Tag Archives: Mental Health

Returning to school after lockdown  

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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

Mental Health – Using Talking Mats for organising and expressing thoughts

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Many thanks to Georgia Bowker-Brady, Advanced Specialist SLT (Berkshire Healthcare Foundation Trust) for this latest guest blog.

I attended the Talking Mats training in June and I work in both dementia care and acute mental health in-patient services.

I had initially imagined that I would primarily be using the Talking Mats to support the dementia patients.

However I’ve been surprised to find that I have been increasingly using Talking Mats with functional patients and it has been a really positive tool when discussing with patients about their self-care, the care they are receiving in the hospital and opinions on discharge.

Due to their mental state, many of the patients may find it hard to organise and express their thoughts, and if patients are hypomanic it can be difficult for professionals to guide the topic to get meaningful information, but Talking Mats has really helped with this! It has also been pertinent in establishing patients’ insight levels and gaining better understanding of their impression of the current situation.

Here is a photo of one my mats from the psychiatric adult acute wards. This was for a patient who is severely low in mood and has relatively recently gone through a traumatic incident. The ward staff and OTs have had difficulty gathering any information about what she ordinarily enjoys doing in order find some activities to try and engage her with.

The staff stated that the patient would simply report she doesn’t enjoy anything and questions about what she used to enjoy received no answer. I went and did a joint session with the OT where I asked about what she enjoyed doing before this incident and we did the mat (see picture below) in a matter of minutes.

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This can now provide a starting point for considering areas for trying to encourage some behavioural activation.

We then extended it by using an emotions wheel to ask how she felt about certain activities available in the hospital. We were able to establish that she felt fearful about trying new things and sad about carrying out certain activities she used to do prior to the incident.

It is wonderful to hear such a great example of Talking Mats in action – if you have any stories you would like to share, please get in touch with us at info@talkingmats.com

 

 

Talking Mats and Supported Decision Making

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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.

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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

 

 

 

 

How Talking Mats Makes a Difference in a Forensic LD Setting

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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.”

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 (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/

 

 

 

Improving Health and Housing outcomes for tenants

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Talking Mats have been part of an exciting research project which looked at whether the Digital Talking Mat App could improve health and housing outcomes for social housing tenants.

Working together with tenants and staff from Loretto Housing and Care, Stirling University, Napier University and Age Scotland we have developed and piloted a new Talking Health and Housing set for the Talking Mats App!

Project Aims

The aim of the project was to:

  • Develop an App that would support social housing tenants with communication difficulties to say what they thought about their Housing and Health.
  • To improve communication between social housing tenants and health professionals.

Researchers were also keen to see whether the App would help to demonstrate the link between tenants’ housing and health solutions.

What we did

The Talking mats team facilitated two focus group sessions with all the partners to decide what topics were needed.

Once the mats had been completed the researchers from Stirling University and Napier University conducted interviews and focus groups with staff from Loretto and related Health professionals and then analysed the data from the mats.

The Talking Health and Housing set

The set has three topics: Home, Wellbeing, Support people

The Top scale for this set is Going well…Going well sometimes…Not going well

THH Blog picture 2 One of the major themes to emerge was safety inside and outside the house. Using the App, tenants were able to identify issues that were making them feel unsafe including:

  • A broken stair door
  • Uneven pavement outside the house,
  • Poor eyesight
  • Poor mobility

This was having a negative impact on tenants’ wellbeing and by doing the mats, actions were identified to address all these concerns and anxieties were reduced.

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It was a great partnership and we hope to work together again to further explore how the App can support the Service Integration agenda by facilitating communication between Health, Social and Care and Housing with the tenant at the centre.

Read the summary report 201908 Talking Health and Housing Summary Report

If you are interested in finding out more about the Talking Health and Housing App please email info@talkingmats.com

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The Symbols are designed and © to Adam Murphy 2015 and assigned to Talking Mats Ltd. in perpetuity. They may not be reproduced without permission