Following on from last week’s guest blog, Edith Barrowcliffe from the Action Group describes how she has continued using Talking Mats throughout lockdown.  Please note that the image used in this blog is from a mock session and has been taken for publicity purposes only.

In the second week of March I was running a 9 week old pilot counselling service (HearMe at The Action Group) for adults with cognitive and/or communication difficulties, supported by Talking Mats.

A week later lockdown catapulted me into remote working and demonstrated just how crucial Talking Mats were. Without access to the digital app or a suitably high resolution webcam my first online sessions were conducted without them. One client immediately began struggling to retain the thread of their subject matter.

I quickly rigged up a secondary webcam, allowing me to shift between my face and a clear view of the physical mat on my desk. Clients direct me how to place the symbols for them.

I’ve recently acquired a Talking Mats digital license and am pleased to find I can add in additional images. My experience with the physical cards is that allowing the client to direct the session often means searching through multiple different sets or hastily drawing new images. We move at a slower pace because of this but it seems to be an important way of giving weight and attention to whatever the client (Thinker) brings. My fantasy version of the digital talking mats app would include an image search function allowing me to rapidly search all the symbols in all the sets, pick one and caption it appropriately mid-session!

The client I mentioned above uses Talking Mats in this very freeform way – when they tell me something I ask if they want to put it on the mat and they will reply yes, or no. Once I’ve located or drawn the image they tell me where to place it. Towards the end of the session we review the mat, photograph it, and I send them the picture.

 Another client uses a more structured approach. I present a choice of symbol sets based on topics that seem to be important to them (eg home environment, relationships, mobility). They select a topic and we begin a more typical talking mat, giving us a framework and focus to explore their feelings around each symbol. After a while the client/Thinker moves on to other emotionally weighted topics unrelated to the symbol set and we transition into something more akin to “regular” counselling – albeit with simplified, concrete, reflections of the kind proposed by Garry Prouty [1] Yet the Talking Mat seems to provide a “way in” to these deeper feelings that we otherwise don’t reach.

Not everyone uses Talking Mats. Lockdown has limited my capacity to offer it – not all clients have a computer/tablet for video calls and some clients actively prefer the phone. I’m continuing to learn, explore and find my way with this very diverse client group, but there is no doubt that Talking Mats opens up emotional exploration for some who might not normally manage it.

 Edith Barrowcliffe, Hear Me, The Action Group

With thanks to our funders and partners for making this work possible – Hospital Saturday Fund, The Action Group Board, Leith Benevolent Society, Port o’Leith Housing Association, and The  Scottish Government.  And to the team at Talking Mats for their support and help!

[1] [PROUTY, G. (2008) Pre-Therapy and the Pre-Expressive Self. In: PROUTY, G. (ed.) Emerging Developments in Pre-Therapy. Monmouth: PCCS Books; also PÖRTNER, M. (2007) Trust and Understanding. Revised Ed. Ross-on-Wye: PCCS Books, pp82-85].

A new, updated version of our Digital app, will be available in the New Year.  You can download a free taster version of our app here:

  https://www.talkingmats.com/product/talking-mats-taster/

For more information about using Talking Mats remotely, check out this recent blog:    

https://www.talkingmats.com/using-talking-mats-remotely/

Many thanks to Edith Barrowcliffe from The Action Group for sharing her experiences of using Talking Mats to support counselling with adults who have cognitive or communication difficulties. Watch this space for Edith’s follow-up blog next week which will describe how she has continued to use Talking Mats during lockdown.  Please note that the image used in this blog is from a mock session and has been taken for publicity purposes only.

Eleven years ago, I began working at The Action Group with adults who have additional support needs and was struck by how many had mental health difficulties that they were getting little help with. Sadly, with services scarce enough for the “mainstream” population, I could see why.

The issue resurfaced for me in 2016 when I began training as a counsellor. I kept returning to whether talking therapy was possible with those who had difficulty communicating – or even thinking about – their feelings.

Then in 2019, I attended Talking Mats training. Immediately excited by the potential for emotional connection, I signed up for the advanced “Keeping Safe” training and approached The Action Group’s CEO with the beginnings of a plan.

I’m fortunate in working for an organisation willing to take new ideas and run with them. Within six months I was embarking on a pilot project, called HearMe, offering counselling to adults with cognitive or communication difficulties, with Talking Mats as a key method to help overcome those barriers. Within a fortnight of opening the service was full to its limited capacity and had a waiting list!

The work has been experimental, learning as I go and adapting to the particular needs of each client. To conduct initial assessments, I’ve assembled symbols based on “Thoughts and Feelings” from the “Keeping Safe” pack. We return to this to review progress. Most clients have used a top scale of “True”/ ”Not True” with statements “about me” for the assessment. We always begin with a practice mat based on more neutral material, allowing the client (Thinker) to learn what’s involved and me to gauge whether the mat is right for them. This is crucial – one client found a way to frame everything we placed on the mat positively even when they’d been able to tell me the opposite was true a moment before! In this case we simply used each symbol as a focus for exploration.

We’ve kept the number of questions relatively small, but the assessment can take two or three sessions to complete as clients often respond quite deeply to the symbols.

Some more verbally able clients move on to a more “freeform” style of counselling as we progress, relying less on the mat to open up. But even in these cases having symbols on hand can be helpful. One client brought up the topic of sex – then apologised and asked if it was OK to talk about it.

“It’s fine,” I was able to reassure her, producing the relevant symbol. “Look, we even have a picture for it”. She laughed and visibly relaxed, the card giving her tangible evidence that the topic was allowed.

It’s still early days, but from the feedback we’ve received so far, the project really seems to be helping people to open up, express feelings they’ve never given space to before, and explore ways they want to change their lives.  The power of simply being heard.

Edith Barrowcliffe, Hear Me, The Action Group

 With thanks to our funders and partners for making this work possible – Hospital Saturday Fund, The Action Group Board, Leith Benevolent Society, Port o’Leith Housing Association, and The Scottish Government.  And to the team at Talking Mats for their support and help!

Follow the link below to find out more about our Keeping Safe training (now available online) and resource:

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

Since the start of the restrictions placed on us by Covid-19 there have been lots of questions to us about how you can use Talking Mats remotely. We have all been forced to learn quickly what we can and cannot do in a virtual world when we need to be physically distanced from each other.

We have tried various ways to do Talking Mats virtually, but the easiest way we have found is to log into your digital Talking Mats through our website and use the Talking Mat in this mode. Then open your virtual meeting app, e.g. Microsoft Teams or Zoom, and share your screen. For both you can share the control of your screen so your thinker can move the options as you talk them through using the standard Talking Mats principles.

For Microsoft Teams see https://support.office.com/en-gb/article/share-content-in-a-meeting-in-teams-fcc2bf59-aecd-4481-8f99-ce55dd836ce8

For Zoom see https://support.zoom.us/hc/en-us/articles/201362673-Request-or-Give-Remote-Control

Sometimes people run into problems with the Talking Mats  digital log in because they get a message about Adobe Flash. If you get that, our advice would be to try a different browser or if you are using Chrome do the following:

• Click on the 3 little dots at the top-right of chrome
• Click on “settings”
• “Privacy and security”
• “Site settings”
• “Flash”
• Change from “Blocked” to “Ask first”

EXTENDED OFFER to increase digital access during the Covid-19 Emergency

We realise that many of you don’t have the digital Talking Mats so we are making it available for a charge of £30.00 including VAT  from now until the END OF 2020. Fill in this form DISCOUNTED DIGITAL TALKING MATS REQUEST FORM. (We hope you will understand that we will not release your digital logon until payment is received.) We always recommend the Talking Mats foundation training to get the full benefit from this communication framework so watch out for our online training offer which will be released next week.

On a personal level we have been testing remote use of Digital Talking Mats amongst the Talking Mats team. We used the coping set from our Health and Wellbeing resource and it has helped our own reflections on how we are feeling about the current restrictions on our lives and the impact it is having on us.

We are aware it is still early days and we do not have a lot of experience of using the digital Talking Mats remotely with people with communication difficulties.  It would be good to have a forum for sharing those experiences. We held a virtual meeting on Thursday 23^rd April at 10.00 a.m. to do that here is the report of that meeting including a link to a video demonstrating how to set up your digital Talking Mat 20200429 post zoom meeting notes_ no link

Many thanks to Professor Anna Dunér, Dr Angela Bångsbo and Associate Professor Tina Olsson for this guest blog describing their research project where Talking Mats will be used to enable service users living with dementia to be involved in decisions about their home care services. The project is based on a collaboration between Department of Social Work at the University of Gothenburg, Borås University College and the municipality of Borås, aiming to develop and evaluate the use of Talking Mats. 

  Professor Anna Dunér

  Dr Angela Bångsbo

  Associate Prof. Tina Olsson

In Sweden, as in many other developed countries, ideas of consumer choice and personalisation of services have been implemented in social care with the intention of achieving better choice and control as well as increased quality of the services provided for the individual. However, persons living with dementia are at risk of being excluded from the opportunities provided to other groups of service users. Thus, it is important to develop both needs-assessment procedures, and improve the performance of home care services, to enable older people living with dementia continuous choice and control in their everyday living.

We hope that Talking Mats will improve the communication between service users, care managers and staff in eldercare and lead to increased influence of service users over the decisions and planning of their home care services.

During 2020 we have funding for a planning study where we can develop and test the Talking Mats decision aid, identify, translate and test outcome measurements, and refine and test the procedures for a comparative intervention project. In 2021 we hope to attain funding for a three year study.

We have already received valuable advice and information about Talking Mats research from Dr Joan Murphy and hope to keep in contact with her and the Talking Mats team throughout our project.

If you are interested in Talking Mats Research, check out our recent blog with details of how you can get involved with our Virtual Network: 

https://www.talkingmats.com/virtual-talking-mats-research-network-launched/

Many thanks to our new Talking Mats Research Associate, Dr Jill Bradshaw (Tizard Centre, University of Kent), for this latest blog focusing on how Talking Mats can help people with communication difficulties to express themselves – to help work out the reasons for behaviour that challenges.

We know that around 10-15% of people with intellectual and developmental disabilities display behaviour that can be challenging.  This might include hitting out at other people or injuring themselves.  These behaviours can serve very important functions for the individual (e.g. to avoid something unpleasant or to get a need met).  When we try to help make things better, we often focus on improving communication, quality of life and health and wellbeing more broadly.

How do we work out why behaviours that are challenging occur?

We often spend time observing the person and talk to carers and staff who work with the person to gain information about what is working well and what might help.  This is part of a functional analysis.  Here, the aim is to identify the factors that have led to and are maintaining the behaviours displayed.   Traditionally, we have not really asked people directly what they think.  This is partly people who display behaviour that challenges almost always have complex communication challenges.

How can we better access views of children and adults and would Talking Mats be one way of gaining views?

Together with Nick Gore, we have been working on ways of using Talking Mats to enable children and adults to give their views.  We developed a series of mats focusing on:

• Likes and dislikes;
• Difficult behaviours;
• Things that help;
• Things that don’t help;
• General preventative variables.

What happened when we used the Talking Mats?

People were able to use these Talking Mats to tell us about what was important to and important for them.  Some information was similar to reports from carers and staff and some information was in addition.   For example:

• we gained information about preferred activities, such as riding bikes and preferred snacks. Doing things we like to do is important for all of us!;
• people gave us information about their difficult behaviours and where these took place;
• people were also able to give us at least some information about what made a bad day and what helped on a bad day. This information helped to inform support strategies.

You can read more about this work here: https://kar.kent.ac.uk/67033/1/PDF_Proof%20%283%29.pdf

Using Talking Mats certainly enabled some people to give their views.  It was particularly helpful as a way of talking about difficulties, where a focus on the mat rather than on direct questioning was useful.

As expected, more people were able to access the more concrete topics we discussed and the more abstract topics were more difficult.  We have also been working with the Challenging Behaviour Foundation to develop a range of methods (including Talking Mats) to help to gain the views of people with communication challenges.  You can read more about this work here:

https://www.challengingbehaviour.org.uk/learning-disability-assets/valuingtheviewsofchildrenwithalearningdisability.pdf

To view Jill’s presentation about this topic from our Talking Mats is 21 event last August, click here: TM and PBS final version for handout

If you are interested in Talking Mats and Research and have completed our Foundation Training Course, you can find out more about our new Talking Mats Research Network Group by emailing Jill at  J.Bradshaw@kent.ac.uk, and watch this space for a new blog all about the group – coming soon!

It’s always great to see pictures of Talking Mats on social media.  The stories behind them, and the positive changes that can result for people keeps us motivated to share this powerful tool.

It is apparent however that not all pictures that are called Talking Mats are actually Talking Mats!  For example,

TOP SCALES   If the  top scale is Yes / No Or  a tick /cross

It is apparent from these mats that the questions are likely to be closed, and don’t provide a scale for reflection.  Closed questions can be leading and suggestive of a set answer the listener is seeking. e.g  ‘Did you enjoy your lunch?’  v. ‘How was your lunch?’

A yes/no, or a tick and cross at the top  are occasionally used with topics which appear to test understanding of rules, e.g acceptable and unacceptable behaviour in a classroom.   In that instance the listener facilitating the mat keeps the control and the power imbalance that exists in conversations for people with communication difficulties isn’t reduced.

The top scale used with each  topic is key to the mat working.  A Talking Mat could find out what the person thinks about the rules, and which ones they feel are good -not good or help -not help.   Our Foundation training includes how to match the top scale to the conversation. https://www.talkingmats.com/training/

TEACHING TALKING MATS   Some people with communication difficulties need to learn how to do Talking Mats.  Learning how to express a view can take time and has to be taught.  We  see pictures of what appear to be Teaching Mats. For example, starting with closed questions might be necessary to introduce the idea of preferences.

It is important that these Teaching Mats are not used as a true representation of a person’s view but seen as a step towards this skill- It can take time but great learning takes place along the way.

We have guidelines for working towards Talking Mats on our website:

Guidelines for working towards using Talking Mats – These guidelines are designed to support Talking Mats trained practitioners working with thinkers who may need to take extra steps to work towards using the Talking Mats framework

Supporting people to share what they think, and giving them the control to say when they are not happy with an aspect of their life, is within their legal rights.

‘To deny people their human rights is to challenge their very humanity’     Nelson Mandela

In the first of two blogs, we talk about how using Talking Mats Resources can help people have better conversations.

Talking Mats provides a visual framework to help people express their views and feelings, using a selection of communication symbols that cover a variety of topics.  Talking Mats resources are used by many professionals across a wide range of health, social care, residential, and education settings.  Most of our resources are available in both low-tech, and digital, formats.  In this first blog we focus on the resource bundles which are available to purchase with our Foundation Training course.

Our resources are available to buy through our website (https://www.talkingmats.com/shop/) however we do strongly recommend completion of one of our Foundation courses (https://www.talkingmats.com/training/foundation-training/) to get the most benefit from Talking Mats – and to use it to its full potential.  If you add a Health and Wellbeing, Consulting Children & Young People, or Social Care resource pack bundle to your training you only end up paying £65 for the training day itself which is a great deal!

Resource Bundles available to purchase with Training

Health and Wellbeing Bundle:

These packs are based on the ‘activities and participation’ domains from the WHO ICF framework and includes 9 topics which are relevant to people, regardless of their health, disability or where they live around the world. We have translated these into more ‘user-friendly’ language and have generated symbols to represent each topic.

In addition to the 9 topics from the Activity and Participation domains, we have also included Environment and Health, which are important topics within the ICF framework and in people’s lives.

Consulting Children and Young People Bundle:

These packs are based on ‘Getting It Right For Every Child’ (GIRFEC), a Scottish framework for everyone to use when working with children and young people. There are three broad topics which are relevant to any child or young person’s life. This resource can also be used with SEND reforms in England.  There are different packs for each developmental stage: Early years (ages 3 to 7); Primary (ages 7 to 12) and secondary (age 13 upwards).

Best Value Bundle: This option includes the Health and Wellbeing and Consulting Children and Young People bundles above, as well as our Social Care resource packs, providing a complete set of resources to support communication on a comprehensive range of topics for children and adults.

If you’d like to book a place on one of our Foundation Courses and would like to know more about our bundle options, get in touch with us at info@talkingmats.com

Find out more about our Foundation Training course here: https://www.talkingmats.com/training/foundation-training/

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

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

How can Talking Mats help?

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

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

Next Steps

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

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

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

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

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

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.

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

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.

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

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/