Rachel Woolcomb, our Talking Mats OT Associate, shares a recent personal experience where she used Talking Mats to support a difficult conversation:

The vision of Talking Mats is to improve the lives of people with communications difficulties. I have been reflecting recently on the definition of ‘communication difficulties.’

When I first heard about, and started to use Talking Mats 10 years ago, my perception was that it was fantastic for those that could not speak but I must admit I didn’t really consider using it with people who, such as myself, could use their voice to communicate.

Over the years as my understanding has developed, and I have looked further into the use of Talking Mats as a ‘thinking tool’ I have come to a different conclusion.

I would like to suggest that at some points in our lives, each one of us is likely to experience a communication difficulty. I don’t mean that we cannot physically speak, but that we cannot express what we really want to say in words. Perhaps a topic is too difficult to talk about with someone so we don’t bother, or we are overwhelmed by the subject that we don’t really know where to start.

One such subject is that of death and dying.

We know it will happen to us all one day but to talk openly with loved ones, is for some reason, too much to comprehend, too emotive, or considered bleak.

I am very fortunate enough to have grandparents in their 90’s however the conversation about their wishes for the future goes unspoken. It is a challenge for my parents to raise the issue therefore it remains the big unknown.

This is a common problem. In 2009, The National Council for Palliative Care wanted to address this issue and set up the Dying Matters Coalition in England and Wales, to help people talk more openly about dying, death and bereavement and to make plans for the end of life.

Talking Mats have produced a set of topic cards called ‘Thinking Ahead.’ https://www.talkingmats.com/product/thinking-ahead/

These were created in consultation with Strathcarron hospice to help people with advanced illness or long term conditions to think ahead and plan for the future. The three topics in the set are: Affairs, Care and Treatment and Personal Values.

My Mum was interested in my role with Talking Mats and wanted to understand what it was all about. We had already started to talk about the challenges of having difficult conversations, especially about death, and therefore over a drink, in a relaxed coffee shop, we embarked on a journey of discovery using a Talking Mat. My Mum as the Thinker and myself as the Listener .

She used the Talking Mat to help her think about things she had not considered and was able to make plans about what she wanted to do next. I heard her wishes and her thoughts, on why certain things were important to her. It was a very special time, facilitated by a Talking Mat.

My challenge to you as readers of this blog is to ask yourself ‘what do I have difficulty talking about’ – A Talking Mat just might be the answer!

Another resource you might find helpful is ‘Let’s Talk about Death and Dying’ –  www.ageuk.org.uk

Rachel will be running a ‘Talking Mats as a Thinking Tool’ workshop at our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019. Dr Sally Boa from Strathcarron Hospice will also be running a ‘Talking Mats in End of Life Care’ workshop at this event. Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Last week, Laura Holmes, our NW England Associate, had the pleasure of interviewing our inspirational Founder, Joan Murphy. Joan will be retiring after our Talking Mats 21 event on 15^th August 2019 and so this was a great opportunity to find out more about her Talking Mats experiences:

Are there any stand-out moments for you, from your Talking Mats time?

Talking Mats are now used in many countries across the world and it has been great to have the chance to travel widely. One particular moment which stands out for me was during one of two trips I made to China with Sally Boa. I was asked to demonstrate Talking Mats with a man who was in hospital having had a stroke. He had no speech and was using a wheelchair. I used Talking Mats to find out what the man felt he could/ couldn’t do. The man shared that he felt he could walk. I had to present the symbol three times as the family members and medical staff watching were adamant that the man could not walk. On the third time, the man pushed the table, moved his wheelchair back then stood up and walked around the room. His family and medical team were completely shocked and realised that no-one had actually thought to ask him if he could walk. This was a massive turning point both for the man – and also for his family and medical team, who could now see the power of using a Talking Mat.

Have you done any Talking Mats yourself that helped you to make an important decision for you or your family?

Absolutely – quite a few! My husband and I both used Talking Mats for our Power of Attorneys and shared them with our lawyer and grown-up children. My husband and I also used Talking Mats to talk about the Scottish Referendum as we had opposing views – it really helped as it made us listen to each other without interrupting. We then went on to use the mats as part of a presentation. Various members of my family have used mats to explore personal issues and decisions 

What are the top tips you have gained from your Talking Mats journey – from working in the NHS and then more recently as a social enterprise?

You have to have humour. And be able to listen. It has been essential to be able to work in partnership with Lois and the other Talking Mats team members. The team are such nice people to work with and we have lots of laughs. Setting up as social enterprise was vital for Talking Mats – in terms of having the freedom to be creative. It felt as though someone had a big rubber band which was able to be released. It was a huge risk and there have been lots of leaps of faith along the way.

Do you have any top tips for people using Talking Mats in the Listener role?

Be quiet – and Listen! It’s also important to feel relaxed and to have a sense of humour whilst using it. A Talking Mat is not a test – it is serious, and can be used to explore difficult issues, but it should be fun.

Talking Mats is a low-tech AAC system – do you think it has a place in the modern world?

It is absolutely crucial! Low-tech resources are fundamental in terms of being able to have and develop conversation skills and social closeness.

What do you want for Talking Mats in the next 10 years?

World Domination! Talking Mats has the potential to be used everywhere in the world, by everyone. However I would like to see Talking Mats continue to have a small core team, but increasing Licensed Trainers across both the UK and the rest of the world.

Our Talking Mats is 21 Event is in Stirling on Thursday 15th August 2019.  Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August.  Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Many thanks to Jenny Trott for our new guest blog about her interview with Talking Mats Director, Lois Cameron – Jenny’s video provides some great information about the Talking Mats approach and our original and digital resources:

A year ago I started my YouTube channel (www.youtube.com/jennytrott) as a way of supporting parents and carers with information and inspiration. As a parent of a disabled child myself I knew that one of the best ways to find out things is from other parents, and YouTube was just a different and new way to do that. To date I have published nearly 50 films about subjects ranging from Self Directed Support to Rebound therapy, and including interviews with parents, professionals and disabled people.

Quite early on I knew that I wanted to make a film about Talking Mats. I had used Talking Mats when I worked with people living with dementia, and I knew that my son’s school were using them too. I had seen the benefits of this innovative communication tool but I also knew that many parents and carers didn’t really understand it because they hadn’t been given the right information.

Lois was kind enough to agree to join me in front of the camera, so in April I visited Talking Mats in Stirling with my tripods, microphones and cameras. It can be a bit daunting interviewing someone I’ve not met before but Lois instantly put me at ease and had the great idea of demonstrating a Mat rather than just talking about it. It was so interesting, experiencing using a Mat first hand and it helped to show the viewers what Talking Mats is really about.

You can view the video here: https://youtu.be/Fmyt1fE-_U8

The feedback from the film has been great, both from professionals, parent carers and SLT students; lots of lightbulb moments; “ah, now I get it”!

I am still making films but less frequently as I am now also setting up a social enterprise, Mecoco (www.mecoco.org) here in North Ayrshire.  We’ll be offering work experience and volunteering opportunities to disabled people to work alongside us making candles and melts. I am sure Talking Mats will be invaluable in our workshop!

If you’d like to find out more about accessing Talking Mats training take a look here- https://www.talkingmats.com/training/  – we offer a range of options including online, and bespoke training for organisations, as well as advanced courses and specialist seminars for those who have already accessed Talking Mats Foundation Training.

We are all looking forward to celebrating Talking Mats is 21 on the 15^th August

The morning is aimed at people who are experienced Talking Mats practitioners and will extend thinking and Talking Mats practice. There are an interesting range of parallel sessions to choose from. Each participant will get to choose three topics to attend.

• Talking Mats as a Thinking Tool
• Embedding Talking Mats in Schools
• Talking Mats in Forensic Settings
• Talking Mats in End of Life Care
• My experience of using Talking Mats as a parent
• Talking Mats and Positive behaviour Support
• Talking Mats and Supported Decision- Making
• Empowering people with Learning Disabilities to be Talking Mats Listeners and Trainers
• Talking Mats and Children’s Mental Health

The afternoon is more informal and there will be an opportunity to engage with some of our partners – see how they use Talking Mats and try things out . There will be posters on the use of Talking Mats in lots of different places and for a wide range of applications.

Plus there will be lunch, cake and a few bubbles !

Thanks to funding from NHS Forth Valley endowment committee the event is free but you do need to book your space https://www.eventbrite.co.uk/e/talking-mats-is-21-tickets-62362171935

You can come to the morning only, afternoon only or come for the whole day.

If you can’t come to our event watch out for out blogs and social media celebrating the reach of Talking Mats for 21 days before the 15^th of August .Please join in with your contributions using the hashtag #TMis21. For 21 days after our event we will be having a special Birthday offer! Watch this space, more to follow …….

Here Laura Holmes, our North-West England Associate, describes how she used Talking Mats to support mid and end of placement reviews with a Speech and Language Therapy Student:

I am very familiar with using Talking Mats to help the children I work with to express their views and opinions – to give them a voice in terms of therapy planning and to enable the children to think about and share what works for them.

However I recently also used Talking Mats to support a Speech and Language Therapy student who was on placement with me. I introduced the approach to support our discussion during her mid-placement review, and then again, during the final review at the end of her placement.

I introduced a Talking Mat with the topic ‘Clinical Areas’ and the topline question ‘Confident/OK/ Not Confident’. I made up options relating to each clinical assessment area as described in the University Student Handbook/Guidelines.

Here is the mat from the student’s mid – placement review:

And here is the mat from the end of placement review:

The pictures help to show the shift in the student’s confidence from the mid-point of the placement in comparison to the end of the placement.

The first Talking Mat helped us to focus our discussions in terms of what skills needed further support/development during the placement. The second Talking Mat then supported our evaluation of current learning outcomes at the end of the placement, as well as helping to identify key learning outcomes for the student’s next placement.

The student shared that she found Talking Mats a really useful thinking tool to help her to think carefully about her skills and the progress she had made during the placement. This was easier than during a typical face-to-face discussion due to the focus on the mat. The interaction itself was also more relaxed as a result.

My next step will be to introduce use of symbols for topic and options – here are some examples from a Scotland-wide Talking Mats project which involved asking students about their work placements:

We often have members of University and College staff coming to our Foundation Training Courses – find out more about this and other training options we offer here:

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

If you have any examples of using Talking Mats for student supervision, and would like to share them, it would be great to hear from you! Just email me at laura@talkingmats.com

In this latest blog, our Talking Mats OT Associate, Rachel Woolcomb tells us how Talking Mats can support delivery of Personalised Care:

“Person centred practice”, and “partnership approach” are common phrases heard in health and social care settings but what does this really mean in practice?

How good are we at ensuring our service users are truly heard, and given opportunities to talk about what is important to them?

Recently NHS England set out their ambitions for the delivery of personalised care. This is a commitment to enabling people to have the same choice and control over their mental and physical health that they have come to expect in every other part of their life.

This however requires a shift in culture.

One of the cornerstones of personalised care is shared decision making. This is a collaborative process in which people are supported to understand the options available to them including the various risks, benefits and consequences. A shared decision will have acknowledged personal preferences, circumstances, values and beliefs. This ensures that when a choice is made it is fully informed.

There is substantial literature which demonstrates the usefulness of goal setting as part of the communication and decision making process.

A well written person-centred goal will describe the anticipated achievement of a specific activity. It will be meaningful and help create a common vision within the rehabilitation process.

Talking Mats is an ideal tool to help facilitate these processes. They enable better conversations and provide an interactive thinking space. They have also been demonstrated to be a useful tool in enabling people to think about their rehabilitation goals.

Read more about this in the TMOT Resource 2: How Talking Mats can help facilitate shared decision making and goal setting: Goal setting TMOT 2

If you would like to find out more about the different Talking Mats training options we offer, take a look here:  https://www.talkingmats.com/training/

In this latest blog, Laura Holmes (Talking Mats Associate based in Stockport) shares a great example of how Talking Mats can be used by education staff to help children to share their thoughts and feelings:

One of Teaching Assistants I work with at Woodley Primary School in Stockport, Lucie Porteus, attended Talking Mats Foundation Training in December 2018. Since then Lucie has been using Talking Mats with many of the children on our Speech and Language Therapy caseload in school.

Lucie’s use of Talking Mats with a group of Year 6 children is a great example of the benefits of using Talking Mats to help children to share their views and opinions. Lucie had carried out initial Talking Mats sessions with four children, on a one-to-one basis. These sessions had focused on getting a general idea of each child’s thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resources. A common theme had emerged through use of ‘blanks’ – all four children wanted to talk more about their upcoming school residential trip.  Here is a picture of one of the mats (click on the picture for a clearer view):

Lucie then planned and prepared options to ‘sub-mat’ the topic ‘PGL’ – the residential school trip, and chose the topline questions ‘happy about/not sure/ not happy about’. She then met with each child individually to complete the mats. Some of the issues/ questions which emerged from the mats were:

• ‘I don’t know who the people there are’/ meeting new people
• ‘I don’t know what we will be doing’
• ‘Do we have a choice about what activities we can or can’t do?’/ ‘I’d like to have a choice’.
• Privacy – getting dressed
• Will any instructions be written down – do we just listen or will we be shown what to do?
• The instructions might be confusing – what will I do?
• I don’t like heights – I’m worried about climbing up high
• Working in groups – we might all fall out
• Sleeping – it might be hard to get to sleep. Sometimes other children talk and I can’t get to sleep.
• What will the food be like?
• What happens if I don’t feel well?
• The journey – I might feel sick if I’m not at the front of the coach/ Do we get to choose who we sit with?

This information was passed on to each child’s Class Teacher and Teaching Assistant. Further conversations then took place to answer/address the above queries and concerns. Using Talking Mats meant that these conversations were personalised and focused. The children’s queries/concerns were listened and responded to well before the school trip itself.

School staff report that all the children had a fantastic time on their school trip!

Talking Mats enabled these children to have their voices heard about a topic which was really important to them. If you are interested in finding out more about accessing training to enable you to support the children and young people you work with to have their voices heard, take a look at our training options here: https://www.talkingmats.com/training/

Many thanks to Tina Wood, Occupational Therapist at Therapy In Motion, for this great example of how Talking Mats can be used to explore thoughts and feelings both in present-day and in retrospect, to evidence positive outcomes from a change in educational placement. Tina’s use of colour coding and pie charts really helps to illustrate this.

Tina attended our Talking Mats Foundation training back in September 2016 and since then she has been using Talking Mats regularly in her work as an Independent Occupational Therapist.

In this example, Tina has used Talking Mats to enable Ben (name changed for anonymity, age 12½ years) to share his thoughts and feelings using the Talking Mats ‘Consulting Children and Young People’ resource packs – focusing on the topics ‘My Body and Skills’ and ‘What I do and Support’.

At the time of this Talking Mat, Ben had been accessing a new placement at a Pupil Referral Unit for the past 11 months (click on the picture below to see a clearer version).

As there was clearly a difference in how Ben felt things were going when he was attending his previous school, Tina decided to ask him to do a retrospective Talking Mat of how things were going for him 11 months ago in January 2018, when he started to feel “unwell”.

This enabled comparison with how he feels now in the “safe setting” of the Pupil Referral unit (click on picture to see a clearer version).

Tina then compiled the information from the above tables into pie charts, enabling a clear visual comparison between the two times/situations (click on picture to see a clearer version):

As can be seen from these charts, there had been a huge change in Ben’s perception of how he is coping with life in general and school in particular.

Tina recommended that this information needs to be considered along with the rest of Ben’s sensory needs (as reported in her full OT report) when deciding on what is the best educational setting for him after leaving the pupil referral unit.

We love this use of colour coding and pie charts to illustrate the information from Ben’s Talking Mats – to really ensure that Ben’s feelings and thoughts are seen and heard.

 If you would like to know more about accessing Talking Mats training – available across the UK and Ireland as well as online – please take a look here: https://www.talkingmats.com/training/

 If you have any examples of how you report/share information about completed Talking Mats we would be interested to hear about it! Just email laura@talkingmats.com

In this latest blog, our Director, Lois Cameron describes the initial stage of a Scottish Learning Disabilities Observatory project aimed at enabling involvement and engagement of people with learning disabilities in supporting people with learning disabilities to have a voice. A great example of co-production in action:

Background

The Scottish Learning Disabilities Observatory aims to generate evidence, build understanding and provide information on the causes of poor health and health inequalities experienced by people with learning disabilities in Scotland. However, they recognised that there was a need to develop their approach to involving people with learning disabilities. They considered whether a citizens’ jury for people with learning disabilities on health and health research would be a constructive way of engaging people with learning disabilities in supporting people with learning disabilities to have a voice. From the outset, they acknowledged that communication would be a key challenge and approached Talking Mats to work with them to put forward a bid to the Welcome Trust Public engagement fund. This bid was written, submitted and was successful.

To establish the project, our first task was to recruit a Public Engagement Lead to take the lead on project delivery. This raised the first hurdle, as since the Engagement Lead was not in post there was no citizen’s jury and therefore no pool of people with learning disabilities to approach to be involved in the interview panel. From the outset, involvement of people with learning disability was seen as central to the project. Talking Mats had recently completed a course working with people with learning disabilities from the National Involvement Network to become Talking Mats interviewers, so we approached one of the participants who had completed the course and asked if he would be willing to be on the interview panel. He was very happy to take part and contribute his skills and experience to the interview panel.

Planning the interview Talking Mat

We examined the job description and divided it into questions that were more factual and knowledge-based and those that we might describe as ‘softer’. However, calling them soft might be misleading as they were actually value based and we felt that the successful candidate’s proficiency and self-awareness in responding to these options would be central to the success of the project. After going through this sifting process we came up with 8 possible options for the interview talking mat. We met with our interviewer from the National Involvement Network and with him honed it down to six and choose the top scale: extremely confident, confident, not that confident. He also choose the symbols he wanted to use. Candidates would be asked to justify where they placed their options. A script was developed to support the interviewer e.g. ‘It would be good if when you placed the card down you gave us a reason why you placed it there. Examples from other work you have done would be helpful’ .   The full script can be found here – Interview Script

The six options were:

1. Making information accessible
2. Making sure everyone has a chance to speak
3. Helping the group understand research
4. Helping the group set its goals
5. Involving people with severe learning disabilities in the research agenda
6. Not taking power away from the group

The interview

In the interview, candidates were asked to give a short presentation, and then the member of the National Involvement Network carried out the Talking Mat. After this, there were some further panel questions and a chance for the candidate to ask questions.

The experience and outcomes

“I really liked being involved in making the mat. At the interview I knew what I had to do and I felt the other interviewers listened to me and my opinion.”

Other panel member’s perspective

“Having never used a Talking Mat in a recruitment interview before I was not sure how effective it would be as a recruitment tool. We wanted the process to be as inclusive as possible, where all interviewers had a clear and purposeful role. The Talking Mat worked really well, both as a way of gathering knowledge and information from the candidates, but also by providing an opportunity to observe the interactions between the candidate and the interviewer. I also think that the structured framework of the Talking Mat put the interviewer at ease and it was nice to observe that his confidence in using it in this context and, where necessary, in prompting and supporting the interviewee. All in all this was an effective way of conducting an inclusive interview process that signalled to our candidates that people with learning disabilities should be involved meaningfully in all stages of the process. It also meant that when we came to reviewing the candidates against the role criteria all members of the panel were able to contribute. I can’t wait to do more interviews like this!”

Candidate perspective:

“For me, an interview process is really about making sure that you and your potential new employer have compatible values. Therefore, it was a relief to have someone with learning disabilities on the interview panel who could help direct the questions. It was also clear that the interviewer knew how he fit into the interview process and was taking the lead on his section of the interview.

The Talking Mat itself was an interesting tool for the interview discussion because the top scale allowed me to look at where my skills and confidence were but also identify some potential challenges within the project. The interviewer also really kept me on my toes with some good follow up questions. In one in particular, he asked me what I would do if he was talking too much and dominating the conversation in the group. It was a challenging question and quite uncomfortable on the spot, but it forced me to be honest about my own values and say that actually, the right thing to do is to politely confront someone who is not letting others speak.

The benefit of a Talking Mat is that it has to be really clear and concrete to work, so I actually felt that I understood the demands of the role better than reading the much longer job description.”

Summary

The involvement of people with learning disabilities was possible from the start of the project because we were able to harness the skills and experience of a person from the National Involvement Network who was trained in Talking Mats. He had a clear independent role which was central to the interview process and improved the quality of the information gained by panel members . The Talking Mats design gave all panel members particular insight into those ‘soft skills’ that were felt to be crucial to the project and that might not have come through so clearly if just the traditional presentation and questions were used.

If you are thinking about a Talking Mats project for your own organisation/service you can find more information here:  https://www.talkingmats.com/projects/

Rachel Woolcomb, our Talking Mats OT Associate, tells us about the recent Royal College of Occupational Therapists’ Report and considers the ways Talking Mats can support:

The Royal College of Occupational Therapists have recently published a new report. “Making personalised care a reality: The role of occupational therapy.”

As the OT Associate for Talking Mats, I took the opportunity to review the document and consider how Talking Mats can help OT’s in fulfilling the recommendations made.

The report recognises that people living with long-term conditions bring different and equally important, knowledge and expertise to the decision –making process.

It challenges OT’s to ensure that they really listen to, and hear the views of the people they work with.

A Talking Mat can help facilitate this. It helps people to understand what is being discussed, to reflect and organise their thoughts, to say what matters most to them and record their views. It helps OT’s to really listen, to learn new information, to involve the person in their own planning and support decision making.

Read more about how Talking Mats can help OT’s to make personalised care a reality in the TMOT Resource 1:  TM Personalised Care – Copy.

The RCOT report is available here: https://www.rcot.co.uk/news/delivering-personalised-care-frontline

Rachel would love to hear from you if you have any examples of how Talking Mats have helped you to provide personalised care, or if you want to know more about OT and Talking Mats. Her email is: Rachel@talkingmats.com.

If you are feeling inspired and would like to find out about accessing Talking Mats Foundation Training, take a look at our upcoming courses across the UK, as well as online and organisational training options: https://www.talkingmats.com/training/