Thanks so much to all the practitioners who have sent us guest blogs about using Talking Mat in a Criminal Justice setting. Here are our top 5 – in no particular order!

1. Supporting Families in the Criminal Justice System: Sally Kedge, Speech and Language Therapist from Trouble Talking New Zealand shares two powerful case examples of using Talking Mats with children and families caught up in the criminal justice system. https://www.talkingmats.com/support-for-prisoners-families-experience-from-new-zealand/

2. Communication Needs within Youth Justice – Part 1: On 17^th April 2017, we organised a seminar to look at underlying issues and share good practice when addressing the communication needs of people in youth justice. We had representatives from: the Scottish government, the NHS; Third sector organisations working in youth justice, the police, social workers, professional bodies, universities and social work – from as far afield as New Zealand. The emphasis from the start was that understanding communication is key to improving service delivery. https://www.talkingmats.com/communication-needs-in-youth-justice/

3. Communication Needs within Youth Justice – Part 2: The afternoon session of our seminar on 17.04.17 continued the underlying theme that communication support needs are often hidden and many looked after children have support needs that remain unidentified. The outcome of the day was the establishment of a collaborative network. https://www.talkingmats.com/youth-justice-and-communication-needs-2/

4. Setting up a SLT Service in Prison: This inspiring blog by Jacqui Learoyd explores her role in setting up a speech and language therapy ( SLT )  service in a prison and her use of Talking Mats in that setting https://www.talkingmats.com/setting-up-an-slt-service-in-prison/

5. Has Talking Mats been used in Court? Two registered intermediaries talk about a couple of cases where Talking Mats was used as part of the achieving best evidence (ABE) interviews. https://www.talkingmats.com/talking-mats-used-court/

If you have been inspired and are not yet trained, come along to one of our Foundation training courses – for details see https://www.talkingmats.com/training/foundation-training/

We also offer online training if you are unable to access the training locations – for details see https://www.talkingmats.com/training/online-training/

  Improving communication with board games

Thanks to Karen MacKay from Focus Games for this new guest blog.

 Playing board games can deliver more benefits than just having fun with friends and family. In the workplace they help people to learn, collaborate and communicate, while they are having fun:

1. Breaking the ice

Ever attended an event or meeting where you didn’t know anyone? A board game helps everyone to become involved, talking and interacting, with each other – who doesn’t feel more comfortable, relaxed and happy to chat after playing a game together?

2. Learning through play

We learn through play when we are children, and it works just as well for adults too. Educational board games are a great way to learn from others, share experiences, ideas and gather new knowledge from the game itself. Plus you’ll be having fun – what’s not to love?

3. Developing social skills

Playing board games helps children learn to share, take turns, be a gracious loser and, for shyer children, to come out of their shell more. As adults, we continue to refine our social skills through games. They promote collaboration, communication, and teamwork, useful skills for us all!

 If you like the idea of improving your communication skills using a board game, The Communication Game is your ideal tool. Effective communication allows everyone the opportunity to express themselves clearly. In health and social care, effective communication is vital to ensure individuals receive safe and appropriate care.

For many people who have communication support needs, accessing health and social care and other public services is a challenge. We partnered with Talking Mats who worked with us and a group of people with communication support needs to develop and test The Communication Game. Initial development was funded by NHS Education For Scotland, and The Communication Game was born as an engaging way to help us all to reflect and develop our own and our teams communication, and thus improve the quality and safety of services.

The Communication Game is designed to help anyone working in health and social care to improve how they communicate, particularly with people who have communication support needs. Playing the game will help you think about the barriers to effective communication; and things you can do to ensure you communicate well with others. It is being used by many groups across the country including allied health professionals, nurses, charities, voluntary and community groups, nursing/care home staff and students studying nursing, speech and language therapy, social care and more.

The Communication Game uses questions to help build knowledge, scenarios to help you see the issues people face when communicating, and activities to help you practise different ways of communicating. It is a 1-hour training session for up to 10 people that you can use over, and over again with different groups.

The game is available from Focus Games and you can learn more and order at www.communicationgame.co.uk

Addressing the communication needs of people in youth justice is key to improving lives. The lack of attention to this is costly. On the 17^th of April, we organised a seminar to look at the underlying issues and share good practice.

We were delighted with the collaborative mix of people attending. We had representatives from: the Scottish government, the NHS; Third sector organisations working in youth justice, the police, social workers, professional bodies, universities and social work.

Our thanks to Professor Richard Simpson for chairing the day and setting the tone by emphasising from the start  that understanding communication is key to improving service delivery. Following his introduction a series of excellent and stimulating presentations took place creating a fusion of ideas and practice from Scotland and New Zealand.

• Kim Hartley Kean, head of the Royal College of Speech and language therapy  Scotland office highlighted the current position in Scotland
• Sally Kedge and Alayne Mckee described the approach adopted by their organisation Talking Trouble in New Zealand.
• Jane Macer the therapeutic service co-ordinator from Starley Hall Fife described an whole system approach to embedding good communication practice within an organisation
• Yvonne McKeown and Sandra Polding Speech and Language Therapists working with young people in a NHS inpatient psychiatric unit in Glasgow shared some case examples.

In different ways the speakers brought up very similar themes:

1. Communication can be treated glibly. There is a lack of understanding of what communication difficulties are and of the impact that they have on the lives of young people. These difficulties are often hidden and take time to identify. Lack of identification can have a huge impact on the future lives of young people.
2. Finding ways to hear the young person’s voice is key both for the young person but also for organisations in order to deliver appropriate and effective care.
3. Recognition of the intergenerational cycle and the importance of getting care and support correct so we break patterns and enable change.
4. Providing collaborative solutions and understanding the breadth of communication will help services improve. However, given services often don’t know what they don’t know in terms of the impact of communication difficulties we have to find ways to express those solutions in language that those services can relate to and understand. Listening to organisations and exploring their processes by analysing the communicative demands of each stage can be a helpful way to start.
5. Moving forward it is important to knock on open doors i.e. work with people who are receptive to recognising the impact of communication difficulties on young people and their lives but also find the strategic influencers who are sympathetic, in the words of our New Zealand colleagues ‘the aunts and uncles in the field’ who can help to promote the issue and raise awareness at a National level.
6. You can’t explore the issue of trauma and adverse childhood experiences without certain precursor, building blocks being in place. This takes time and requires a constancy of approach.
7. The importance of inclusive, visual tools becoming common place so that they are not used in isolation and in a vacuum.
8. The challenge of supporting and nurturing a young person’s inner voice when they have significant difficulties with language.
9. Lack of understanding of communication difficulties may lead to services responding to internalized behaviours that can lead to a fork in life; one way can send the young person down a route of offending behaviour services and the other mental health services.
10. The solutions lie in partnership and collaboration between professions and services.

There were lots of creative ways of using Talking Mats that were shared. A couple of examples that stand out were

• Using Talking Mats with social workers to help them unpick what they already know about a young person’s language and communication. This approach helped them think about all the different aspects that contribute to communication and where the young person’s strengths and weaknesses lay e.g. non verbal communication , humour , word finding , understanding complex information, understanding simple information etc .
• Using Talking Mats to support a psychiatric assessment of a young person. One person used his Talking Mat to say he was hearing voices something he was unable to disclose verbally. In this case this enabled an accurate mental state assessment and non-custodial sentence.

I will leave the last word to a young man living in an inpatient unit to support his mental health, his words about communication difficulties are ‘They make you more vulnerable when bad stuff happens’ how true that is and this is why it is important we work together to improve services .

Next steps The community justice network met in the afternoon and were challenged to think about the opportunities and barriers in developing services – read the for blog that covers the afternoon ……… If you missed the seminar and want to join a multiagency network to discuss this and help take this forward in Scotland then please let us know .

Click to read the excellent presentations from the seminar

• CJSCENTalkMatsPresentation170418
• Talking Mats presentation 17 April 2018 Sally Kedge Alayne McKee TTANZ final
• TM seminar 04-18
• Talking Mats & Justice CEN April 2018 Draft

This story, which highlights the importance of finding out what really matters to people, was shared by one of the staff attending the second day of an enhanced Talking Mats training course. She works in a NHS facility for people assessed as needing hospital-based continuing care.

I was working with Bill (not his real name) who is a man with severe cognitive impairment resulting from a head injury and stroke. He was very angry and agitated and we couldn’t work out what was wrong. At times he was physically aggressive when we couldn’t understand him.

One day he drew a picture of a rabbit and was very insistent about it but we didn’t know what it meant. We contacted his sister about him being angry about a rabbit. She asked around to other family members and friends but no one could think what it meant.

Bill continued to draw a rabbit and then other pictures including money and TV  so I made an improvised Talking Mat using his drawings as the options and began trying to find out what really mattered to him. I gradually connected that the TV was about about programme called Dickinson’s Real Deal (a TV programme about antiques) and that in the past Bill had had an ornament of a rabbit which he thought was worth a lot of money.

We phoned his sister again about a possible rabbit ornament and she then remembered that he had collected figurines in the past. She finally discovered the rabbit in her garage.

Once we were able to reassure Bill that his rabbit was safe his frustration lessened,he was much less angry and became more settled.

This lovely story shows us how important it is to never assume that someone is just ‘being difficult’  but that if we can try to find out what really matters to them we can make a huge difference to their lives and ours.

Huge thanks to all the practitioners who have sent us guest blogs. We selected our 10 favourite guest blogs…in no particular order!

1.  Talking Mats to support children who stammer Kirsten Taylor, Speech and Language Therapist tells a moving story about how finding out what was upsetting a boy with a stammer helped to implement change.
2. Hearing the voice of the child Emma Atkiss, Senior Educational Psychologist, shares her findings from the Wigan Pathfinder project reporting that using a Talking Mat helps to meet the 5 criteria of Shier’s model of participation.
3. Talking Mats for capacity assessments in people with ASD/LD Ruth Spilman, Senior SLT from The Cambian Group, shares practical tips on assessing capacity.
4. Castle hill school supports pupil voice Jenna McCammon, SLT and Rebecca Highton, SLT Assistant, tell 3 inspiring stories using TMs in: selective mutism; safeguarding and motivational interviewing.
5. Supporting Looked After Children to have their say Karen Wilson, Principal Teacher for children with additional support needs in a mainstream secondary school  shares her experience of using TMs to give young people a stronger voice in making decisions affecting them.
6. Hearing the voices of Looked After Children Rachel Clemow, Head Teacher and Donna Wood, Education Support Worker, report that Talking Mats has enabled children to express their thoughts and views in a safe, neutral environment.
7. Talking Mats and Mental Health  Carla Innes, Clinical Psychologist for learning disability from Healthy Young minds Stockport talks about the impact of TM training on the whole team.
8. Mummy I don’t want to go to nursery today read about how using a Talking Mat might shed some light on why a 4 year old was upset at the thought of going to nursery.
9. How do you feel about starting school? The story of 4 year old twins and their thoughts about starting school.
10. Sibling Attitudes Prof Juan Bornman from Pretoria in South Africa publishes a report on a study carried out with 27 typically developing children who have a younger sibling with a severe speech and language disability.

If you have been inspired and are not yet trained to use Talking Mats – come along to one of our training courses.

Five short stories from our recent accredited training course in Stirling.

1. A looked after child was unhappy but no one knew specifically why. Using the Talking Mats, she indicated that she was upset by the weekly phone call with her mother because it always happened when it was her playing time. The time of the call was moved to just before her bedtime but this resulted in bad dreams. The time of the call was finally moved to Saturday afternoon which helped her settle and reduced her distress.
2. Talking Mats was used with an Iraqi boy who had come to England via Libya, Italy and the jungle camp at Calais. When he picked the symbol of a waiting room he indicated that despite all she had been through he really liked this because it reminded him of all the children in his family and made him happy.
3. A 76-year-old man with a learning disability disclosed that he had been attacked and suffocated by his upstairs neighbour one week previously. It was only when he used the Talking Mats that he disclosed to anyone what had happened.
4. A lecturer usually used quantifying measuring with her students to find out how they were managing their studies. Instead she used Talking Mats to find out how they were coping with their work life balance. One student told her that she was managing fine except that her pet rabbits always escape under the bed and it takes her a long time to get them back out so she does not let them out very often!
5. Talking Mats was used with a man who had had a stroke and had to go into residential care because his family could no longer look after him. They were very worried that he was unhappy with the new care set up. He was able to show with the Talking Mats that he was happy about everything except that he was not given enough time when he went to the toilet. Once the staff realised this they then gave him more time which resolved the situation and reassured his family.

Please send us your Talking Mats stories – we love hearing them.

The Keeping Safe Talking Mat resource provides a structured framework to ask someone ’How’s your life going?  It has 3 topics: Your Well-being;  Relationships; Thoughts and Feelings

Do you find it difficult discussing feelings with people who have limited understanding?

Do you have limited time to discuss sensitive issues with people?

Do you want to find out any issues which may be slowing recovery or preventing someone moving forward in life?

A cost benefit analysis demonstrated that using the Keeping Safe resource to create a listening space for people to think and share how their lives are going, is cost effective for organisations.

The design of the resource is described in the Tizard Learning Disability Review More Than Pictures TLDR 2017

It has been trialled and tested with people with learning disabilities throughout Scotland, but has also been used effectively with a range of people who find it difficult to discuss their life e.g. Young people with mental health condition.

It  has been shown as a helpful way to

•      discuss new information (89%),
•      discuss and resolve fears (84%)
•      support thinking (89%)

This poster gives an overview of the project KS 2nd Poster (click to enlarge)

The Thoughts and Feelings topic uses a different top scale and this resource is best used by people who have completed Talking Mats Foundation Training.  If you want to buy it (£55.00 +VAT)  contact the office  www.talkingmats.com   tel. (+44) 01786 479511

Health professionals from Stockport have shared how using Talking Mats has positively impacted on their clinical work.

Laura, our North West  Associate, met up with Carla Innes, Clinical Psychologist for learning disability from Healthy Young minds Stockport (a child and adolescent mental health service provided by Pennine Care NHS Foundation Trust) and Clare Royle, Family Support Worker,from the Children’s Learning Disability Team (provided by Stockport NHS Foundation Trust). The two organisations work closely together to provide joined up care to young people with a learning disability.

Six months ago Carla, Clare and seven others from the Healthy Young Minds Stockport Team  received training to enable them to introduce Talking Mats as part of their challenging behaviour pathway.

Carla and Claire said that the staff team are very positive about the impact of Talking Mats. The overall impression is that Talking Mats has enabled staff to gain an individualised sense of the child or young person they are working with, as well as empowering the children and young people to share their views and opinions. Carla also notes that using Talking Mats has helped her to focus on the child/young person’s abilities/potential – their ‘zone of proximal development’ – and to ensure that everyone is working within that.
Some of the other positive features of using Talking Mats include:
– Providing ‘headspace’ for the child/young person to process their thoughts and to really consider what is important to them.
– Giving a holistic, child/YP centred account and narrative of their feelings and behaviour.
– Helping to inform and direct clinical decision making e.g. introduction of an approach such as CBT.
– Enabling children/young people who have previously refused, or been very reluctant, to share their views and opinions about topics which have been troubling them for example, school attendance and issues with sleep.
– Providing of a communication framework which is neutral and non-threatening – much less intense than direct verbal questioning or conversation.
– Helping to make abstract concepts more concrete for the listener to understand.
– Being a safe, flexible and quick method of finding practical solutions and determining direct actions.
– Enabling the listener to gain a better understanding of the thinker’s level of knowledge and understanding about a particular topic such as healthy eating. This can help inform capacity assessments e.g. in terms of medical consent or the use of medication. The mental capacity act states that appropriate support should be given to young people to make informed decisions and to communicate those decisions.
In addition, from a wider team perspective, Carla and Clare report that they have all noticed benefits in terms of consistency of Talking Mats use by all members of the multi-disciplinary team. Each team member using the Talking Mats tool is working from a slightly different perspective; using Talking Mats ensures that the child/young person is kept at the centre of the process. This results in a truly holistic view of the child/young person’s feelings, views and opinions.

Conversation with friends is key to our well- being.

Talking Mats is a tool to maximise people’s capacity to communicate about things that matter to them.   For people with communication difficulties the ability to have a good conversation is restricted.  For this reason we have developed Conversation sets, described in an earlier blog http://www.talkingmats.com/talking-mats-conversation-sets/ 

The topics include Holidays, Gardens, Trips out, Sport.  Football even has one if its own!

Some of the members of the National Involvement Network in Edinburgh tried out the conversation sets.  Fiona’s conversation is generally limited to responding to questions and she has a tendency to agree with what other people say.  Using the Holidays topic, she told me that she liked camping and added that she had tried this a long time ago when she was a member of the Girl Guides.    I told her I had also been camping with the Girl Guides so immediately this created a bond between us.  Sharing experiences can be the start of a friendship.

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David and James used the Football topic to chat about a recent match they had attended together.   Before using the mat to discuss the match they did not know that they had felt differently about the stadium and the crowd.  This was a surprise and stimulated further chat. Together they relayed a funny incident that had happened and we all had a good laugh- another aspect of building friendships.

David and James have good conversational skills but the Talking Mat took their conversation to a more detailed level.  For people who have difficulty getting involved in conversations these topics allow them to share experiences and find links with other people.