Our next train the trainer course is in 2 weeks and we’re  looking forward to welcoming people from a range of professions and a range of places-  New Zealand, Japan, England and Fife!

Becoming a trainer for Talking Mats means the staff member can offer Foundation training within their organisation or partnership.  This ensures that the standard of the communication and thinking tool is maintained and sustainability of its use is supported.  It is  a positive investment  for organisations in person -centred practise.

The trainers are provided with resources for delivering the Foundation course and their licence is renewed annually .

Comments from people who attend include:

Practical approach to training made it easy to try out and learn from ‘doing’

A wonderful inspiring course- really looking forward to continuing to work as part of the TM team

Really enjoyed the training.  Learnt a lot not just about my use of TM but also just about myself as a presenter and communication

If you’ve attended a Foundation course and would like to become a trainer, our next course is in June. You can find out more details on our webiste or on this link  20180621 Accredited Training flier Jun 2018

Apart from the necessity of fulfilling the requirements of the General Data Protection Regulation which has to be completed by 25th May, I have been pondering on other advantages of complying with the GDPR.

Here at Talking Mats we are all going through files, bagging up paper for shredding, deleting data files on our master computer and preparing text to send to all our customers and contacts to make sure we only hold information that is adequate and relevant.The first advantage for us is that it’s a good way to re-establish contact with people.

I’ve been given the task of going through all the research data and have ploughed through 16 drawers of research data starting in 1992!  Way back then I worked with a wonderful professor who was keen to hold onto all our raw data just in case we wanted to check or replicate anything. Its all been under lock and key but the time has come to bite the bullet and get rid of it.  I found this to be not only nostalgic but also emotional – all those fantastic participants who gave us their time and insights.

Its also been cathartic because as well as filling bags for shredding I am smashing up discs of video footage. We filmed lots of people with a range of communication difficulties using Talking Mats to compare with the same conversations without Talking Mats to analyse any differences. So… another big advantage is that I’ve destroyed all evidence of my dodgy hair cuts throughout the years!!

I counted 41 completed projects going from the very first one in 1992 which was a demographic survey of people who used AAC (Augmentative and Alternative Communication) systems in Scotland. In 1998 the Gannochy Trust funded the original project where Talking Mats was born Gannoch Final report. We then went on to carry out a wide range of projects which include working with people with Motor Neuron Disease, Stroke, Learning Disability, Children with Additional Support Needs, people living with Dementia to name but a few. The website contains the final reports on all our projects and in looking back at them I am also very proud of the good quality research the team here at Talking Mats has carried out.

Many others are now doing projects using Talking Mats but I leave it to them to organise their own GDPR and hope they also find the process worthwhile and rewarding and not just seen as a chore to be done.

 ‘For every pound invested in the Talking Mats Keeping Safe resource and training there is a potential saving to services of £23.00’ .This was the findings of a cost benefit analysis carried out during the development phase of the Keeping Safe Talking Mat resource.  A Cost-benefit analysis demonstrates the overall economic value of an intervention with numbers and evidence.

 The Keeping Safe resource

The Keeping Safe resource is a visual framework that has been developed and trialled over 6 years in partnership and with funding from various organisations e.g. Survivor Scotland, Scottish government , Kingdome Abuse survivors project and NHS Fife

The Keeping Safe resource provides:

• A listening space for people with learning disability and communication difficulties to raise concerns and express their point of view.
• A structure for staff to find out what people are thinking about their lives, and raise issues that can be difficult to discuss.

A reflective practice training was developed and  provided to over 700 staff to allow staff become familiar and confident with using the the resource

Findings of the cost benefit intervention

There is a significant financial advantage to services using Talking Mats. Analysis of six scenarios found that for each pound invested in the Keeping Safe training there is a potential saving to public services of £23.00. In learning disability services it is easy for costs to accelerate quickly. If services don’t respond effectively, challenging behaviours can escalate and relationships and placements are at increased risk of breakdown. Talking Mats can help provide staff with a comprehensive and accessible framework to help them listen to people who can find it difficult to articulate what is really going on for them e.g. issues of pain, relationships or levels of support. In this project 89% of Talking Mats resulted in staff learning new information about the person they were working with, even when they thought they knew them well.  The Talking Mats framework provides a way to turn these points of views into actions that can be monitored and reviewed. It is these early interventions that not only save money but improve quality of life.

Cost benefit Process

With support from Inspiring Scotland a cost benefit analysis was done that examined the cost of the Talking Mats intervention and any resulting actions. 6 cases were chosen from over 100 detailed descriptions of how practitioners working with people with learning disabilities had used the resource.  These descriptions  represented a cross spectrum of  people with learning disabilities in Scotland in terms of living situations e.g. living at home , in supported settings and an inpatients facility . They were also chosen to represent the comorbid conditions that often exist with learning disability e.g. autism, mental health and cerebral palsy. An alternative scenario was created and tested with critical friends as to the likelihood of what might have happened without the Talking Mats intervention. All the scenarios that were developed are  available here 20180110 scenarios cost benefit   The primary source of financial information and the subsequent calculations  was the Unit Costs of Health and Social Care produced by the Personal Social Services Research Unit (PSSRU) 2015/16 . This contains detailed cost estimates for a range of services such as care placements, NHS services, social work, mental health, and family interventions. This analysis can only be illustrative as assumptions are subjective.

The findings from our final report 160512 Keeping Safe report 2013-2016 showed that effective use of the resource   not only led to  improvements to quality of life for individuals but that it can save services money. Book a place on our  webinar and get the Keeping Safe  resource 20180122 Keeping Safe Webinar  or if face to face discussion is more your thing attend the advanced course in April 2018 – you get the resource with that booking too!

This new resource has been developed by Strathcarron Hospice and Talking Mats to help people with advanced illness or long term conditions to think ahead and plan for the future.

It consists of a booklet and 3 topic symbol sets: Affairs; Care/treatment; Personal values

It can be used to help people have conversations about:
• the extent to which their personal affairs are sorted;
• what they would or would not consider about future treatments and care;
• what is going well/not going well in relation to their personal values

It is widely recognised that having discussions about end of life issues can enable people to remain in control for longer and help them to identify the care and support they need and want as they approach death. In spite of this, in Scotland:

• 74% of people have not discussed what their wishes would be if they did not have long to live
• 79% of people don’t have any written plans for their end of life care, financial wishes or funeral plans
• Only 35% of people have written a Will

It can sometimes be difficult for people to start conversations about planning for end of life and people this is exacerbated if people have specific difficulties communicating their thoughts and feelings because of symptoms, fatigue and emotional factors. Before initiating this type of conversation it can be helpful to check the extent of a person’s understanding of their illness and whether or not they want to talk about the future.

The importance of having conversations and making plans for end of life has been highlighted as being relevant for people in the early stages of life limiting illness as well as for those nearing the end of life. There is evidence that people who have Advance or Anticipatory Care Plans in place are more likely to receive the care that they want and treatment can be less invasive. ACP is a process rather than a one-off conversation. It is acknowledged that ACP discussions should take place in appropriate settings with sufficient time to enable to people to consider and weigh up different options. ACP should also be developed in line with peoples’ personal values and goals (Sinuff Tasnim, et al.(2015) “Improving end-of-life communication and decision making: the development of a conceptual framework and quality indicators.” Journal of pain and symptom management 49.6 2015): 1070-1080).

Perhaps we should think about planning ahead whether or not we have advanced illness or long term conditions??

Training

To get the most out of the resource we run half day advanced training courses which will include the Thinking Ahead Resource. This course will be relevant to you if you:

•  have attended a Talking Mats foundation training and are experienced in using Talking Mats with adults
• want to extend your use of Talking Mats and consider its role and application to advance care planning
• want to discuss sensitive topics around end of life care

Please contact us at 01786 479511 if you are interested in future dates.

We are delighted that ‘Talking Mats in German’ is now available in the Digital version and includes the latest technical and symbol upgrades. These upgrades are also now included in the English version.

Please click on this link to find out about all the upgrades.

We are very grateful to Prof Norina Lauer for sending us this blog which explains how ‘Talking Mats in German’ has been developed.

In 2016 Prof. Dr. Norina Lauer, a German professor for speech language therapy contacted Joan Murphy from Talking Mats because she was initially interested in the digital version for goal setting with people with aphasia. We found out that it would be interesting to have a German version of the app. So we started a project for translating Talking Mats into German. Prof. Dr. Norina Lauer managed the translation process. The project was financially supported by a German health insurance “BKK Dachverband” in cooperation with the German aphasia self-help organization “Bundesverband für die Rehabilitation der Aphasiker” (www.aphasiker.de). The translations were performed in a special scientific procedure to make sure that they match the English terms.

What did we do?

Norina Lauer and her colleague Holger Grötzbach independently translated the English terms into German. Subsequently these translations were compared and the differing terms were discussed until a consensus was reached. The agreed translations were given to a professional translator who only got the German words and the corresponding pictures. She re-translated the terms into English and these re-translations were checked by Talking Mats if they were in accordance with the original English terms. For those terms that did not match, the process started again until all terms matched the original English terms (figure 1 shows the translation process). This process was performed for all topics of the app. So we have the complete Talking Mats app in German now.

Figure 1

So what’s next?

Norina Lauer completed the foundation training and the accredited training in 2017. In October 2017 she performed her first foundation training for 6 of her SLT students. One of these students will do her bachelor thesis about the German app version in 2018. Under accompanying consultation of Norina Lauer the student will perform two workshops for people with aphasia. In these workshops they will practice doing Talking Mats and afterwards evaluate the app concerning its content and practical use. For the evaluation we are planning a short questionnaire and a focus group.

It has been a delight to work with Norina and we look forward to hearing the results of her student’s project.

If you already have the Digital Talking Mats make sure you upgrade to get all the new features.  The German version with the upgraded is now available from the App store, Google Play (Free and Lite versions) or purchase the full version from our website .

Do you need training to use Talking Mats ?

Talking Mats is an effective but deceptively simple tool so a question we are often asked is do you need training to use it.  Communication and supporting people with communication difficulties is a complex process and Talking Mats is based on a number of research projects which examined who could use Talking Mats, and how best to use it in different situations. It is therefore important that the integrity of the Talking Mats model is maintained and that Talking Mats training teaches the principles developed from our evidence base.
All our trainers are registered with Talking Mats and provide high quality training based on robust research findings. Only trainers accredited by Talking Mats are eligible to train others.

Some of these principles include:

• Understanding who can and who cannot benefit from using Talking Mats
• Asking open questions
• Handing over control
• Pacing
• Maintaining neutrality
• Interpreting additional information including both non-verbal and verbal information
• Matching the top scale to the question or view being explored
• Presenting the options in an order that maximises the individuals ability to respond by using our model which focuses on concrete to abstract symbols
• Monitoring language complexity and topic sensitivity

All our training courses include hands-on practice and video examples as well as reflection on all these aspects of using Talking Mats

The techniques used in Talking Mats accord with best practice guidance in semi –structured interview techniques including:

• being clear in what you want to find out and using open questions
• enabling elaboration in whatever form is appropriate
• planning in advance but in a context that is flexible and can respond to the dynamics of the conversation
• being cognisant of the influence of the environment
• taking time to establish engagement and rapport
• being non-judgemental
• supportive of periods of silence
• ensuring there is a summary at the end so that both parties agree on what was said .

So whilst Talking Mats may seem simple, it is not simplistic. The listener is creating a space that enables the thinker to think and express themselves. Training gives the listener time to reflect on the components of an effective Talking Mats conversation and identify which ones they are already skilled in and which ones they need to develop further. There are no short cuts to reflective practice training and we know Talking Mats foundation training has impact. Time and time again people who thought they knew about Talking Mats reflect and say things like ‘I got so much more from this training than I expected’ or ‘ I now see I  can use Talking Mats for so many different conversations not just ’ I like’ , ‘I don’t like’ ‘or ‘I have been using Talking Mats but now feel much more confident to use it and to make my own submats’

This is why we put so much emphasis on training.  We have developed our successful “Train the trainer” scheme to ensure that quality is maintained and reflective practice maintained.  If Talking Mats is passed by word of mouth then key aspects of the framework are missed and/or misinterpreted which in turn lessens its effectiveness and impact.

People who come on training are often excited, want to tell colleagues and share it with others. Demonstration and sharing is fine, but it is important to be aware of the difference between sharing and training.

Sharing can often be appropriate especially when there is a team of people supporting the person or  parents are keen to see how it works. You can show someone how to use a Talking Mat about a specific conversation. We call this a ‘demonstrating model’. It is helpful to give the listener the words to say to go with it. That way you are enabling other colleagues or family members to have an effective but specific conversation only.

If they then want to use it for other conversations we would strongly recommend they go on to attend the training. Attending a foundation course will enable them:

• to get more out of the technique
• to understand more about their own communication
• to become creative in their use of Talking Mats whilst still adhering to the research principles
• to be able to create their own mats or explore a topic in more depth using submats

So do you need training to use Talking Mats ? The answer is a resounding  yes . Training supports you to be an effective Talking Mats listener and get the most out of this versatile communication framework. So if you have not attended a course check out our course opportunities.

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

There are a few myths around about Talking Mats. What does it do? – It  supports communication and it doesn’t replace a person’s existing modes of  communication, be that speech, signing, a symbol book, a voice output communication device or app.  Talking Mats works alongside  these modes to help people communicate even more effectively about a particular topic.

Some more myths busted!    Click on the picture to make it clearer.

We are working with our colleagues at Strathcarron Hospice to develop a resource for Advance Care Planning which should be available early in 2018.

This poster illustrates how we are developing the resource:
2017 TM and Advance Care Planning

During the pilot phase our colleague Sally Boa (Head of Palliative Care Education, Research and Practice Development at Strathcarron Hospice) received the following moving story from Lorraine. We are extremely grateful to Lorraine for allowing us to publish it.

 “My name is Lorraine and I am a carer for my husband who has cancer and is a palliative care patient.

I have been involved as a volunteer with Susan at Strathcarron Hospice since February this year. This was a group formed from the community put together by volunteers to get their help and opinions of thinking ahead and to understand what a loved one wants for their future and awareness of information and services available to people caring for someone with a long term illness/palliative care, but most importantly how best to get a loved one to open up and talk about their feelings and what they want for their future and arrangements.

Personally it has been for me interesting, draining and emotional at times, but this journey I have been on has made me think and realise that these are very important issues that need to be talked about with my husband and family.

I had tried to get Gordon to talk about these things, but it was difficult to bring the subject up. He just changed the subject. I tried leaving booklets lying on the table when I was out, but if he did look at them he never mentioned it.

Thinking about death is very emotional and stressful subject to talk to someone you love about. I know how I felt with these thoughts going round in my head and it was not nice. As for our two sons they seem to have accepted the situation now, although it was difficult. We have never lied to them and tried to explain what’s going on, but finding the right words isn’t easy. Moving to acceptance instead of denial is very, very hard on everyone.

I also have been involved with trying out Communication Cards (Talking Mats) which had been designed to help people who have difficulties in communicating. I went to the Hospice where I was asked some questions that I answered using the cards. I answered using the cards under the guidance of “feelings” I was surprised to find I had more positive replies than any of the others, I feel the cards would help people show their feeling better. I was asked if Gordon would be interested in doing the same. Sally emailed me a photo of my cards/answers, and I showed it to Gordon and I took the chance and asked him and he said yes. Sally came to the house and they did the task using the cards with no input from me {I kept very quiet ha ha}. The benefit Gordon got from this was really good. He was quite surprised to find he had placed more cards on the positive side as well his thoughts and feelings and he felt good about actually seeing that in front of him.

When Sally left I thought to myself this is my chance to approach the subject but again deep down I was scared as the last thing I wanted was to upset him.

I approached the subject with Gordon…. how about we continue chatting about what he wanted for his future and arrangements etc. I put it to him he knew what I was involved with for months with Susan and Mandy and that he was always interested to hear what we were doing but the truth was I still didn’t know what he wanted, I only knew he wanted a church service and burial. We sat at the table and talked about everything, I took notes what Gordon was telling me he wanted about everything.

I am an awful one for my Diary/ Journals I recorded everything we discussed finances, lawyer, wills, his wishes, Hymns he wanted, service at the graveside,what was to be given to family etc. in fact everything we could think of is now recorded and in one place. Both our boys will be told and where to find it. Jokingly to make it a bit light hearted I said I could go first you know, so we both took the opportunity to write and record all my wishes which is listed in the same journal.

Afterwards I really don’t know how to explain it but I felt a tonne weight off my shoulders, I now know everything I need to know.

More important for me I’ll never need to discuss it again with Gordon the book will be locked away safe and we can get on with our lives.

Please try and find the right time to talk, it’s very important and it will stop a lot of stress and emotional turmoil at what would be a very sad time for all.”

We are always very grateful for comments and suggestions about our resources, so have been listening to our customers and working to upgrade the Talking Mats Health and Well-being resource and the 4 digital resources.

There are several additions which apply to both the original and the digital versions of Health and Well-being.

• Originally we had asked our artist not to put clothes on the characters to try to make them culturally neutral but following a number of comments – (in particular the bare hairdresser who caused much amusement!) – our artist has added clothes on those symbols where the character was obviously naked.

• Next we have included additional relevant symbols and altered others to make the resource more comprehensive.

Our App developer has also been working to incorporate all of the above features into the digital version. He has included a more comprehensive list of wording for the top scale. (Click on the image to enlarge)

He has also added a feature which lets you toggle the wording for the top scale on and off; he has sorted the split words under the symbols and he has improved how the final record of the Talking Mats is displayed in the email sent.

Finally we are delighted to announce that our 4 main Talking Mats resources have been developed in German for the Digital version in collaboration with Professor Norina Lauer at the University of Idstein. All 4 resources – Health and Well-being, Children and Young People, Eating and Drinking and Social Care will all be available on the App by clicking on the German flag in the opening page.

The German version is not available in the original hard copy but you can order the resources with no words to allow you to add your own.

The upgrades to the digital will happen automatically in the next few weeks at no extra cost and if you would like the hard copy sets to upgrade your original resources, you can order them from us at a reduced cost. 2017-18 Additional Symbols Post Training Order form

Thanks again for your feedback – keep the comments coming!

Thanks to Rosie Murray for this great blog describing how she used a collaborative Talking Mats ‘Wall’ to help students comment on how different activities inside and outside college make them feel.

As a student, I trained in the Talking Mats approach, after finding it incredibly useful in clinical placements. I am now a speech and language therapist at St John’s College in Brighton. This is a college for young adults with autism, learning disabilities and SEBD. Our learners have a wide range of communicative needs and cognitive abilities. I was approached by our nursing team in the lead up to world mental health awareness day, as they were organising a ‘tea and talk’ session for our learners of all abilities.

We organised a range of activities, such as symbolised conversation starters. However, we felt we needed something to allow our less verbal learners to make their voices heard. I thought back to my training, and remembered Joan Murphy talking about large, collaborative Talking Mats – or ‘talking walls’. We discussed this idea, and felt it would be a great way for students to feedback on how different activities inside and outside college make them feel.
It took some considerable planning. Due to the emotional needs of some students, our top scale required us to avoid words that were too upsetting for individuals. In the end we settled on ‘good’ (with a widget ‘calm’ symbol) and ‘worried’. We also wanted it to provide a genuine opinion, so although we considered including activity options that were clearly negative, e.g. ‘fire alarms’, we took the opportunity to show our learners that we all have different opinions on things, and that this is good. We hypothesised that because of this, learners would be skewed towards giving positive opinions, and this informed the order of presentation of the top scale and the activities themselves.
On the day, we had 15 different activities to give an opinion on, each with different border colours for differentiation, and of course blank tiles so our learner’s could come with their own activities. Students were encouraged to write their name on the back of a chosen activity, and a consistent script was used to present the wall to each learner. Makaton signing was used alongside the script to support understanding.

Everyone loved the wall!

Learners of all abilities offered their opinion, and it generated discussion between learners of differing abilities. It signposted staff to particular likes and dislikes of learners, and showcased the power of talking mats to all staff. For example, one of our learners is a cheerful young man, who uses minimal verbal utterances to communicate. When the board was presented to him, he very clearly selected ‘talking’ as an activity, and clearly indicated that it makes him worried. This has allowed us to reflect as a staff team about how we can support him to communicate with minimal anxiety.
Learners too took away some important lessons from using the wall. They saw that while some activities are VERY popular (e.g. computer time), some are quite polarised, e.g. animals. This highlights the important issue of mutually respecting each others differences. Since the event, staff have discussed ideas they have on how to utilise this tool. We are considering how we could use Talking Mats as a tool in our peer mentoring sessions between learners of higher and lower verbal ability, as we feel it would be beneficial for both mentee and mentor. We are looking forward to using Talking Mats as a flexible tool for the college in the future.

Please let us know of any other innovative ways of using Talking Mats!