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

  Professor Anna Dunér

  Dr Angela Bångsbo

  Associate Prof. Tina Olsson

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

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

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

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

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

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

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

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

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

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

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

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

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

What happened when we used the Talking Mats?

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

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

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

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

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

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

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

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

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/

The Talking Mats Board is delighted to appoint Dr Jill Bradshaw from the Tizard Centre, University of Kent, to the position of honorary research associate. This is our first appointment of this kind. Talking Mats is an evidence-based framework and research is important to us – but that research needs to be much more diverse, and involve a much wider range of people.

Jill’s role will be to give the Talking Mats team:

• A sounding board for research ideas and proposals
• Advice and support on publishing articles
• Identify research gaps and advise on funding avenues

We are also very aware that a number of people are using Talking Mats as a research tool, and Jill will also help to develop a virtual research network to bring interested researchers together.  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, Jill would love to hear from you. Please email her on J.Bradshaw@kent.ac.uk – or email info@talkingmats.com and we will forward your interest to her.

Jill is really excited about this new post.  She says ‘We know that the voices of people who have communication challenges can be excluded from research. This is a great opportunity to work with others to think about how we can use Talking Mats creatively in research and to find ways of including views from a wider range of people’.

Lois Cameron

November 2019

Many thanks to Lynn Blair, SLT (NHS North Lanarkshire) for writing this guest blog describing a recent project in which she and her colleagues used Talking Mats to gather the thoughts of secondary-aged pupils with social, emotional and behavioural support needs:

Do you remember your school janitor? Was he/she a cheery soul who you enjoyed talking to?  Perhaps there was another member of school staff who you trusted and felt you could chat with.  Secondary school can be a challenging environment for any teenager, let alone those who have speech, language and communication needs (SLCN).  Young people need adults in their lives who they can feel at ease talking with.

The purpose of our recent project (See Lanarkshire SLT SEBN Poster 2019 and Lanarkshire SEBN Project Summary) was twofold.  Firstly we wanted to find out how many of the young people in our local secondary schools for pupils with social, emotional and behavioural needs (SEBN) had language and communication difficulties.  We also wanted to hear about the impact of those support needs by gathering the thoughts of the pupils themselves and that’s the focus of this blog.

We have to admit we were a bit anxious before we met with the pupils.  Would these young men and women even give us the time of day with our friendly faces, mats and pictures? In the actual event, for the most part the tool was met with curiosity and then full engagement.  The young people quickly grasped the idea.  Some did not speak at all as they placed the images and others used the opportunity to tell us a great deal about how they felt about talking to different people in their lives and in different settings.

The information that we gathered is now being used to plan evidence-based speech and language therapy services to the school and young people.  The use of Talking Mats gave us interesting information like the fact young people felt auxiliary staff such as janitors and assistants are often easier to talk with than teachers and as a result, we are thinking about how we involve all school staff in future events.

We are only too aware that the young people we met have often felt excluded from other people and from certain places.  Talking Mats gave them the opportunity to be heard and we’re excited to consider how we can use them in the next phase of our work to support their communication needs.

If you are feeling inspired and would like to find out more about accessing Talking Mats Training – check out this link here: https://www.talkingmats.com/training/

Many thanks to Dr Sally Boa, Head of Education, Research and Practice Development at Strathcarron Hospice in Stirlingshire, for this latest guest blog – linking to her great presentation at our TM is 21 event in August.  Sally’s presentation – Talking Mats and Palliative care – focused on using Talking Mats in Palliative and End of Life Care, and included information about the Talking Mats ‘Thinking Ahead’ resource – here Sally shares her own experiences:

Talking about death and dying and making plans for the future is difficult to do. This is partly because no one likes to think about their own mortality and partly because as a society we don’t talk about it. I work in a hospice where people are encouraged to talk about the care and treatment they would want as their condition deteriorates. Even here, these conversations can be difficult, particularly if someone has communication or cognitive difficulties, if there is uncertainty about prognosis or if there are different opinions within the family. The ‘Thinking ahead’ Talking Mats resource is a great tool to use to enable these conversations to happen. In my presentation at the ‘Talking Mats is 21’ event, I provide some background about how the resource was developed. I have used it to support those with communication difficulties to have a voice and also with people who simply find this a difficult topic to think and talk about. Use of the Mats helps people to think through the issues one at a time and see for themselves how they feel about things in relation to one another. Most importantly, it helps open up the conversation about the future and helps people to prioritise and see for themselves what they need to do in relation to making plans for the future. Then they can get on with living and doing the things that are most important to them.

A most memorable example of using Talking Mats with someone towards the end of life is when I was asked to work with ‘Gill’ who had severe communication difficulties. I used the ‘Thinking ahead’ resource with her and found out that she had made many plans in relation to sorting out her affairs (e.g. power of attorney, funeral arrangements). She hesitated when I showed her the ‘making memories’ symbol and at the time I couldn’t work out why. To finish the session, I used the ‘indoor interests’ symbols with Gill and we had a great conversation about all the things she enjoyed doing. When I gave Gill the ‘arts and crafts’ symbol, she became really animated, and was able to tell me that she wanted to finish creating a memory book of photos that she had been making up for her family. Using the Mats, Gill managed to convey why she had hesitated with the ‘making memories’ symbol. Following on from this, we had a conversation with the hospice creative arts coordinator who was able to support Gill to complete, not only her memory book, but also other creative pieces. In her last few days of life, Gill was able to identify and work towards really important goals and left some amazing memories for her family.

To find out more about our Thinking Ahead resource, which is available to those who have accessed our Foundation Training – follow this link – https://www.talkingmats.com/product/thinking-ahead/

If you haven’t accessed our Foundation Training yet – find out more here https://www.talkingmats.com/training/foundation-training/

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

 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.

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

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

What an amazing day we had celebrating 21 years since the first article about Talking Mats was published in August 1998 in the Communication Matters journal. Over 180 people attended from so many different walks of life. We are grateful to them all for coming and helping us mark the occasion. We are also grateful to the endowment fund of Forth Valley NHS for helping us fund the event.

In the morning thanks to a fantastic group of speakers we discussed a diverse range of topics:

• Rachel Woolcomb, our OT associate explored how she sees Talking Mats as an ‘energy efficient’ thinking tool and outlined how it supports people to think through issues Talking Mats as a Thinking Tool
• Two teachers, Fiona Graham and Claire Forgan examined the benefits and challenges of embedding Talking Mats in school to encourage and extend pupil participation
• Susan Gowland, a speech and language therapist discussed the use of Talking Mats in a forensic setting illustrating from a case example how Talking Mats helped staff see that incidents do not come out of the blue. When they looked at the pattern of mats over time they could see when the patient was expressing concern about small things. This was an indication that bigger things were going on for him.
• Sally Boa the Research Manager for Strathcarron Hospice led on how Talking Mats was a way to enable ‘end of life’ conversations, things that can be hard for any of us to talk about. The mats give a safe space and structure to enable these conversations to take place. Talking Mats and Palliative care
• Two parents Tracey Campbell and Sarah Robertson spoke about their experience with using Talking Mats with their children. Sarah said ‘Talking Mats gives us a happier home. It helps me be patient, listen and give power to him’ (her son). Talking Mat A Parents View 15.08.19
• Jill Bradshaw of the Tizard Centre, University of Kent outlined her research including her work exploring Talking Mats as a tool to sit beside functional analysis of behaviour where the person’s own view of what challenges and helps them is often overlooked and not included fully. TM and PBS final version for handout
• Anne Lafferty of The Advocacy Project , give a powerful example of using Talking Mats in a legal setting. This important work is in need of funding so we can explore this more fully. Everyone also got to play legislation bingo!  Talking Mats and Supported Decision Making PP 2
•  Liz Taylor (Talking Mats licensed trainer) and Lynnette Linton (Talking mats co-trainer) from The Action Group shared their experience in a fantastic film.  They used a Talking Mat to reflect on the experience and would recommend co-training as an effective way to deliver the Foundation course.
• Brian Robertson and Paddy Carstairs described how they developed a Talking Mats to allow members of the National Involvement Network to explore with other people with a learning disability how The Charter for Involvement related to their life experience.This is an empowering way of using Talking Mats that shows that people who get support can help change and improve the support of other supported people.This is an empowering way of using Talking Mats that shows that people who get support can help change and improve the support of other supported people.
• Rosie Noyce from Pennine Care NHS described a whole team approach to supporting Healthy Young Minds and how they have embedded Talking Mats into their care pathway. She cited powerful case examples of impact and a real commitment by the team to hear the voices of young people  Talking Mats and Young People’s Mental Health

And that was just the morning! Lots of delegates have asked for copies of the presentations so watch this space

The afternoon demonstrated just how far Talking Mats has come through its partnerships with other organisations. We are so grateful to all the people who came and had stalls and engaged with our networking activities! There was a real buzz in the room as people explored the variety of ways in which Talking Mats is used to support and enable more effective communication. Lots of connections were being made, people thinking about new ways of working and applying Talking Mats in their settings. People enjoyed seeing old friends but was good to see new networks were being built.

So, thank you Care Opinion, Turning Point Scotland, The Action Group, Capability Scotland, The CALL Centre, The Indigo Group, The National Involvement Network, Forth Valley NHS, The Stirling University Careers Service and Alzheimer Scotland. In addition, Talking Mats had a stand with all its products. Also, to promote our Birthday offer since we are 21, we have a 2 for 1 offer on resources for 21 days so order quickly. It ends on the 5^th of September!

Today was also the day that Joan marked her ‘retirement’. She gave a very moving speech that celebrated her distinguished career and her very significant achievements. She leaves an amazing legacy in the Talking Mats framework and with all the energy in the room we are sure it will continue to grow and develop. Thank you, Joan.

Talking Mats is now used in many countries all over the world.  As part of our #TMis21 blog series, we wanted to share this great example of Talking Mats being used in Germany.

In March 2019 Prof. Dr. Norina Lauer (OTH Regensburg) and Elena Maxheimer held a lecture and a workshop about Talking Mats at the “aphasia days” in Wuerzburg, Germany.  Many thanks to Norina and Elena for sharing information about the “aphasia days” for this blog post.

The “aphasia days” are a large congress – unique in Europe – for people with aphasia, family members and speech and language therapists (SLT). Every year around 600 people from Germany, Austria, Switzerland and Hungary are coming to this event. There are talks, workshops and podium discussions held by participants with aphasia, family members or SLTs. In front of approx. 150 listeners Norina and Elena gave a lecture about Talking Mats and the results of Elena’s bachelor thesis, in which she worked with people with aphasia, who learned to use Talking Mats.

In a three-hour workshop at the “aphasia-days” Norina and Elena taught nine people with moderate to severe aphasia how to use Talking Mats. All persons brought their own tablets and logged into their own account. They where shown how to choose a topic and a top scale and practiced in teams of two. All of them conducted several sessions with different topics and switched partners a couple of times. They had a lot of fun talking about things that matter to them and learn more about their peers. At the end of the workshop they were able to use Talking Mats themselves and are going to use it with their relatives and friends at home. As the workshop was very well received by the participants, it is likely to be repeated at the next “aphasia days” 2020.

If you would like to find out more information about Talking Mats in Germany, and the Digital Talking Mats app which is now available in German, check out https://www.talkingmats.com/talking-mats-in-germany/  and https://www.talkingmats.com/german-digital-talking-mats-with-people-with-aphasia/

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 …….

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 …….