medical issues or engaged in self-harm. 

ETHICAL ARGUMENT

The use of S/R provides “no therapeutic value, [causes] human suffering, 
and frequently [results] in severe emotional and physical harm, and 
even death” (Mental Health America [MHA], n.d., p. 1). The use of 
S/R exacerbates the suffering of patients who are already dealing with 
difficult mental health conditions. Psychiatric hospitals should not further 
patient suffering by placing unconsenting patients in seclusion  
or restraints. 

Many psychiatrists argue that S/R is a necessary tool within acute 
psychiatric inpatient settings because it allows for the management of 
behavioral issues related to a patient’s mental condition, but “there is 
little evidence that seclusion provides long-term benefits in terms of 
treating symptoms or reducing aggression” (Newton-Howes, 2013, p. 
422). From an ethical perspective, S/R practices disregard a patient’s 
autonomy and directly contradict patient-focused and trauma-informed 
care. Evidence of therapeutic benefits to seclusion rooms and restraints 
is lacking, so it is hard to ethically justify using either practice on a 

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patient against their will. Finally, the antiquated and cruel practices of 
S/R are not only violations of human dignity but also direct contributors 
to preventable deaths, serving as glaring symptoms of the poor quality 
of care, inadequate staff training, and misinformed public policy that 
continue to enable these abuses (Grasso et al., 2007).
 
FINANCIAL ARGUMENT

Significant organizational and healthcare costs also contribute to the 
argument against S/R. A single episode of either seclusion or restraint 
can cost the hospital “between $302 and $354” (SAMHSA, 2010, p. 2). 
Beyond the economic costs, hospitals may have to consider legal costs 
as a consequence of using seclusion rooms and restraints, as patients or 
family members may take legal action against the hospital due to the 
harm, trauma, and in some cases preventable deaths that result from these 
interventions.

Hospitals must consider both patient safety and regulatory compliance 
when evaluating the use of S/R. Under federal regulations, “all patients 
have the right to be free from restraint or seclusion, of any form, 
imposed as a means of coercion, discipline, convenience, or retaliation 
by staff” (Condition of participation: Patient’s rights, 42 CFR 482.13(e), 
2008/2025). While S/R may be used to ensure “the immediate physical 
safety of the patient, a staff member, or others,” it must be discontinued 
at the earliest possible time (Condition of participation: Patient’s rights, 
42 CFR 482.13(e)(2), 2008/2025). In addition to these protections, 
hospitals that receive Medicare and Medicaid are required to report 
deaths associated with S/R to the Centers for Medicare and Medicaid 
Services (CMS), including “each death that occurs while a patient is in 
restraint or seclusion,” deaths occurring within 24 hours of removal, 
and cases where it is “reasonable to assume” that S/R contributed to 
a patient’s death (Condition of participation: Patient’s rights, 42 CFR 
482.13(g)(1)(iii), 2008/2025).

CMS has emphasized the importance of preventing such adverse events, 

commonly referred to as never events, which are defined as “preventable 
medical errors that result in serious consequences for the patient” (CMS, 
2008, p.1). In response, CMS has implemented payment policies that 
discourage preventable harm, stating that “never events cause serious 
injury or death to beneficiaries and result in unnecessary costs to 
Medicare and Medicaid due to the need to treat the consequences of the 
errors” (CMS, 2008, p. 1). These regulations and policies reflect both 
the ethical obligation to protect patients from harm and the financial 
consequences hospitals may face when safety standards are not upheld.

S/R can also significantly lengthen a patient’s hospital stay, placing 
additional financial burdens on both the hospital and the patient (LeBel 
& Goldstein, 2005). Patients subjected to S/R experience prolonged 
hospitalization due to increased psychological distress, physical 
injuries, and disruption in their treatment process (Newton-Howes, 
2013). Instead of de-escalating crises, S/R has been found to increase 
agitation, aggression, and trauma symptoms in patients, leading to 
prolonged care requirements and, in some cases, readmissions (MHA, 
n.d.). These extended hospitalizations not only delay recovery but also 
exacerbate healthcare costs, further burdening patients, hospitals, and 
insurance providers. These findings underscore that S/R is not a neutral 
intervention but a practice that actively contributes to deteriorating 
patient health, prolonged institutionalization, and increased systemic 
costs—all of which highlight the urgency for policy change.

The use of S/R also contributes to workforce burnout and staff turnover, 
creating additional hidden costs for hospitals. The emotional toll on staff 
and the physical risks associated with managing aggressive incidents 
contribute to turnover rates as high as 62% in psychiatric facilities 
(MHA, n.d.). The costs of recruiting, training, and retaining new staff 
further strain hospital budgets, making the reduction of S/R a financially 
sound decision.

From a systemic perspective, it is clear that S/R is not only unethical but 
economically unsustainable. Research consistently shows that reducing 
the use of S/R leads to better patient outcomes, lower healthcare costs, 

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and fewer legal and liability expenses (LeBel & Goldstein, 2005). 
Policy reformers must recognize that in a capitalist-driven society where 
financial arguments hold significant weight, demonstrating the economic 
inefficiency of S/R is a crucial strategy for policy change. The data 
overwhelmingly supports a transition toward alternative interventions, 
such as sensory rooms, which improve patient care, reduce hospital costs, 
and align with trauma-informed care principles (Björkdahl et al., 2016).
 
POLICY ALTERNATIVES TO SECLUSION  
AND RESTRAINT
Given the well-documented harm and inefficiency of S/R, psychiatric 
facilities must adopt alternative interventions that prioritize patient 
autonomy, emotion regulation, and trauma-informed care. One such 
evidence-based alternative is the use of sensory rooms, which provide 
sensory modulation interventions (SMIs) to help individuals regulate 
their emotions in a safe and controlled environment. A sensory room 
offers patients a safe space where they can learn to regulate their 
emotions and gain skills they can use outside the hospital. Sensory rooms 
have long been used to support individuals with autism spectrum disorder 
(ASD) and other behavioral conditions by helping them regulate their 
bodies and better adapt to their environment. These rooms are commonly 
found in schools and educational settings, where they not only support 
emotion regulation but also improve how individuals with ASD interact 
with teachers and peers. They foster the person’s independence and help 
them advocate for themselves when they are feeling overstimulated or 
overwhelmed (National Autism Resources, n.d.). 

If a hospital replaced its seclusion rooms with sensory rooms, patients 
could learn methods for emotion regulation that they could then easily 
transfer into the world outside the hospital. Patients who are being 
discharged would have a set of skills that allow them to regulate their 
emotions rather than resorting to self-harm, aggression, or withdrawal. 
Sensory stimulation methods empower patients by giving them the 
control and the autonomy to decide for themselves how they want to self-

regulate, rather than confining them within prison-like isolation rooms at 
hospitals (Haig & Hallett, 2023). 

Sensory rooms can also be used as a proactive intervention that helps 
prevent violent outbursts from escalating into crisis situations requiring 
S/R (Haig & Hallett, 2023). Eliminating the practice of S/R would 
improve patient outcomes, lower the financial burden on psychiatric 
hospitals by reducing the average length of inpatient stays, and increase 
the likelihood of patients’ successful reintegration into their communities 
(Ma et al., 2021). 

SENSORY MODULATION AS A RESPONSE TO 
COMMON S/R TRIGGERS

As mentioned earlier, S/R is applied broadly to patients exhibiting 
certain behaviors, regardless of diagnosis (Georgieva et al., 2020). 
Individuals experiencing severe agitation, self-harming behaviors, 
physical aggression, or extreme emotional distress are the most likely to 
be restrained or secluded, even when alternative interventions could have 
prevented escalation (Ma et al., 2021). Sensory rooms are a proactive 
alternative that could help patients manage these behaviors before they 
reach a crisis point.

The use of S/R remains prevalent across the globe, yet these practices are 
traumatizing for both patients and hospital staff. Sensory rooms provide 
a viable alternative that allows psychiatric facilities to implement sensory 
modulation strategies in place of coercive interventions. Haig and Hallett 
(2023) explain that “sensory modulation refers to the personalisation 
of sensory input by controlling the environment, and use of equipment 
and/or activities designed to support an individual to self-regulate by 
achieving their optimum level of calm or alertness” (p. 55). Patients who 
practice self-regulation inside a sensory room can carry those techniques 
into life outside the hospital and apply them in daily life to enhance 
healthy behavior. 

Sensory modulation techniques (SMTs) can be used to help prevent 

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behaviors that trigger S/R interventions. These techniques include:
• Tactile: Weighted blankets, fidget tools, or textured surfaces to 

reduce distress and ground patients.
• Auditory: Sound machines, white noise, or calming music to lower 

arousal levels.
• Visual: Soft lighting, visual projection tools, or soothing imagery to 

decrease anxiety.
• Olfactory: Aromatherapy using calming scents like lavender to help 

regulate mood.
• Proprioceptive: Deep pressure input through body movement, such 

as via rocking chairs, yoga balls, or stretching, to improve emotional 
control (Recovery Ways, 2022).

By offering self-directed and patient-centered regulation strategies, 
sensory rooms reduce the need for coercive interventions that strip 
patients of their agency and dignity (Haig & Hallett, 2023). These 
strategies are not only less harmful but are also therapeutic, as they 
equip patients with new coping skills that promote long-term emotion 
regulation and autonomy beyond the hospital setting.

SENSORY ROOMS AS A PROVEN 
INTERVENTION
Ongoing research within acute psychiatric care is developing the best 
possible interventions for reducing S/R in inpatient facilities. One 
intervention suggests treating “patients as active participants in seclusion 
reduction interventions” (Gaskin et al., 2007, p. 298). One of the many 
benefits of implementing sensory rooms as an intervention against S/R 
is that it allows the patient to remain in full control of how they choose 
to regulate their emotions and manage their distress, thereby making 
them “active participants” in their own treatment. Psychiatric staff must 
shift their perspective from treatment happening to a patient to treatment 
happening with a patient, thereby reinforcing collaborative care models 
rather than coercion-based interventions. 

Table 1 and 2 show some of the benefits of using sensory rooms instead 
of S/R in psychiatric care, along with considerations when switching to 
this model.

While there are currently no sensory rooms in inpatient psychiatric 
settings in the United States, psychiatric hospitals in Sweden have 
begun exploring this solution. Although staff in such hospitals were 
initially ambivalent about implementing sensory rooms, over time they 
observed meaningful improvements, including patients becoming more 
independent in managing their emotions, building greater confidence in 
their ability to care for themselves, and experiencing enhanced overall 
well-being (Björkdahl et. al., 2016). Sensory rooms supported “the 
important principles of person-centered nursing and recovery-oriented 
mental health and the ability of staff to implement these principles” 
(Björkdahl et. al., 2016, p. 472). Implementing sensory rooms in 
psychiatric inpatient settings aims to help patients regain their individual 
autonomy within the treatment they receive, as they learn ways to self-
soothe and choose which sensory stimulation methods and tools to use.

IMPLEMENTATION OF SENSORY ROOMS

Before implementing sensory rooms as a matter of state or federal policy 
in the U.S., this brief recommends identifying one acute psychiatric 
inpatient hospital to implement sensory rooms as a replacement for 
S/R. Over the course of one year, research would be conducted within 
the identified hospital to track the results of the sensory rooms. At the 
conclusion of the year-long research project, the evidence collected could 
be brought to governmental bodies to propose policy changes regarding 
seclusion and restraint practices within acute psychiatric inpatient 
hospital settings.

Jackson Behavioral Health Hospital (JBHH), located in Miami, Florida, 
could be used to implement the recommended intervention due to its 
existing inpatient psychiatric infrastructure. Each of the psychiatric 
inpatient units at JBHH has two rooms designated as observation 

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rooms, or rooms used exclusively for S/R. For the duration of the year-
long research project, one of the adult behavioral health units at JBHH 
could transform one of their two observation rooms into a designated 
sensory room. All staff within the unit would be educated on how to use 
the sensory room when a patient is overstimulated. The patient would 
be instructed to use the coping tools in the sensory room before staff 
considered using seclusion and restraint.

To successfully create a sensory room, the room needs to be filled with 
a variety of objects that appeal to the different senses. There should be 
multiple options for each of the five senses so that the patient can choose 
what works best for them as they learn emotion regulation and distress 
tolerance. Table 3 offers examples of different objects and tools within 
the sensory room that will provide a sensory experience for each of the 
five senses.

Given the nature of behavioral health hospitals, the objects in the sensory 
room cannot put the patient at risk of suicide or self-harm. For example, 
headphones must be wireless, and there cannot be any sharp objects. 
In addition to providing tools that appeal to the five senses, the sensory 
room can contain resources such as books, journals, and handouts that 
allow the patient to occupy their mind while simultaneously doing 
something therapeutic. The sensory room should shift away from the 
traditionally all-white walls of a psychiatric hospital and include decor 
such as soft carpets and light paint colors, which have been shown to 
create a calming atmosphere and support patient well-being (Eminovic et 
al., 2022). 

Sensory rooms are not just a theoretical alternative—they represent 
a research-based intervention that can replace outdated and harmful 
S/R practices. The transition from coercive interventions to sensory 
modulation techniques is a necessary step toward ethical, patient-
centered psychiatric care.

CONCLUSION AND POLICY 
RECOMMENDATIONS
The goal of acute psychiatric inpatient treatment is to ensure that the 
patient is stable enough to return to their community without being at 
risk for self-neglect or self-harm. As such, acute psychiatric care seeks 
to help patients reintegrate with their communities upon discharge. 
Giving patients access to sensory rooms while still admitted to inpatient 
psychiatric care will show patients the variety of ways in which they can 
self-soothe and self-regulate, through a variety of sensory modalities 
that they will be able to carry over into the world outside the hospital 
after being discharged. Sensory rooms can eliminate the use of seclusion 
and restraint in psychiatry by making the patients active participants in 
their treatment and equipping them with necessary distress tolerance 
and emotion regulation skills. Learning such skills will give patients 
transferable, relevant, and effective methods of coping, both inside the 
hospital and in their communities after discharge. 

However, achieving systemic change requires collective action at all 
levels of psychiatric care, not just from policymakers. Social workers 
play a crucial role in advocating for and implementing alternative 
interventions within their own workplaces and communities. Even 
social workers who do not hold policy making roles can educate 
hospital administrators, clinical teams, and leadership about the proven 
benefits of sensory rooms. By advocating for pilot programs within 
psychiatric facilities, conducting data-driven evaluations of sensory room 
effectiveness, and documenting reductions in S/R use, social workers 
can generate the evidence needed to push for larger-scale policy reforms. 
If multiple hospitals implement sensory room interventions and gather 
compelling research on their impact, this evidence could influence 
national mental health policies and establish sensory rooms as the 
standard of care in inpatient psychiatry.

Sensory rooms are not just an abstract recommendation—they are a 
practical, evidence-based solution that can replace outdated and harmful 

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psychiatric interventions. Through advocacy, education, and research, 
social workers at all levels of practice can contribute to a fundamental 
shift in psychiatric care, ensuring that patients receive compassionate, 
trauma-informed, and effective treatment.
 

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system 

LeBel, J., & Goldstein, R. (2005). The economic cost of using restraint and the value added by 
restraint reduction or elimination. Psychiatric Services, 56(9), 1109–1114. https://doi.org/10.1176/
appi.ps.56.9.1109

Ma, D., Su, J., Wang, H., Zhao, Y., Li, H., Li, Y., Zhang, X., Qi, Y., & Sun, J. (2021). Sensory-
based approaches in psychiatric care: A systematic mixed-methods review. Journal of Advanced 
Nursing, 77(10), 3991–4004. https://doi.org/10.1111/jan.14884



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TABLE 1
BENEFITS RELATED TO SENSORY ROOMS

Benefits of Sensory Rooms

Empowers patients Sensory rooms encourage self-regulation and 
autonomy by allowing patients to choose their 
own coping mechanisms, reducing trauma from 
coercion-based interventions (Haig & Hallett, 
2023).

Reduces aggression  
and violence

Sensory rooms provide a proactive, nonrestrictive 
intervention that can de-escalate situations before 
they reach a crisis leading to the use of S/R 
(Björkdahl et al., 2016).

Improves patient  
outcomes

Sensory rooms reduce the need for S/R, decrease 
inpatient stays, and enhance emotional  
well-being, leading to greater patient stability 
post-discharge (Georgieva et al., 2020).

Space requirements Hospitals can use existing rooms designated for 
S/R to create sensory rooms.

Cost-effective for  
hospitals

Lower reliance on S/R reduces hospital costs 
associated with longer inpatient stays, lawsuits, 
staff injuries, and insurance penalties.

Mashour, G. A., Walker, E. E., & Martuza, R. L. (2005). Psychosurgery: Past, present, and future. 
Brain Research Reviews, 48(3), 409–419. https://doi.org/10.1016/j.brainresrev.2004.09.002

Mental Health America (MHA). (n.d.). Position statement 24: Seclusion and restraints. https://
mhanational.org/issues/seclusion-and-restraints 

National Association of Social Workers. (2021). Code of ethics of the National Association of Social 
Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

National Autism Resources. (n.d.). School sensory rooms. https://nationalautismresources.com/
school-sensory-rooms/

National Human Genome Research Institute. (n.d.). Eugenics and scientific racism. https://www.
genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism

Newton-Howes, G. (2013). Use of seclusion for managing behavioural disturbance in patients. 
Advances in Psychiatric Treatment, 19(6), 422–428. https://doi.org/10.1192/apt.bp.112.011114

Prins, H., Backer-Holst, T., Francis, E., & Keitch, I. (1993). Report of the inquiry into the death 
of Orville Blackwood. Midlands Centre for Criminology and Criminal Justice, Department of 
Health, Afro-Caribbean Mental Health Association, & Institute of Criminology at Cambridge 
University. https://www.mentalhealthlaw.co.uk/media/1993_SHSA_Blackwood_Inquiry_report.
pdf

Recovery Ways. (2022, August 26). Sensory-based strategies for self-regulation. https://www.
recoveryways.com/rehab-blog/sensory-based-strategies-for-self-regulation

Scull, A. (2022). Desperate remedies: Psychiatry’s turbulent quest to cure mental illness. Harvard 
University Press. https://doi.org/10.4159/9780674276475

Substance Abuse and Mental Health Services Administration. (2010, March). Promoting alternatives 
to the use of seclusion and restraint issue brief #4: Making the business case. https://www.
samhsa.gov/sites/default/files/topics/trauma_and_violence/seclusion-restraints-4.pdf

Turda, M. (2022, October 24). Exploring the legacies of eugenics in psychiatry—Part I. History, 
Archives and Library Blog. Royal College of Psychiatrists. https://www.rcpsych.ac.uk/news-and-
features/blogs/detail/history-archives-and-library-blog/2022/10/24/eugenics-in-psychiatry-part-
one

United Nations General Assembly. (1992, February 18). The protection of persons with mental 
illness and the improvement of mental health care: resolution / adopted by the General Assembly. 
United Nations Digital Library. https://digitallibrary.un.org/record/135851

Weiss, E. M., Altimari, D., Blint, D. F., & Megan, K. (1998, October 15). Deadly restraint: 
A nationwide pattern of death. The Hartford Courant. https://www.charlydmiller.com/
LIB05/1998hartfordcourant11.html



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TABLE 3
SENSORY ROOMS AND THE FIVE SENSES

Sensory Rooms and the Five Senses

Taste • Sour candies
• Cold ice cubes
• Calming tea (available upon request)

Touch • Cold washcloths
• Kinetic sand
• Weighted blankets
• Calm Strips
• Fidget toys

Smell • Essential oils
• Scented markers
• Scented Play-Doh

Sight • TV screen with calming visuals such as nature walks, 
relaxing ocean waves, and gentle rain

• Posters with breathing techniques

Hearing • Ambient music
• Wireless noise-canceling headphones 

TABLE 2
CONSIDERATIONS RELATED TO  
SENSORY ROOMS

Considerations for Sensory Rooms

Initial resistance from 
staff

Some staff members may struggle with 
relinquishing control and adapting to a less 
authoritative model of care (Björkdahl et al., 
2016).

Not a one-size-fits-all 
solution

Sensory interventions must be tailored to 
individual needs, and not every patient will 
respond equally well to the same sensory 
modulation techniques (Georgieva et al., 2020).

Need for staff training Effective implementation relies on well-
trained staff who understand how to guide 
patients in using sensory tools effectively rather 
than reverting to traditional control-based 
interventions (Haig & Hallett, 2023).


