The influence of the contextual framing on physio- and occupational therapists' clinical reasoning in sensory rooms with patients admitted to psychiatry - a qualitative case study

Abstract

Aim: To investigate the influence of contextual framing on physio- and occupational therapists' clinical reasoning in sensory rooms for patients admitted to psychiatric units.

Material and method: Physiotherapists and occupational therapists from acute and intensive care units with sensory rooms were invited to participate in the study. The therapists were interviewed following sessions with patients in sensory rooms, using a semi-structured interview guide. These therapists also participated in a focus group interview. All interviews were transcribed and analysed based on the thematic analysis by Braun and Clarke.

Results: Twenty individual interviews and one focus group interview were conducted with seven physio- and occupational therapists. Three themes with accompanying subthemes emerged: (i) The contextual influence: Therapists' perceptions of the use of sensory rooms, The dominance of the medical paradigm). (ii) The therapeutic alliance: The therapists' relational skills, The importance of a good therapeutic patient relation, and Physio- and occupational therapy in a psychiatric setting.: (iii) The therapeutic diagnosis, Therapeutic sensory room interventions, and Holistic approach in a limited timeframe.

Conclusion: The clinical reasoning of physio- and occupational therapists in sensory-modulating sessions for patients admitted to psychiatric units is influenced by a primarily medically dominated paradigm; legally, economically, and politically. Occupational therapists mainly focus on everyday skills and being in the present, whereas physiotherapists focused on activities with bodily anchoring and awareness.

Keywords: Sensory room; clinical reasoning; occupational therapy; physiotherapy; psychiatry.