Category Archives: Communication difficulties

Talking Mats and Supported Decision Making

being_involved_in_decisions

 

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.

SDM picture

 

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

 

 

 

 

Talking Mats in Cyprus – Another pin in the map

Cyprus map

 

Many thanks to our Talking Mats Founder, Dr Joan Murphy, for this latest blog talking about the training course she recently delivered at the Cyprus University of Technology.

Cyprus is a beautiful Mediterranean island with a population of approximately 1 million.

I was invited by Dr Eliada Pampoulou to run a 2-day course on Talking Mats for 12 Speech and Language Therapists, some of whom are masters students and some, lecturing staff at the Cyprus University of Technology. The Cyprus University of Technology founded the first Department of Rehabilitation Sciences  in Cyprus and the Department offers the first public recognised university bachelor degree in Speech Language Therapy / Speech Language Pathology in the Greek language (https://www.cut.ac.cy/faculties/hsc/reh/).

Day 1 was a Talking Mats foundation training course and Day 2 focused on discussion around capacity, research and clinical applications. This model worked very well as the participants were able to think about and discuss how to apply the training immediately.

Cyprus 1

Some of the immediate plans of the participants were both clinical and research oriented and are outlined below:

  • To administer the Greek Stroke and Aphasia Quality of Life Scale (SAQOL-39) with healthy people over  50 both with the text version and an adapted Talking Mats version quality and to examine which they prefer.
  •  To use Talking Mats both with people with people with aphasia and their carers in order to share their understanding about  the communication skills and needs of people with aphasia.
  •  To use Talking Mats as a tool to identify the factors that are related to AAC system acceptance or abandonment by focusing directly to the views of people with complex communication needs
  • To use Talking Mats as a goal setting tool for both paediatric and adult population
  • To use Talking Mats to gets clients feedback about therapy services
  • To use Talking Mats for student appraisals regarding their clinical training

Cyprus 2

 

Dr Eliada Pampoulou has created the first Talking Mats centre in  Cyprus which aims to gather all people who received training every few months to share their experiences and support each other to embed Talking Mats in practice and research.

We hope that Eliada will come to Stirling next year to gain her Talking Mats licence to enable her to train others and extend the reach of Talking Mats even further.

We regularly run our Licensed Trainer 2-day courses at our base in Stirling – if you have attended Talking Mats Foundation Training and would like to train other people find out more here:

https://www.talkingmats.com/training/train-the-trainers-accredited-training/

 

 

 

 

When Supported People can Help Others Improve their Support

Charter for Involvement symbol

NIN blog 2

Many thanks to Paddy Carstairs, Development Worker (NIN) at ARC Scotland, for this guest blog describing the recent Talking Mats ‘Charter for Involvement’ project.

 

The National Involvement Network (NIN) is a large group of people who get support from different organisations across Scotland. Members meet to share ideas and experiences of being involved in things that affect their lives. In 2015 NIN published the Charter for Involvement. The Charter explains in their own words how people want to be more involved in:

  • the support they receive
  • the organisations that support them
  • the wider community

 

Organisations are invited to sign up to the Charter. This means making a commitment to put the Charter into practice. At time of writing 81 organisations, including 7 H&SCPs have done so.

 

NIN members wanted to make sure that more people could engage with the Charter. In particular it wanted to help people express their views on living independently and taking part in their communities.

NIN drawing

 

In partnership with Talking Mats and ARC Scotland eight NIN members trained in how to use a Talking Mat. They then created and designed a Talking Mat for the Charter for Involvement, using images that featured in the Charter. The theme was “Taking Part” and came in two stages, firstly using concrete images and then more abstract ones. A film was made to record the experience of NIN members developing and trying out the new tool.

NIN mat picture

With the help of the organisations that support them, NIN members piloted the new Charter Talking Mat and conducted 60 interviews with supported people. This helped everyone learn about what worked well and not so well, and changes were able to be made.

Charter example mat 1

Charter example mat 2

Just as importantly, it showed that people who get support were able to use a Talking Mat to help other supported people make changes and improve the support they receive. NIN members found that when thinkers gave a card the thumbs down, as listeners they were able to support people to seek changes to their support that they wanted, or pass on information that would help improve their lives. Some thinkers said they felt more comfortable doing the Talking Mat with another person who gets support.

These experiences have been recorded in a film called Talking Mats Stories. In it NIN members describe the impact the Charter Talking Mat has had, the changes that were made possible to enable people do things they wanted, and the confidence and satisfaction they drew from being able to help other supported people.

Talking Mats Stories can be viewed at https://www.youtube.com/watch?v=1aer7v4fyFU&t=3s

Or by visiting the NIN page on the ARC Scotland website – https://arcscotland.org.uk/involvement/national-involvement-network/

Talking Mats Stories was produced by Media Education

 

Organisations that supported NIN members to produce the Charter Talking Mats were: the Action Group, Hansel, Turning Point Scotland, Cornerstone, Streets Ahead Borders, the Redwoods Caring Foundation and Hillcrest Futures (formerly Gowrie Care)

Paddy Carstairs

Development Worker (NIN)

ARC Scotland

 

If you are interested in finding out about Talking Mats Projects check out this link  – https://www.talkingmats.com/projects/

And do get in touch if you’d like to discuss any potential projects – we would love to hear from you!

 

Supporting Communication – Secondary-Aged Pupils with SEBN

COMMUNICATION

Many thanks to Lynn Blair, SLT (NHS North Lanarkshire) for writing this guest blog describing a recent project in which she and her colleagues used Talking Mats to gather the thoughts of secondary-aged pupils with social, emotional and behavioural support needs:

Do you remember your school janitor? Was he/she a cheery soul who you enjoyed talking to?  Perhaps there was another member of school staff who you trusted and felt you could chat with.  Secondary school can be a challenging environment for any teenager, let alone those who have speech, language and communication needs (SLCN).  Young people need adults in their lives who they can feel at ease talking with.

The purpose of our recent project (See Lanarkshire SLT SEBN Poster 2019 and Lanarkshire SEBN Project Summary) was twofold.  Firstly we wanted to find out how many of the young people in our local secondary schools for pupils with social, emotional and behavioural needs (SEBN) had language and communication difficulties.  We also wanted to hear about the impact of those support needs by gathering the thoughts of the pupils themselves and that’s the focus of this blog.

We have to admit we were a bit anxious before we met with the pupils.  Would these young men and women even give us the time of day with our friendly faces, mats and pictures? In the actual event, for the most part the tool was met with curiosity and then full engagement.  The young people quickly grasped the idea.  Some did not speak at all as they placed the images and others used the opportunity to tell us a great deal about how they felt about talking to different people in their lives and in different settings.

The information that we gathered is now being used to plan evidence-based speech and language therapy services to the school and young people.  The use of Talking Mats gave us interesting information like the fact young people felt auxiliary staff such as janitors and assistants are often easier to talk with than teachers and as a result, we are thinking about how we involve all school staff in future events.

Support people

We are only too aware that the young people we met have often felt excluded from other people and from certain places.  Talking Mats gave them the opportunity to be heard and we’re excited to consider how we can use them in the next phase of our work to support their communication needs.

 

If you are feeling inspired and would like to find out more about accessing Talking Mats Training – check out this link here: https://www.talkingmats.com/training/

 

How Talking Mats Makes a Difference in a Forensic LD Setting

talking about myself

Many thanks to Susan Gowland, SLT at NHS Fife Forensic Learning Disability Service, for this guest blog summarising the fantastic presentation she delivered at our TM is 21 event in August 2019.

 

As a speech and language therapist within NHS Fife’s forensic learning disability service, I work across two low secure wards. In my presentation for the “Talking Mats is 21 event”  I talked about the way in which Talking Mats is used within these wards and the positive impact this has had for staff and patients.

Regular Check In: “it’s the same questions, but it’s easier to talk with the pictures”

Some of the people I work with use Talking Mats as a regular check in tool. Conversations are often based around the Wellbeing, Relationships and Thoughts and Feelings cards of the Keeping Safe resource, with personalised adaptations agreed with the thinker. Some people who find it difficult to express how they are feeling and irritations can either build up to a serious incident or the person can get weighted down by unexpressed needs and concerns. For these people a regular check in can address the small things before they become big things. This can help the thinker feel listened and responded to, build experiences of communicating effectively, as well as trust and therapeutic relationships, all of which are assets which will support the person to move on.

Self Reporting: “It helps me understand how I’m feeling about things”

For some people, the check in can have a specific focus. In a hospital based forensic service, unexpected and unrecognised changes in mental health can lead to serious incidents. To address this we have used Talking Mats to talk about mental health. SLT have worked with individuals, psychiatry & nursing to identify personal symptoms of mental health changes. These symptoms become options in the Talking Mat & can be used to support person to self report at the times their mental health changes. Being able to do this enables people to discuss the support they need & reduce the risk of out of the blue incidents. The Talking Mat itself can be a support. As one thinker said, “Talking Mats relaxes you, it calms you down”.

 As and when required:

The regular use of Talking Mats on the ward has led to other patients asking for Talking Mats sessions. As a licensed trainer I offer training to all professionals within our multi-disciplinary team and there is often at least one Talking Mats trained nurse on shift. This means ad hoc requests can be facilitated and some thinkers have started using Talking Mats in weekly meetings; as a tool to talk through emotional events and as a way of exploring the mixed emotions around discharge. In the words of one of the charge nurses:

“Talking Mats has enabled me to communicate with people in a way that is meaningful. To support someone to express and understand their thoughts and feelings regarding both joyous and distressing events is a privilege. The format may be simple, but the outcome is often comprehensive and insightful.”

Fife SLT blog pic 2 - Copy

 (Picture drawn by Fiona Glanville, staff nurse, NHS Fife)

 

If you would like to find out more about accessing Talking Mats training, check out this link:

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

 If you are interested in our Keeping Safe resource mentioned here (available to those who have accessed our Foundation Training / Online Training Course) please see these links for more details:

https://www.talkingmats.com/keeping-safe-a-new-talking-mats-resource-available-to-purchase/ 

 https://www.talkingmats.com/product/keeping-safe/