Communication is a fundamental human right, yet many individuals with communication difficulties face daily challenges in expressing their thoughts, needs and feelings.  Augmentative and Alternative Communication (AAC) is a powerful tool that bridges this communication gap, and Talking Mats is one innovative approach that has proven highly effective in enhancing the lives of those who use AAC.

However, in the 25 years that Talking Mats has been developing resources we have never created one that specifically addresses the needs of AAC users.

 Until now!

The new resource, Supporting Communication with AAC and the online advanced training module, AAC will be launched at this year’s Communication Matters Conference 9^th-11^th September.

The idea

Ace Centre first contacted us in 2018 with the idea of developing a specific assessment resource that would allow the person considering using AAC to express their views about it; were they ready to use AAC, did it fit with their life and communication needs and how much support would be required? This could then inform decisions around referrals onto specialist AAC services.

Development

As with all Talking Mats resources, this one was piloted and discussed and changed until the final version was reached.  Thank you to all the practitioners and clients who gave their time and energy in that process. Thank you also to the Scottish Centre of Technology for the Communication Impaired who also collaborated on the resource and the module.

Outcome

 The outcome is a resource that can contribute to both assessments and reviews, and an Advanced online training module, both of which aim to put the AAC user at the heart of decision making about their communication.

Here is a brief outline of the resource and the module. 

Supporting Communication with AAC (card and digital resource)

Topics

 Your Communication

This topic considers the ‘How’, ‘Who’ and ‘Where’ of interactions and helps develop an understanding of the Thinkers communication needs.  It can be completed when you are getting to know the Thinker.

Joining in conversations

These topics are designed to help a Thinker explore how they feel about their AAC resource when it comes to joining in conversations and reflect the fact that an individual often uses a combination of communication modes to be effective. The three topic cards are: Verbal conversation, Paper support and Electronic Support.

How your AAC works

This topics explores different ways of accessing the  AAC device as well as the different features it has, incluing functions, appearance, sound, and access.

If you are trained in Talking Mats to Foundation level you can buy the resource from our website

AAC Advanced module

To access this course you must have already completed the Foundation Course.

The objective of this course is to ensure that AAC users are at the heart of decision making and that necessary adaptations are in place to support those conversations

The course is split into three different sections:

The Resource

Aim – to recognise the different topics and who they might be suitable for

Access

Aim – to recognise different positions, places and methods for a Thinker to access a Talking Mat

Communication Dynamics

Aim – to recognise the dynamics in a conversation, and appraise the process of using additional people during a Talking Mat

To successfully complete the course participants must pass the quiz and contribute to the forum telling us about their experience.

Courses will run from the 1^st of every month starting in November.

Talking Mats: developed in Scotland, embraced world wide with close working relationships in Japan, Sweden, Australia and New Zealand, but can the framework be adapted to reflect different approaches to communication that these diverse cultures embody? Victoria Mardell’s discoveries offer a fascinating insight into differences between Western communication and that of the Māori culture showing that the Talking Mats framework can be a cross culture communication tool.

Using Talking Mats in Te Ao Māori (The Māori World)

A Non-Māori SLT’s collaborative journey to deeper understand whether the Talking Mats process is culturally responsive to Māori

My Project

Working for the Aotearoa New Zealand Ministry of Education, I was approved to undertake a project which would investigate the suitability of Talking Mats to capture child voice. 

A key part of this project was to review whether Talking Mats were culturally responsive to Māori and reflective of Māori worldview and if not, whether they could be altered accordingly.

This led to a rewarding journey for me as a non-Māori practitioner as I was able to collaborate with Māori colleagues and improve my cultural awareness.  I got to experience Māori ways of gathering and acquiring information and I came away with new perspectives, which have shaped my practice.

Information Gathering: Learning About and Holding a Wānanga

To gather the information needed, it was suggested that I hold a wānanga.  The word ‘wānanga’ would loosely translate as a “forum” in English.  However, a more accurate description would be a collaborative process which involves engaging, sharing, and reflecting, with space for all viewpoints.  A wānanga would often lead to the creation of new knowledge and decision-making. 

This was my first experience with a wānanga and whereas Western ways of acquiring knowledge would likely have placed myself as an “expert”, seeking “feedback”, the wānanga was an unhurried deep discussion, in which all participants were partners, collaborating on an important subject.

Findings

There was overall agreement that Talking Mats are a good fit with Te Ao Māori.

Talking Mats were seen as a good way to promote Mana Motuhake (self-determination) and whakamana (giving prestige to children and their families).

Te Ao Māori (the Māori worldview) is strengths-based and the wānanga participants thought Talking Mats was a good fit with this approach.

Some considerations were discussed:

Codesigning the top scale:  Participants discussed that concepts such as “going well” “not going well” are Western and that if a Talking Mat was used in a Māori kura (school), or with a Māori whanau (family), then categories might need to be adjusted or changed.  This could be done via discussion and collaboration.

Māori colleagues have also shared some ideas with me for potentially suitable top scales:

(Sonja Macfarlane, 2021)

The key point was the importance of collaborating on the top scale rather than having this pre-determined before delivering the Talking Mat.

Being mindful about predetermination:  Participants discussed how a practitioner turning up with a Talking Mat and a set of visuals might be seen as pre-determination and this could lead to discomfort and resistance.  It would be more helpful if the practitioner facilitated a discussion, with the use of drawing visuals ‘on the fly’ as well as using the Talking Mats visuals.  In practice this could look like a more collaborative process, with a greater input from the thinker in the early stage of the mat, rather than just at the end.

Action points may be strength-based rather than deficit-focussed:  We discussed how there is a tendency in Western thinking to set goals or action points around improving things which the thinker has identified as not going well.  However, in keeping with a Māori worldview, actions points might be to do more of what you already like, or to mentor others.  We need to be careful that as practitioners, our unconscious bias is not inadvertently encouraging the thinker to focus on areas they have rated negatively.

Practice Example and Changes to my Practice

During the wānanga my former colleague, a Māori SLT, shared an example of a Talking Mat she had done about how a student wanted to participate in kapa haka (group performance of Māori dancing and chanting).

The SLT created her own visuals to reflect the kapa haka process.  During conversation the SLT and student discussed how she could fatigue easily so the SLT drew an option to sit or stand.  The action point was for the student to participate in waiata a-ringa (action song), with an option to sit if fatigued.

The process of considering Talking Mats through a Te Ao Māori perspective has changed my practice and I am grateful to my Māori colleagues for their time and insights.  I am now more mindful when reviewing a Talking Mat, to make sure the action points are coming authentically from the thinker.  I am also a lot more collaborative in the visuals and top scale of the Talking Mat.  I have found that practising with more collaboration has led to better relationship building and more in-depth conversations.

Mauri Ora

Thank you to Victoria for her work on this blog. If you have any questions about this please contact us on info@talkingmats.com

Question: What is a Talking Mat? 

Answer: Talking Mats is a visual communication framework which supports people with communication difficulties to express their feelings and views. 

That’s what our website says in black and white and you wouldn’t be alone in thinking it actively excludes people with a visual impairment.  However, one of our Licenced Trainers and Speech and Language Therapist, Olivia Ince recently got in touch to share a story of a creative and innovative approach to using the tool; a Braille Talking Mat.   

The mat was facilitated by an Outreach worker for Children with disabilities (the listener) who had been trained in Talking Mats by Olivia.  The young person sharing their opinions (the thinker) has a genetic neurodegenerative disease which affects the nervous system, causing progressive difficulties with physical and cognitive skills including communication impairment and vision loss. The Outreach worker and Olivia worked on the project together.  

Trialling a Braille Talking Mat 

We have been working together on a project to trial a Braille version of a Talking Mat. Talking Mats is a visual tool, but we knew that a Braille version could work in theory if some adaptations were made and if the thinker had the cognitive ability to understand the Talking Mats process. 

We thought a Talking Mat would be a good approach for this young person because it could help to make the conversation more engaging and create a more balanced interaction than asking a long list of questions. For this young person, the Talking Mat was primarily a thinking tool.  

Introduction: 

We started the process by introducing a concrete, familiar topic; food with the topscale of ‘like/ don’t know / don’t like.  Using a concrete topic like food meant that the listener could discuss the responses with the young person’s wider network and find out if the mat was a true reflection of food preferences, thus giving further insight into the young person’s understanding of the Talking Mats process. 

Adaptations: 

The support team had access to a Braille machine which meant that a Braille sticker could be added to each laminated symbol card in the Talking Mat. Having both Braille and symbols on the cards meant that the Talking Mat was meaningful to the thinker and the thinker’s network, as a photo could still be taken as a record and to allow any actions to be followed up.  

As usual, the listener handed the card to the thinker which allowed them to read the Braille.  

• After reading each option card, the thinker then passed the card back to the listener and told the listener where to place each one under the top scale.  

• At the end, the listener asked the thinker if they would like to read the Braille on all the cards again as part of the review and reflect. The thinker did not wish to do this, so the listener verbally reviewed the Talking Mat for the thinker.  

We considered the alternative approach of guiding the thinker’s hand across the top scale allowing them to read the Braille after having read the Braille on each option card.  The thinker could then have placed each option card under the top scale with some hand over hand guidance, but this was decided against due to the increased physicality and cognitive load of this additional action for the thinker.  

Reflections: 

When the Talking Mat was initially discussed the young person expressed curiosity about what it was and how it worked.  Throughout the session they appeared to feel involved, enjoying the tactile and interactive nature of the Talking Mat process, increasing engagement with the process. 

The Talking Mat helped the thinker to share their views on a wider variety and greater number of options than what would have been possible in a verbal conversation on the same topic. The Talking Mat also facilitated a more structured, empowering and accessible interaction for the thinker and created the time and space for them to share their views.   

Now that this trial Braille Talking Mat has demonstrated that the thinker can engage in the Talking Mat process from start to finish and that they seemed to enjoy sharing their views using this tool, in future further Talking Mats could be used to help the thinker share their views on more abstract, emotive topics.   

Overall, this project has shown that a Braille version of a Talking Mat can successfully support people who have a visual impairment to share their views. 

If you would like to find out more please contact us on info@talkingmats.com and questions can be passed onto Olivia.

Licenced Trainer and co-developer of the Funeral Planning Resource, Gillian Robertson is running Talking Mats Foundaion Training with specific sessions relating to the Resource. To reflect the working hours that practitioners interested in this may we are offering these sessions outside the 9am-5pm ‘norm’.

1. Live video link (Teams) over 4 sessions, from 7pm until 8.30pm. 16th October, 23rd October, 13th November and 4th December (all sessions must be attended). 16 places available
2. Face to face training at our headquarters in Stirling. 2 half day sessions, 7th February 2024 and 6th March 2024 (both sessions must be attended). 8 places available.

Gillian Robertson, an Interfaith Celebrant with a background in Special Education, instigated and drove this project with funding from the Big Lottery Awards for All.  In a previous blog she describes her motivation and the early stages of the project.

Here’s a bit more information on the topics and who might use them. 

Funeral planning – this topic supports the initial conversation in planning a funeral leading to decisions about what someone would or would not like.  It is particularly useful when planning for the future but can also be used by a celebrant / religious leader or funeral director to discuss what the family want for their loved one after a death has occurred.

Funeral Service – this topic supports the conversation which would follow on from Funeral Planning, leading to decisions about what someone would like or not like for the actual funeral service. Recording the first mat on this topic is a useful tool to refer to as plans progress.  Who carries out this conversation depends on the context it is being used in.  For example, if planning the service of a family member who has recently died then this is a very helpful resource for the celebrant or religious leader.

Eulogy – This topic supports conversations which highlight the important themes that someone would want included in their Eulogy.  It is most useful when planning a service for someone who has recently died and relevant for the celebrant / religious leader to carry out when planning the service.  The testing phase also highlighted that this topic can be used as part of the grieving process in a reflective way to help someone with learning disabilities remember the person who has died.

At the close of the project, with the testing phases completed, Gillian reflected and summed up the importance of this resource beyond the planning of funerals. 

“The values behind Talking Mats are about making sure that everyone has a voice.  If we deny people the ability to be heard, we deny them their human rights.  When people’s voices are heard, improvements in their lives can be made.”

Foundation Training based on the resource is now available to book. There is a 20% discount if you attended the launch seminar and have the code to use at the shop checkout.

Walking Back to Happiness.

We may not be able to guarantee happiness but our friend and advocate, Karen Mellon is running a further training on our Foot Care resource and that is definitely something to sing about!

Developed late 2021 and launched in 2022 the Foundation Training with the Foot Care resource was so popular we are running it again. The resource was developed in collaboration with Karen and her team at NHS Fife Podiatry but it is aimed at anyone for whom footcare is part of their role. The College of Podiatry recently published figures on costs to the NHS in England and diabetic foot care alone cost £1 – £1.2billion per year. Supporting patients to communicate health issues around their feet is one step towards ensuring they access the right care at the right time.

Karen recently presented to the Allied Health Professional’s Dementia webinar describing the resource from development to practise. You can view the presentation here, and read her blog from 2021 here.

The training is delivered on Teams in 2 sessions – January 24th 2024 and February 21st. Both sessions run from 9.20am – 12.30pm and both must be attended. The cost is £210 and this includes a copy of the Foot Care resource.

We have an exciting opportunity for a Development Associate to join Talking Mats Ltd.

Talking Mats Ltd is an award-winning social enterprise which originally developed from research at Stirling University and now has an international reach. We were delighted to receive a SMART award for research and innovation which allows us to embrace future technologies and Artificial Intelligence to enhance and develop our communication framework. We want to build a proof-of-concept system that can track user behaviour from both the Talking Mats app and video recordings and use data to automatically detect interactions that require the skill of a trained observer. This will be done using a combination of computer vision and machine learning algorithms.

We will also build the Data platform and Architecture on to our existing technology to allow TM Ltd to create new Data Services. These will provide key insights to support individuals and services by assessing organisational performance, identifying trends and risk factors. We want to be able to measure the quality of the input to maximise independent views. The successful candidate will understand the impact of communication impairment and have a track record of carrying out research. You will work collaboratively with the research team including, Dr Kevin Swingler, Head of Mathematical Science, University of Stirling and Dr Jill Bradshaw, University of Kent conducting qualitative and quantitative research. You will also be committed to the vision of Talking Mats to improve the lives of people with communication difficulties.

We are offering this position on a full time, fixed term basis until May 2023 but with the potential of joining our team in the longer term.

Closing date: 5pm Wednesday 11^th May 2022

Interview date: Monday 16th May 2022

To view this vacancy and read a full job description, please click here.

Our new digital platform with enhanced features

Talking mats have been researched and developed over a period of more than 20 years. Initially Talking Mats developed as a paper based communication framework but there was always much interest in having it as a digital resource so our first digital Talking Mats platform was released in 2012.  

In the years since its release the Talking Mats digital platform has helped thousands of people who otherwise would find it challenging to express how they feel, but with the discontinuation of Flash player the opportunity to create a new web-app presented itself. We are delighted to say that it is here! Combining it with the new website means that we are able to include many of the features that our customers have wanted, including the ability to:

• Add and save photos
• Personalise conversations by adding symbols from other sets
• Create and save your own personalised mats ( provided you are foundation trained )
• Think through and order your Talking Mats conversation
• Change and select an appropriate Top Scale
• File your thinker’s mat in an easy to retrieve manner
• Easily carry out remote Talking Mats conversations

Our Digital Support Officer, Mark, is here to take you through the headlines of the new app, as well as some useful information for existing users.

In a nutshell

The new Digital Talking Mats (DTM) is a subscription-based web app which is access via our new look website www.talkingmats.com. It contains all the Talking Mats resources currently available to purchase to ensure that it can be used in as many different contexts to help as many different people as possible.

The subscriptions

We wanted to ensure that there was a DTM subscription for everyone. To that end, there are three different levels of individual subscription (starter, enhanced, complete) which can be renewed on a monthly or annual basis. There is also a licence specifically for organisations which offers the chance to have multiple users tied to an organisation, all at ‘complete’ level.

Once you have signed up for a subscription, you can easily see the details in the ‘subscriptions’ section of your account.

Existing Digital Talking Mats customers

If you had access to version 1 of the digital Talking Mats please keep an eye on your inbox as you will be getting an email giving you access to the new version . If you do not receive such an email please get In touch with us.

App Features and How to Use Them

Once you have subscribed and accessed the app, there is immediately a helpful video which tells you all you need to know about how to use the app. This includes setting up a new thinker, creating a new Talking Mat with the symbols of your choice, and how to view snapshots of previous sessions you have carried out.

Technical Tips

Browsers

All browsers are equal, but some are more equal than others. Our app is optimised for Google Chrome, but will also work on Firefox and Microsoft Edge. Internet explorer is not supported. It is a good idea to make sure your browser is as up to date as possible for the best user experience. Mor detailed information on browser compatibility is available here

Offline Functionality

We recognise that internet is not always available in homes, schools or many other places, and so it is very important to us that the app works offline. Unfortunately due to the fact it is till relatively fresh, the app will not work offline yet, but rest assured this feature is in the pipeline. One option in the meantime is to use a device that can hotspot (most smartphones will have this feature) and carry out a Talking Mat online.

App Navigation

When you are navigating from page to page in the app, it is actually creating overlays on a single web page. This means that when you are in the app, if you press the ‘back’ button on your browser, it will take you out of the app completely.

If you have any questions about the Digital Talking Mats platform or you are interested in learning more, you can get I touch with Mark at mark@talkingmats.com.

On Wednesday November 10^th we held a colloquium with the University of Edinburgh and NHS fife to report on the findings of the research that was funded with the Burdett foundation . The easy-read version of this report can be found here.

48 people attended the online event on Wednesday and engaged in some very thoughtful discussion and reflection on communication in forensic settings. There was much to think about including whether ethos and values align with self-determination , how to get communication taken seriously by staff who are often under huge pressure. Consideration of  where power lies in an organisation and an acknowledgment that  in order to share power staff themselves need to feel they have power.

The recognition that in the promotion of shared decision making, you increase the risk of people taking what others may see as unwise decisions. The need to support the capacity of people to be involved in decision making early on and in the smaller decisions of life and not leaving including them to a crisis.

The importance of further research in his area and that small clinically driven research projects have an important role to play in addition to ones funded by bigger grants. There is much to digest and we are hoping to keep the conversation going.

If you would like to see for yourself the research presented and the topics discussed at the colloquium you can watch the recording of the Zoom session here.

If you want to attend foundation Talking Mats training please find out more here. if you have completed your foundation training please consider attending the Keeping Safe advanced online module which includes the Keeping Safe resource . If you have the Keeping Safe resource please download the new Being Included bolt on to use with it.

Many thanks to Natalie Paris, CashBack 180 Project Lead for our latest guest blog.  Natalie shares some powerful examples of how Talking Mats has helped her to open up conversations with the young people she works with:

I joined Y2K Mayfield and Easthouses Youth 2000 Project  in February 2018 as a sessional worker looking to gain practical experience in youth work, I then became Part Time Young Women’s worker at Y2K, which gave me experience in working with vulnerable young women in Midlothian across an age range of 11 to 24, some with mild to moderate learning difficulties.  When I first heard about the 180 project, I knew it was something I really wanted to be involved with, as I have always been interested in Criminology and Youth Offending.

In September 2018 I became the full-time 180 Project Lead, and have helped to shape and develop our  CashBack 180 Project. CashBack 180 is a referral-based service, focusing on early support and prevention for young people involved in or at risk of becoming involved in offending, anti-social and risky behaviours. 

The Project:

We work with young people to make positive changes in order to work towards more positive futures. Young people accessing this service have the opportunity to take part in fun, participative and educational programmes of activities as well as 1:1 supports. The CashBack180 programme is delivered at Y2K, but we can also deliver programmes within High Schools.

CashBack 180 offers a menu of options and has adapted where necessary for our journey through the pandemic.

• 1:1 supports
• Groupwork programmes
• Community outreach support through detached youth work

Case Example 1:

A 12-year-old girl had been referred to me for violence, as she had attacked a girl in the playground, which was out of character for her.  She was very uncomfortable in the 1 to 1 session, so I used a Talking Mat. This made the conversation flow more naturally.

I used the Relationships topic, with the top scale ‘going well/okay/not going well’.  This helped me get more information. I found out that most of the issues she was having were around peer relationships.  For example, friends saying things that weren’t true, and not being believed by others in her friendship group.  This allowed me to plan a session around what is healthy and unhealthy in friendships.

Case Example 2:

I was working with a 14-year-old care experienced boy, who had been referred to me for Anti-social behaviour, and because he was easily led.  Once I got to know this boy a little better, I realised that he did not have much support within his family, apart from his older brother who he lives with now.  I realised he was someone who had just learned to cope himself, and probably didn’t have many people to turn to when worried about things.  I thought coping would be a good topic for a Talking Mat, as he always said things were fine, but I didn’t feel it was the full truth.  I used the top scale ‘going well/okay/not going well’. This gave us the opportunity to discuss healthy and unhealthy coping mechanisms that he had and what he could do instead.

Case Example 3:

I was working with a 12-year-old care experienced boy, who had been referred to me due to his inappropriate sexualised language and reference to sexual experience.  He has been out Mainstream school for 1 year, so had missed P7 sex education.  I decided to start working on friendships and relationships over the first couple of weeks with him, to get an understanding of what he knew was acceptable in relationships.  I used the Relationships Topic with the top scale ‘Going well/Okay/Not going well’.  The Talking Mat helped me keep his attention for a little longer than usual, as he is a very chaotic young person and often gets up and walks about, or jumps on tables and pretends to be sleeping.  It also showed me that he felt quite happy but was missing his friends from where he used to live. We are now looking at ways to address this.

Follow this link to Find out more about this project:

180 Service – Mayfield and Easthouses Youth 2000 Project

If you are feeling inspired and would like to know how you can access Talking Mats training, find out more here: https://www.talkingmats.com/training/

We are delighted to share this latest guest blog from Debbie Mole, Clinical Nurse Consultant in Mental Health and Intellectual Disability for DHM Mental Health Care in Melbourne, Australia.  This is a great example of the positive impact Talking Mats can have for people who have experienced trauma.

Throughout my 35 year career I have always had a big interest in finding ways to help clients express themselves. My passion is around trauma and working in creative ways to help bring some closure and recovery for the person.

This desire grew when I met a woman who had multiple disabilities. She was blind, deaf, and non-verbal. She was sensitive to touch and had very few ways to express herself. She needed to be admitted to hospital as she was unwell, we had no way to explain to her what was happening. At the time I was working in a new specialised mental health and disability team. This humbling experience of working with her pathed a way for me to find ways to help people communicate and understand.

Working in mental health I am acutely aware of risks and that so many people who struggle to verbalise thoughts, feelings, and past issues. I was always concerned that because a person could not verbalise their thoughts, feelings, and intentions that so much information and potential risks were being missed.

I heard about Talking Mats training in Australia and booked myself on the course. This inspired me and has helped me support clients to find a voice and solutions to issues.

My client was a 30-year man with Down Syndrome, he also has ASD and over the last five years had lost his ability to speak. When I met him, he had poor eye contact and appeared to be locked into his world. It was evident he was also suffering from psychosis as he was responding to auditory and possibly visual hallucinations. He could use some sign language to communicate. He had chronic OCD and anxiety and sleep was a major issue.

I did a Talking Mat exercise and checked his understanding of “like”, “don’t like” and “not sure”. I did a simple exercise to start using the images for his family and carers. There was no real form and the cards appeared to become a collection of images that did not hold any clues.

I decided to use to the personal care cards, this was very different. Showering, bathing, and going to the toilet were placed in the negative area. There was also a change of behaviour and some vocalisation of words that made no sense. Talking to his team and mother, there was a restive quality to his behaviour – he wanted to avoid this area.

I did further assessments and his mom believed that in the past when he was young, he may have experienced some bullying, she also feared that he had suffered some form of abuse. Through the assessment it also transpired that my client was one of five children, all had a significant mental health issue. I organised a specialist to see him and he was diagnosed with Schizophrenia. He was treated with antipsychotic medication.

As the psychosis was being treated his team became aware that my client was starting to talk, it was not clear, but the content had a theme. Tragically themes, names and places started to be spoken about. When he spoke about these events his OCD behaviours of arranging his items on the floor became more chaotic. He spoke of trauma from other boys that took place in bathrooms.

I worked with the client and introduced some basic trauma work, simply allowing him to say what he wanted to and then helping him to realise that he was safe and that was the past. His team did the same. We offered choice about showering, bathing and looked at ways it could be fun or a nice activity to follow. The idea was to change his thinking around baths and showers and for him to realise he was safe and free from threat. We used the talking mats to build upon the things he liked.

I repeated the Talking Mats exercises three, six, nine and twelve months after treatment.

After the psychosis was treated, we became aware that the client looked sad and flat. There was a loss of interest in social activities and there was a lot of talk about the past. We assessed that he was depressed and that it was possible that his recall about the past was becoming clearer. He was commenced on an antidepressant and monitored intensely. We also needed to address the sleep issues. His OCD had led to his bed to being covered in items. We later realised that this helped reduce his anxiety when he was heightened.

My client has regained some speech, I believe he was locked in a world of trauma and psychosis. Now he mentions the names of some of the people who have hurt him. His team reassure him that he is safe, that was the past, and he is ok. He seeks physical attention when he distressed, and he is acknowledged and reassured. We cannot offer typical trauma therapy to him, but just helping him unlock his thoughts, knowing that what was happened was wrong and being heard is healing.

I have since developed my own set of cards, based on the Mental State Examination. I use these to expand on issues and focus on problem areas. These cards talk about perceptual issues, thought problems, beliefs and risks, all areas that are typically private and too often unexplored. The cards have images on them, so clients who struggle to verbalise can use the same system as the talking mats.

Talking Mats allowed me and his team to see things from a different angle. There were many hypotheses used to gain an understanding of his behaviour. This led to effective treatment and partial recovery.

Picture 1 at the assessment stage, images of the clients family were made into an orderly collection with no clear indication of how he felt towards the images:

Picture 2 was also at assessment, showing a clear ability to like, not like and feel unsure about aspects of self care.

Picture 3 was during treatment for Psychosis and therapy – some changes were being noted with his self care and allowing his team to help him:

Picture 4 was towards the end of treatment and intensive therapy. Some aspects of bathing remained unsure, but his behaviour indicated that he was more comfortable with activities around bathing.

Picture 5 was a repeat of the family cards after treatment:

Picture 6 are the cards I have created based on the Mental State Examination – this was six months into therapy and medication. He expressed issues around his mood, thoughts and sleep – these needed more explaining. With the mood pictures, I offered my client different images for mood and he picked the ones that reflected what he was feeling. My mood collection has happy, angry, scared and sad in them as I tend to quote these 4 basic raw emotions daily in my work:

Picture 7 was at the end of treatment the same cards were used with a very different result. As for the previous mat, for the mood pictures, I offered my client different images for mood and he picked the ones that reflected what he was feeling:

Many thanks to Debbie Mole for sharing this powerful example.  If you would like to read more about Talking Mats use in Mental Health, take a look at top 10 blogs here:   https://www.talkingmats.com/top_10_mental_health/

If you are feeling inspired and have not yet accessed our Talking Mats Foundation Training Course, find out more here: