Author Archives: Laura Holmes

Therapy Goal Setting with Children in a Specialist SLCN Setting

Talking Mats

Many thanks to Charlotte Phillips and Laura Douglas, SLTs at Blossom House School, New Malden, for this latest guest blog which looks at how Talking Mats are used for therapy goal setting within the context of a specialist school for children with SLCN.   Further information can be found on their RCSLT Poster Presentation (September 2019) here – AAC Poster RCSLT Conference September 2019

Goal setting can be a labyrinth to navigate! Do these goals reflect the pupil’s own views? Is there a discrepancy between staff and pupil ideas for goals? Are these goals motivating? Are the goals functional? Are pupils avoiding goals they would like to achieve for fear of failure? Add to this the language rich dialogue required in order to establish goals and similar to a maze you may encounter dead ends, twists, turns and a feeling of entrapment. How can we ensure we do not assume needs and that the goal setting process is collaborative and person-centered? Enter Talking Mats; a tool which enables you to make sense of the maze, like the lookout tower in the middle it allows you to have a clear view of how everything fits together. You’ll now find the goal of exiting is far easier!

How can Talking Mats help?

At Blossom House the Talking Mats framework is utilised at the beginning of therapy to support pupils with DLD and specific learning difficulties to identify areas of their strengths and needs and develop personally meaningful goals that are associated to these areas. Some of the pupils are competent verbal communicators within a social context but due to the emotive subjects they may be exploring they may not be able to access these skills within therapy. Talking Mats are also used to baseline students’ self-awareness alongside prompting pupil voice. Talking Mats are tangible and have low linguistic demands which allows students with kinaesthetic and/or visual learning style preferences, and communication needs to engage in these discussions.

Case Study SLCN school exampleThis Talking Mat (using Widgit Symbols as options) was created with a student at the start of therapy whilst the therapist was building a therapeutic relationship. It helped a student who was reticent to share with a new adult to have a full conversation about things that he was happy with and those that were not happy. The mat options were chosen to include a) communication strengths and needs, b) school subjects and c) some areas the SLT knew were areas of strength. The function of this mat was threefold: to baseline the confidence the student felt about certain areas (with the aim to increase this over therapy), to assess his self-awareness of his strengths and needs and finally to act as a tool to help prioritise targets for therapy and develop relevant goals. The student’s self-awareness was accurate as he was able to rate known areas of strength e.g. singing, dancing and drama, as ‘happy’, whilst known areas of difficulty e.g. spelling were accurately labelled as ‘not happy’. Some of the areas of need that the student rated matched the SLT’s referral information as priorities for therapy from his teacher (starred) therefore these were used to go on to create joint goals with the student.

Next Steps

The school would now like to embed Talking Mats as a whole school approach. The first step will be Talking Mats forming a core part of School council meetings to ensure that every pupil has a voice. There will be consultation with SLTs around integrating Talking Mats into the Annual review pupil voice protocol and into therapy outcome measures. This will be facilitated through the use of the digital talking mats package which allows for staff to create mats with pupils on the move, with minimal resources. These can then be emailed to staff and pupils which makes this information practical for staff to use within the context of their extremely busy school day. The use of technology to facilitate self-advocacy is an interesting field which needs further investigation.

If you are feeling inspired and would like to access Talking Mats training to enable you to introduce a similar approach in your school take a look here – 

https://www.talkingmats.com/training/foundation-training/

To find out more about our resources, including our Digital Talking Mats app, check out this link here – 

https://www.talkingmats.com/shop/

 

Mental Health – Using Talking Mats for organising and expressing thoughts

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Many thanks to Georgia Bowker-Brady, Advanced Specialist SLT (Berkshire Healthcare Foundation Trust) for this latest guest blog.

I attended the Talking Mats training in June and I work in both dementia care and acute mental health in-patient services.

I had initially imagined that I would primarily be using the Talking Mats to support the dementia patients.

However I’ve been surprised to find that I have been increasingly using Talking Mats with functional patients and it has been a really positive tool when discussing with patients about their self-care, the care they are receiving in the hospital and opinions on discharge.

Due to their mental state, many of the patients may find it hard to organise and express their thoughts, and if patients are hypomanic it can be difficult for professionals to guide the topic to get meaningful information, but Talking Mats has really helped with this! It has also been pertinent in establishing patients’ insight levels and gaining better understanding of their impression of the current situation.

Here is a photo of one my mats from the psychiatric adult acute wards. This was for a patient who is severely low in mood and has relatively recently gone through a traumatic incident. The ward staff and OTs have had difficulty gathering any information about what she ordinarily enjoys doing in order find some activities to try and engage her with.

The staff stated that the patient would simply report she doesn’t enjoy anything and questions about what she used to enjoy received no answer. I went and did a joint session with the OT where I asked about what she enjoyed doing before this incident and we did the mat (see picture below) in a matter of minutes.

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This can now provide a starting point for considering areas for trying to encourage some behavioural activation.

We then extended it by using an emotions wheel to ask how she felt about certain activities available in the hospital. We were able to establish that she felt fearful about trying new things and sad about carrying out certain activities she used to do prior to the incident.

It is wonderful to hear such a great example of Talking Mats in action – if you have any stories you would like to share, please get in touch with us at info@talkingmats.com

 

 

Talking Mats and Supported Decision Making

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Many thanks to Claire Wiseman & Ann Lafferty from The Advocacy Project (Scotland) for this guest blog, including a great example of how Talking Mats helped a young woman with learning  disabilities and psychosis share her views about being in hospital, receiving medical treatment and her preferences in respect of future post discharge welfare decisions:

 

For some time, The Advocacy Project have been thinking about how we could use the Talking Mats Framework to support people going through legislative processes such as the Mental Health (Care and Treatment) (Scotland) Act 2000, Adults with Incapacity (Scotland) Act 2000 and the Adult Support and Protection (Scotland) Act 2007.

Recently the Mental Welfare Commission published a best practice guidance on Supported Decision Making – https://www.mwcscot.org.uk/good-practice/guidance-advice, which we referred to as part of our presentation for the recent Talking Mats is 21 celebrations (click here to see the presentation Talking Mats and Supported Decision Making PP 2 (1)). The feedback from this session was that ‘yes’ there is a need for symbols to support legislation. As accredited trainers, we’ve also been asked when we’re delivering training to lawyers, Mental Health Officers, Social Workers, support workers and other advocacy organisations if there are specific symbols related to Supported Decision Making, particularly with regard to legislative issues.

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Here is one of the Supported Decision Making and Talking Mats examples shared in our presentation:

One of our staff supported a young woman with a learning disability who was thought to be experiencing a psychotic episode. She had been detained in an in-patient learning disability unit under the Mental Health (Care and Treatment) (Scotland) Act 2003 on a Short Term Detention Certificate. The clinical team then made an application for a Compulsory Treatment Order, which was granted. Later, when discharge planning was in progress, an application for Welfare Guardianship was made under the Adults with Incapacity (Scotland) Act 2000.

Although the young woman was able to communicate verbally, the effects of the psychosis combined with her learning disability meant that her conversation was discursive and she was very easily distracted. Using a combination of Talking Mats and our additional symbols over a number of sessions, the advocacy worker managed to ascertain her views about being in hospital, receiving medical treatment and her preferences in respect of future post discharge welfare decisions.

The Talking Mats reports were submitted as evidence at two mental health tribunal hearings and the Welfare Guardianship hearing at the sheriff court. We received positive feedback from the Curator Ad Litem, Mental Health Officer and Sherriff regarding the reports as they had never had Talking Mats reports submitted before during these proceedings.

The use of Talking Mats had been instrumental in supporting the young woman to put forward her views and ensuring an outcome she was happy with.

 

Going forward, Talking Mats and The Advocacy Project will be exploring the possibility of a symbols set for Supported Decision Making and legislation. We are currently looking at funding possibilities.

 

A fantastic example of the power of Talking Mats – if you have any Talking Mats stories you would like to share, please get in touch!  Just send me an email at  laura@talkingmats.com

 

 

 

 

Introducing our New Talking Mats Honorary Research Associate

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The Talking Mats Board is delighted to appoint Dr Jill Bradshaw from the Tizard Centre, University of Kent, to the position of honorary research associate. This is our first appointment of this kind. Talking Mats is an evidence-based framework and research is important to us – but that research needs to be much more diverse, and involve a much wider range of people.

Jill’s role will be to give the Talking Mats team:

  • A sounding board for research ideas and proposals
  • Advice and support on publishing articles
  • Identify research gaps and advise on funding avenues

We are also very aware that a number of people are using Talking Mats as a research tool, and Jill will also help to develop a virtual research network to bring interested researchers together.  We are still exploring ways in which this could work, but it could involve an email network, virtual seminars and/or twitter chats. If you are interested in being included, and have completed our Talking Mats Foundation Training course, Jill would love to hear from you. Please email her on J.Bradshaw@kent.ac.uk – or email info@talkingmats.com and we will forward your interest to her.

Jill is really excited about this new post.  She says ‘We know that the voices of people who have communication challenges can be excluded from research. This is a great opportunity to work with others to think about how we can use Talking Mats creatively in research and to find ways of including views from a wider range of people’.

Lois Cameron

November 2019

 

Do you think you are worth it? Using Talking Mats to provide a reflective space for clinicians

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In our latest blog, Rachel Woolcomb, Talking Mats OT Associate, discusses how Talking Mats can support Reflective Practice for Occupational Therapists.

Taking time out to stop and reflect on our practice can be a challenge. We convince ourselves there are more important things to do, people to see, targets to meet, and therefore we just don’t have the time.

However, I suggest, that with this mind set we are doing ourselves, and the people to whom we provide support and care, a disservice.

Clinical supervision has always been embedded in the culture of occupational therapy and at its best should create a safe and supportive environment in which reflective practice can take place.

Unfortunately, in practice, the reality can look different.

The more I have used Talking Mats to enable my clients to think and express their opinions, the more I have been convinced, that there is also great benefit to them being used within the clinical supervision process.

I want to thank the occupational therapists who agreed to explore this further with me. They used Talking Mats to think about their coping skills at work, or reflected on how their ability to learn and think, impacted their job role.

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They were surprised how easy they found it to think about the full breadth of their working life and the impact this had on their wellbeing. As clinicians, we are great at looking after other people and ensuring that their health and wellbeing needs are met, however, we are not so great at caring for ourselves.

The latest TMOT resource provides more information about why and how, Talking Mats can be an effective tool in enabling a reflective thinking space for clinicians. Check it out here: TMOT3 Reflective practice

Give it a go… You are worth it!

 

To find out more about our Talking Mats resources, check out this link:

https://www.talkingmats.com/shop/