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/

We are delighted that we now have around 20 members of our Talking Mats (TM) research group.  Members come from a variety of countries including the United Kingdom, Denmark, Cyprus, Germany, Sweden, Australia and Japan!  We are a mix of academics and practitioners, with many combining both roles.  So far we have spent time getting to know one another via video sessions and thinking about how the group might work. 

We have decided our initial focus will be thinking about ways of analysing the data that is generated from conversations that are supported by TMs. This idea was suggested by Nikita Hayden.  Nikita is a PhD student at the University of Warwick exploring the outcomes of siblings of children and adults with learning (intellectual) and developmental disabilities. Part of her research has used TMs with children with severe learning disabilities and their siblings to further understand their sibling relationships.  

The types of data generated have been rich, vast and varied, leading to an overhaul of Nikita’s initial plan to analyse her TM data. This has raised questions about how TMs are interpreted and analysed in a research context, and what scope there is for our group to explore and synthesise the analysis potential of TMs. This is a question that the TM team is often asked and so having some information on the different options would be useful.  

TM discussions generate various types of data, including: 

• The photograph of the mat (which symbols are placed under the various columns); 
• The conversation generated during the discussion; 
• The body language and facial expression of the ‘thinker’; 
• The speed of placement of symbols; 
• The symbols that are moved following feedback etc. 

We would like to review existing publications that have used TMs as research data and think about possible methods of analysis. This may include consideration of both within and between group research analysis techniques. It may also involve exploring the potential of both traditionally qualitative and quantitative analysis techniques, such as thematic or conversation analysis, or by drawing on data from the symbol placements to provide pre-post evaluation data.  

We hope to generate a list of guidelines about what you might need to take into account when considering how to analyse these data.  A challenge when analysing TMs data, is how to handle the variation in the types of data collected between participants. For example, some participants may place a large number of symbols, whereas other participants may have placed relatively few. This raises questions about how we deal with ‘missing data’. In small samples, how can we conduct a pre-post evaluation where some symbols are missing for some participants? If some participants use a five-point scale, and some use a two-point scale, what numerical analysis potential is there, if any? How can we appropriately derive qualitative themes from across our sample if some of our participants were minimally verbal? What sorts of non-verbal cues have been analysed in research using TMs?

Please do share any ideas or questions you have with Jill Bradshaw, our Talking Mats Research Associate – J.Bradshaw@kent.ac.uk  

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.

I stole the lyrics and altered them slightly, but this is the song line that has kept popping into my head over the past few weeks as we find ourselves hurtling through the different phases of lockdown easing. The rules and recommendations that have guided our lives for the past 3 months or so are changing rapidly and change can be difficult.  Communicating how we feel about change and life in general can be difficult.

We have seen creative uses of our resources and have really enjoyed learning how they have helped young people and adults express how they coped throughout lockdown and beyond.  Kirsten Lamb’s guest blog about Returning to School After Lockdown is just one example of how the TM framework was invaluable in gaining the opinions of young people as they adapted to ongoing changes over which they had little or no control.
https://www.talkingmats.com/returning-to-school-after-lockdown/

Another Talking Mats practitioner recently tweeted this mat that she did with a college student, showing how Talking Mats helped structure thinking about how life was going.

We felt a single resource was needed to help kick start a conversation around Life (but not as we know it; I am sure that’s a song too) looking at the following themes:

• Family / Friends / Bubbles / Social Distancing
• Health
• Mood / Emotion
• Sleep
• Exercise
• Work
• School / College
• Activities
• Shopping
• Routine

As with every Talking Mat you can change the top scale to be more or less concrete, you can use blanks to add in things that we haven’t included, you can leave things out that aren’t relevant.  Download your free printable pdf here: LOCKDOWN SET

We look forward to hearing stories from our Talking Mats Community on how you helped others express themselves (definitely another song!)

Thanks to everyone who joined our second Zoom session on using Talking Mats remotely.  The notes from the first session can be found here. It was great to share experiences and to welcome our international Talking Mats’ community too. We were impressed by your ingenuity and creativity in making TMs work remotely and there were lots of great stories of the use of it in practice. Here is a summary of the main points, with special thanks to Sam Quinn for explaining how to use 2 devices in order to see the person as well as the Mat.
Using a second device on a virtual Talking Mat session can help you to capture the thinker’s reaction to the mat and symbols. This can be particularly useful for recording videos to watch again later (obviously with the appropriate video consent). To do this on a tablet or mobile device and assuming you have already set up the meeting:
1. Open the Talking Mat app on your first device and prepare the symbol set you would like to use. When you are finished, minimise this app.
2. On the same device, open your communication app (Zoom, Microsoft Teams) and join your meeting.
3. Click ‘share’ and ‘screen’, then switch to the Talking Mats app. You should be able to control the Talking Mat while other people in the meeting can see it. It is advised you mute your volume to avoid interference.
4. On your second device (this could be a laptop, tablet or mobile) use the meeting ID that you sent to yourself to join the Zoom meeting.
5. On your second device, there is an option to split the screen so you can see both the thinker and the Talking Mat at the same time.
6. If you are using a PC or laptop as your second device there may be an option to record the session if you wish to do so.

Device one (tablet or mobile) hosts the Zoom/Teams meeting and is used to control the Talking Mat.
Device two (tablet, mobile or PC) acts as a second guest in the meeting and allows you to view the Mat and the thinker at the same time and record the session.

You can invite another device using Near Me/Attend Anywhere.
Remember you can still use the physical resources by holding the Mat to the camera and asking the thinker to tell you where to place the option on the Mat. Some have done this successfully.
You can try iPad mirroring https://tactustherapy.com/telepractice-how-to-mirror-apps-computer/ You can download a guide for how to do this if you follow the link.
A couple of people reported setting up Talking Mats by using https://miro.com/ and https://jamboard.google.com/ but, word of warning, it takes time to do this.

Remember you can use your digital login for the app (from Apple Store) and through the web browser http://www.digitaltalkingmats.com/ – make sure you enable FLASH.

And finally just to remind you that you can currently get a discount on the Digital Talking Mats resource:

DISCOUNTED DIGITAL TALKING MATS REQUEST FORM

Our online Foundation training is taking place throughout the year.  Forthcoming courses are starting on 22nd September, 6th October and 3rd November.  Reserve your place here.

If this is all new to you and you want to find out more about it, please listen to a webinar arranged by the Health and Social Care Alliance where Margo and Lois talk about Digital Talking Mats and how it can support wellbeing: https://www.youtube.com/watch?v=84CY3QFFa_g

 Youth Justice Research

How can Talking Mats be used in youth justice research?  I am a clinical psychology doctoral student at the University of Auckland, New Zealand.  My doctoral research is an evaluation of communication assistance in our youth justice system.  Communication assistance is New Zealand’s version of the England and Wales intermediary scheme.  I used a Talking Mat framework to help understand young people’s experiences of working with a communication assistant.

I first learnt about Talking Mats in 2017 when I attended a workshop on enabling effective communication with children and young people run by Talking Trouble Aotearoa New Zealand (www.talkingtroublenz.org).  I have since attended Talking Mats training in New Zealand and have regularly used Talking Mats in my previous work as an intern psychologist at a Child and Adolescent Mental Health Service.  I have found them to be an effective way for children and young people to express themselves.  They have been especially helpful for young people with whom I am struggling to build rapport, and who only give the odd shrug, nod or head shake to questions asked.  I also like the additional information that comes from how the young person places the cards.  I remember one teenager boy, for example, who threw down “teacher” and “school” under “things not going well”.

In my doctoral research, I was interested to know what tools or strategies used by communication assistants were helpful or unhelpful.  I created 17 picture cards of resources commonly used by communication assistants, such as a laptop, post-it notes and a stress ball.  The young person was able to sort these cards into piles, “Yes”, “Don’t Know” or “No” to indicate which ones had been used in their youth justice process(es).  The young person then sorted the “Yes” pile under three top cards or headings, “Helpful”, “Don’t Know” and “Unhelpful”.  This second Talking Mat was then a starting point for further conversation and some simple off “off the mat” questions.

Again, in my research, the Talking Mats framework provided a way for young people with communication difficulties to let me know their opinion.  It helped me to build rapport with young people I had not met before and it took some of the intensity out of the interaction by giving us a shared point of focus.  I really appreciated being able to hear young people’s thoughts on communication assistance and the Talking Mats framework (as well as some other visual aids and strategies) allowed this to happen.

You can read more about this research and the findings on my website https://kellyhoward2.wixsite.com/youthjustice or in a recent article in the Youth Justice journal, https://journals.sagepub.com/doi/10.1177/1473225420923763

Thanks to Kelly Howard for writing this blog about her interesting research . We are always delighted to hear where Talking Mats is making an impact and it has more and more uses in youth justice . If you are working in youth justice then take advantage of our current on line training offer  Training Order Form – 30% Discount. You will not regret it . Plus, watch this space we are currently working with a youth justice organisation and developing a Talking Mats to support conversations in this setting…

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

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/

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