Category Archives: Learning disability

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

 

 

 

 

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!

 

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/

 

 

 

Supporting Children to Understand Hospital Procedures

Video blog 3

Many thanks to Marit Boot, founder of the charity What? Why? Children in Hospital for this guest blog sharing information about the fantastic family-friendly videos they make to help children understand hospital procedures.

video blog 2

As a mum, I know the worry when your child is ill and needs tests in hospital. It’s the not knowing what is wrong, understanding all the different tests and how to explain them to your child. That’s why I founded the What? Why? Children in Hospital charity to make family-friendly videos about hospital. So when we make a new video explaining a procedure in an easy to understand way, it’s the reaction from parents that makes it worthwhile. The relief, that they now have an idea of what will happen and that they can share the video with their child, it makes their preparation much easier. I want to share with you the story of one of the mums in our latest video. Louise talked to us about Rocco’s gastrostomy feeding tube operation.

“We didn’t have anything like the videos WWCIH make when Rocco first had the gastrostomy surgery. Being a parent in that position is daunting. You want to do what’s right for your child but there’s so much to take in. It isn’t always easy to remember what you’re told in the doctor’s office. So when we had the opportunity to help other worried parents and children by making this video, we jumped at it.”

Thousands of children go through a gastrostomy procedure in Scotland every year. It’s a major procedure and can be a complex idea to communicate to children and anxious parents. In the videos, medical specialists talk through how a gastrostomy feeding tube works, how the procedure is done and how parents should look after the feeding tube at home.

Video blog 1

 The videos are absolutely fantastic! With 32 doctors, nurses and specialists helping to deal with my son’s complex needs, it can be overwhelming to take in information they give to us. These videos are amazing for parents to find out information when they’re ready to absorb it. Even if that’s when you finally get to sit down at 2am.Gastrostomy is major surgery and we had to weigh the risks against the benefits for Rocco’s life. There was so much to take in, about the operation, the aftercare. At one point the doctor used a teddy to show how the tube worked – it was useful but didn’t give the full picture. The videos What? Why? have made cover what you need to know in a calm, thoughtful way. They will be a huge help to worried parents and will help them explain to their child what will happen and why. They should make as many videos as possible!”

 We have 55 videos on our YouTube channel about tests such as MRI, CT, ECG, ultrasounds, allergy tests, breathing tests and sleep studies and we are always making new ones. They’re made in partnership with children’s hospitals in Scotland and are suitable for school-aged children, children with learning difficulties and autism as well as parents and carers from all cultural backgrounds and literacy levels. The videos have already been viewed by 2.8 million families across the world.

If you know a parent or carer who’s worried about their child going to hospital send them to our YouTube page (WWCIH charity), Facebook page (@wwcih) or our website: www.wwcih.org.uk

And if there’s a procedure you think we should look at next, get in touch! We’re here to help children and parents just like you!

info@wwcih.org.uk

Marit Boot, Founder What? Why? Children in Hospital, July 2019

 

Amazing Talking Mats is 21 day !

Talking Mats is 21

What an amazing day we had celebrating 21 years since the first article about Talking Mats was published in August 1998 in the Communication Matters journal. Over 180 people attended from so many different walks of life. We are grateful to them all for coming and helping us mark the occasion. We are also grateful to the endowment fund of Forth Valley NHS for helping us fund the event.

In the morning thanks to a fantastic group of speakers we discussed a diverse range of topics:

  • Rachel Woolcomb, our OT associate explored how she sees Talking Mats as an ‘energy efficient’ thinking tool and outlined how it supports people to think through issues Talking Mats as a Thinking Toolrachel
  • Two teachers, Fiona Graham and Claire Forgan examined the benefits and challenges of embedding Talking Mats in school to encourage and extend pupil participation
  • Susan Gowland, a speech and language therapist discussed the use of Talking Mats in a forensic setting illustrating from a case example how Talking Mats helped staff see that incidents do not come out of the blue. When they looked at the pattern of mats over time they could see when the patient was expressing concern about small things. This was an indication that bigger things were going on for him.
  • Sally Boa the Research Manager for Strathcarron Hospice led on how Talking Mats was a way to enable ‘end of life’ conversations, things that can be hard for any of us to talk about. The mats give a safe space and structure to enable these conversations to take place. Talking Mats and Palliative care
  • Two parents Tracey Campbell and Sarah Robertson spoke about their experience with using Talking Mats with their children. Sarah said ‘Talking Mats gives us a happier home. It helps me be patient, listen and give power to him’ (her son). Talking Mat A Parents View 15.08.19
  • Jill Bradshaw of the Tizard Centre, University of Kent outlined her research including her work exploring Talking Mats as a tool to sit beside functional analysis of behaviour where the person’s own view of what challenges and helps them is often overlooked and not included fully.
  • Anne Lafferty of The Advocacy Project , give a powerful example of using Talking Mats in a legal setting. This important work is in need of funding so we can explore this more fully. Everyone also got to play legislation bingo!  Talking Mats and Supported Decision Making PP 2
  •  Liz Taylor (Talking Mats licensed trainer) and Lynnette Linton (Talking mats co-trainer) from The Action Group shared their experience in a fantastic film.  They used a Talking Mat to reflect on the experience and would recommend co-training as an effective way to deliver the Foundation course.
  • Brian Robertson and Paddy Carstairs described how they developed a Talking Mats to allow members of the National Involvement Network to explore with other people with a learning disability how The Charter for Involvement related to their life experience.This is an empowering way of using Talking Mats that shows that people who get support can help change and improve the support of other supported people.This is an empowering way of using Talking Mats that shows that people who get support can help change and improve the support of other supported people.
  • Rosie Noyce from Pennine Care NHS described a whole team approach to supporting Healthy Young Minds and how they have embedded Talking Mats into their care pathway. She cited powerful case examples of impact and a real commitment by the team to hear the voices of young people  Talking Mats and Young People’s Mental Health

And that was just the morning! Lots of delegates have asked for copies of the presentations so watch this space

The afternoon demonstrated just how far Talking Mats has come through its partnerships with other organisations. We are so grateful to all the people who came and had stalls and engaged with our networking activities! There was a real buzz in the room as people explored the variety of ways in which Talking Mats is used to support and enable more effective communication. Lots of connections were being made, people thinking about new ways of working and applying Talking Mats in their settings. People enjoyed seeing old friends but was good to see new networks were being built.

So, thank you Care Opinion, Turning Point Scotland, The Action Group, Capability Scotland, The CALL Centre, The Indigo Group, The National Involvement Network, Forth Valley NHS, The Stirling University Careers Service and Alzheimer Scotland. In addition, Talking Mats had a stand with all its products. Also, to promote our Birthday offer since we are 21, we have a 2 for 1 offer on resources for 21 days so order quickly. It ends on the 5th of September!

Today was also the day that Joan marked her ‘retirement’. gregShe gave a very moving speech that celebrated her distinguished career and her very significant achievements. She leaves an amazing legacy in the Talking Mats framework and with all the energy in the room we are sure it will continue to grow and develop. Thank you, Joan.