We are really looking forward to our first ever Talking Mats Twitter Chat on Thursday 01.10.20 from 7.30 – 8.30pm!

It will be a great opportunity to share experiences and ideas – here are the questions we will be asking:

This will be followed by a brief summary of the key learning points from the discussion.  Join in and remember to use #TimeToTalkTM in all your comments – we look forward to chatting with you all!

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/

As a group of Allied Health Professionals (AHPs) working in a secure hospital we recently embarked on a mini project using Talking Mats to check in with our service users with learning disabilities during Covid-19. We collated the evidence from our respective professional bodies (Royal College of Occupational Therapy, Royal College of Speech and Language Therapy, Chartered Society of Physiotherapists and British Dietetic Association) in terms of changes that people might experience if they’d had Covid-19 and produced a talking mat around these.  

It quickly dawned on us that we might be on to something here, and that creating an opportunity to ‘check in’ more broadly with our service users would serve a useful purpose, so we added some additional categories around changes to routine, psychological wellbeing and feeling safe.  

This was my colleagues’ first experience of using talking mats, and their faces when I turned up clutching my 99p actual doormat were a picture! I introduced them to the theory behind the mat and its presentation and harped on about the benefits in terms of attention, comprehension, non-threatening interaction, initiation and structuring narrative; they nodded supportively.  

We set off across our learning disability wards in multi-disciplinary pairs and all but a few of the service users agreed to have a chat with us. My colleagues commented that they were pleasantly surprised by the engagement and the amount and novelty of the information gained; we  identified things that the service users hadn’t told anyone because they hadn’t been asked that question!  

In talking to others we were asked why weren’t rolling this out in a partner secure hospital for people with mental health conditions? ‘no reason really, we just haven’t got there yet’ we answered. Then came the…. but we can just do it like a questionnaire with them. This question wasn’t, and in my experience isn’t ever ill meant. It comes from a place of naivety in relation to the presence of communication difficulties in people with mental health conditions and because of that, lack of exposure to different professional groups such as Speech and Language Therapy and the skills and approaches we have to offer. Skills in gaining and holding someone’s attention. Skills in decreasing pressure in communication situations. Skills in enabling time, space and ways in which people can initiate their thoughts.  

The Multi-Disciplinary Team (MDT) working around the project has enabled me to show others how talking mats can support their practice. It has enabled them to see how a very simple and non-threatening visual tool can open up conversations and lead to information that the service users hadn’t shared before, in a way that a face to face conversation doesn’t.  

Thanks to Jo Brackley, Clinical Lead, Speech and Language Therapy Secure Services at Cumbria, Northumberland Tyne and Wear NHS Foundation Trust for this inspiring blog – which demonstrates when we shift the way we listen and gather information from patients we get a different result and improve the quality of information and communication . If you or your team want to consider Talking Mats training then we can provide this for organisations . At the moment we can take a cohort through our online course together and then arrange a zoom call to discuss application to your work setting  – email info@talkingmats.com for more information.

What do the young people I work with think and feel about returning to school after lockdown? I am a Speech and Language Therapist working within the Learning Centre at the Donaldsons Trust in Linlithgow. I work with young people with a variety of communication needs and although the Learning Centre was closed for a short period, we re-opened a few weeks ago to provide continuity for our young people who all have additional needs. Given the current situation, many changes having been put into place to ensure the safety of the staff and children in these unprecedented times. This has included children coming in part-time and on different days from some of their peers and a designated staff team for each group of children. For some children the changes have also meant that their parents now drop them to school rather than coming in a taxi and they have their temperatures taken on arrival. The children now see some staff wearing PPE and they are asked to socially distance from those in their class. They have all coped incredibly well, adapting and accepting these ‘new normals’. As a team we have tried hard to make the transition back into the Learning Centre as relaxed as possible as many of our young people find change difficult to manage.

Prior to lockdown I was almost finished my foundation Talking Mats course and was about to submit my video assessment. Lockdown meant that this did not go ahead as planned. On returning to work, I felt a Talking Mat would be a perfect way of exploring the children’s feelings and opinions about the changes that they have been faced with both at home and within the Learning Centre. I printed symbols which I felt were the most relevant for the current situation and this included symbols such as ‘socially distancing’, ‘having temperature taken’, ‘coming to school in the car with mum and dad’, ‘staff wearing masks’ and ‘friends coming on different days’ I  used the top scale of  ‘this is working  well ’ – ‘I’m ok with this’-  ‘this isn’t working well’. I completed the mat with one of our pupils as part of my video assessment, but the aim is to complete with all of the young people within the Learning Centre over the next few weeks.

The outcome from the completed mat was very helpful .Using Talking Mats allowed me to gather information in a clear way that I would not have been able to do otherwise. The framework allowed for improved understanding of the questions presented as well as a clear and visual way to indicate responses. I feel that having the Talking Mat as a tool has been a wonderful resource to gather the opinions of the young people in order to make sure that we are minimising any anxieties that they may be feeling. We hugely value and respect the opinions of our young people and allowing them a means of sharing their opinions about what is happening around them, through the use of Talking Mats, has been invaluable.

Thanks to Kirsten Lamb for her helpful blog describing how she used Talking Mats to help the young people express their views about adjusting to the new normal . If you want to develop your Talking Mats skills like Kirsten then take advantage of the reduced training during lockdown.   Training Order Form – 30% Discount

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/

Thanks to all the people who have expressed an interest in the Talking Mats research group . We are excited to see the range of research going on and how people are using Talking Mats as a research tool in a variety of settings e.g. universities, NHS, not for profit organisations, youth justice – and with such a wide range of client groups e.g. dementia , alternative and augmentative communication , children and young people, people with learning disabilities, and palliative care.

This is a virtual network and we are still exploring ways in which this could work, but it could involve an email network, virtual seminars and/or twitter chats.

If you are interested in being included, and have completed our Talking Mats Foundation Training course, we would love to hear from you.

The network will be coordinated by Dr Joan Murphy, Founding Director of Talking Mats, and Dr Jill Bradshaw (Tizard Centre, University of Kent) who was appointed as our Honorary Associate in November 2019 https://www.talkingmats.com/honorary-research-associate/

If interested please complete and send the following form to info@talkingmats.com:

Application-to-join-TM-research-network

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!

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/