Social workers are required to complete a detailed assessment of their client’s needs. It is recognised that it can be a challenge to ensure clients fully participate in the process if they have cognitive or communication difficulties. The City of Edinburgh Council were keen to explore if we could adapt their standardized assessment tool and make it into a Talking Mat framework. Several staff in the council are already skilled practitioners in Talking Mats so are familiar with the framework and use Talking Mats in their practice. They are enthusiastic about the benefits of using Talking Mats both in terms of how it increases participation of service users but also because in their view it makes interviews easier for staff to undertake.
Structuring Talking Mats assessment framework
In order to develop the bespoke Talking Mat we held a seminar to discuss the social work assessment tool and approach used. Six key staff attended the seminar, facilitated by two Talking Mats associates. The discussion at the seminar identified a structure that would enable us to construct a coherent visual conversation that would cover the issues required to complete the assessment, using mind mapping to support this process. It is also important to identify a top scale that matches the question you are asking and make sure the options you are including are neutral and not leading.
The structure that emerged from this discussion is a Talking Mat that enables people to explore their views on 3 topics
their health and well being
their community involvement
Trialling the Talking Mats framework
Talking Mats then took the mind maps and developed these into symbol sets that were piloted by social work staff. At the end of the pilot a review was held and changes made which included alterations to
the language used
the symbols used
the topic an option was included under
making it clearer to staff when options were more abstract and required further explanation and or personalisation
Nicki Ewing from Edinburgh City Council who leads on the project says ‘ I am very excited that staff have a tool that can make assessment more meaningful for service users to participate in and makes it easier for staff to get good quality information’.
We are thinking of holding a focus group for others that might be interested in using the framework for their practice if, you are interested please contact Lois via the email@example.com email – call your email ‘social work focus group’.
We were recently involved in a discussion about the merits of symbols versus photographs to support communication, a topic which we have spent some time considering over the past few years.
We have also found an excellent small book titled ‘Too late to drive’ by Helen J Bate and published by Pictures to Share C.I.C. In it Helen discusses the meaning of pictures and visual perception in relation to dementia. There are some excellent quotes such as ‘Recognition is not the same as relevance, and relevance is what is important to us when we have dementia’ and ‘The images that really talk to people are produced with a skill and an understanding of the visual image as a method of unspoken communication’..
Our gut feeling is that for many people who use Talking Mats (who we refer to as ‘thinkers’), symbols may be more helpful than photographs and, although we have not carried out any academic research, we have lots of anecdotal evidence from a number of practitioners about some of the pitfalls of using photos. Here are a few:
The ‘thinker’ tends to get caught up in the detail of a photo e.g. Australian colleagues told us about using photos of different rooms in a day centre but the ‘service users’ got caught up with seeing specific details in the photos rather than considering the over place
Sometimes a photo can be too specific e.g. we were told of a person with dementia who was shown a photo of cornflakes to represent breakfast but could only focus on the cornflakes
The ‘thinker’ may be distracted by a photo of a real object e.g a person with learning disability fixed on the make of a particular car instead of considering transport
We are always wary of using photos of real people as it may be too sensitive for the ‘thinker’ – symbols appear to reduce the emotion impact of the image and be easier for people to comment on
If the person in the photo has changed, for example their hairstyle or glasses, this can confuse the ‘thinker’
If the ‘thinker’ has been involved in the place or event in the photo this can affect their views whereas a symbol is more neutral
Sometimes the clarity and quality of home taken photos can be poor.
Commercial photos like Photosymbols are good quality but we are aware that they tend to be used repeatedly, sometimes for quite different meanings
Here is a link to a previous blog which gives some additional information about the development of the Talking Mats symbols.
Academic research evidence on visual images and communication is limited and Helen suggests that that ‘If the academic world wants to explore or challenge anything [in these pages] then at least the conversation has begun’. We would welcome any further information, references or comments.