Category Archives: Training

My Journey with Talking Mats

Talking Mats (TMs) I hear you say, is that a mat that talks?! And so begins my story of Talking Mats. Talking mats is an evidence-based pictorial tool developed by Dr Joan Murphy in 1989. Since its creation, it is used in the UK and worldwide.

What does Talking Mats do? It gives individuals with thinking and talking difficulties a voice. This means that it gives those with difficulties expressing themselves a medium to communicate: for example, to express thoughts, make choices, have a chat. Research has shown its effectiveness with individuals who have sustained a stroke, dementia or MND as well as adults and children with learning difficulties. It is also used with individuals who stutter and asylum seekers where English is a second language.

How do you use it? Firstly, I suggest to anyone new to Talking Mats that they enrol on the day’s Foundation Training to understand the theory of Talking Mats whilst gaining the practical experience on the training. A topic is selected from a core of topics and the individual is asked how they feel about aspects of this topic, placing the picture on the mat where they feel this applies to them. There is a top scale with a range of headings depending on the question asked. For example, see the picture below – the topic is ‘hobbies’ and the top scale is ‘like – so so- dislike’:

Talking mats can be used to explore a variety of elements including the individual’s insight and awareness, their goals, exploring their views, management of activities of daily living, facilitating capacity, and facilitating conversation. The complexity arises in the use of Talking Mats and the skill in asking the relevant questions. Initial mats, can often, lead to a ‘sub-mat’. More to follow on this with case examples in my blog next month!

I initially did my foundation training in London, run by Talking Mats, in 2013. Since that initial day’s training I have not stopped using Talking Mats! In November 2015, I travelled to Talking Mats HQ to train as an accredited trainer in Stirling, Scotland. The 2-day course was inspiring and reflective. Joan, Lois and Rhona brought out the best in us and gave us constructive feedback to continue our learning. Their hospitality and the beauty of Scotland left me feeling inspired and confident to deliver their foundation training. The course participants were teachers, SLTs, OTs and a social worker. In sharing each other’s videos, we exchanged views and ideas. I came away with ideas of using TMs as an outcome tool; and to explore using TMs in our groups – I had not considered this before. It encouraged course participants to reflect on their own communication skills in their videos carrying out Talking Mats, as well as how to teach the core principles of Talking Mats to others. I am now qualified to teach Talking Mats at foundation level (beginners). So far, I have run one course in the NHS and one independently. I have enjoyed teaching Talking Mats and incorporating my own experiences of using Talking Mats. The reflective process is also transformative for the participants who have attended my foundation courses. The use of video and reflective feedback enables changes in SLT practise. Feedback from participants included their use of TMs: using TMs symbols they were able to reflect on what went well and what didn’t. The ideas and the variety of videos shared by the group participants was just as inspiring for me as a facilitator, as it was for them. Ideas such as using TMs with carers to compare their views with their relatives and using a child’s TMs picture on the front of their SLT report or school report, for example.

I highly recommend the accredited training for those that have completed their foundation Talking Mats training and have experience of using Talking Mats in practice.

 

Leila Paxton

For more information about Talking Mats, please visit: www.talkingmats.com
For more information about this blog and foundation training (TMs beginners) please contact me via:
Email: leilapaxton@hotmail.com
Twitter: @leilapaxton

 

Stammering activism and speech and language therapy: an inside view

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This month Sam is guest blogger for the Did I Stutter? Project – you may read her blog here

Power, professionals, privilege and person-centredness…

DSC01389_lightAs an allied health professional and educator in the health and social care sector, I interview a lot of would-be health and social care professionals. Almost without fail, these university applicants talk about caring and their desire to work with people, of communication skills and understanding. In due course the successful students study hard to achieve their professional registration. The academic Caroline Ellis-Hills and her team have written that rehabilitation is about helping people to live a life not dominated by their disability; a shift from the traditional medical ‘fix-it’ models. With professional registration comes the opportunity to use newly acquired knowledge to support people to live such lives. This privileged opportunity is one of both position and potential power.  In policy, education and as health and social care professionals, we talk about being ‘patient-centred’; in reality and borne out in the research literature, we may be falling short in this aspect of our practice. It is my observation that many therapists, including me, readily slip into a ‘gift’ model of rehabilitation; one where as a product of our knowledge, we tend to hold the power and suggest what is best in the light of available evidence. As a result we tend to dominate and drive rehabilitation and in turn lose sight of the person at the centre. Again the research literature reflects this. For some years now, William Levack and his colleagues have looked in detail at what happens in goal setting; a central tenet of rehabilitation practice. They have observed that while therapists talk about person-centredness and empowerment, when there is disagreement between patients and teams about which goals to set, patient preferences seem to get lost. Regrettably, I recognise my own practice in Levack’s observation of therapists steering a patient to set less ambitious, more realistic goals; a goal Levack and his colleagues call a ‘privileged goal’. In the past I have rationalised this as therapeutic, avoiding raising unrealistic expectations and supporting the development of insight, but I am increasingly ill-at-ease with this element of practice and it is fast joining my list of behaviours and practices to eliminate in rehabilitation along with the over used and thinly considered phrase: ‘no rehab’ potential’. Furthermore, I’m asking myself (and my students), what’s the more normal behaviour; setting a realistic goal or setting an unrealistic goal? Hands-up …. I set a lot of unrealistic goals … for myself, over and over again …. so, I don’t really demonstrate very good learning either. Is this a health condition?

It’s reassuring that the research literature is documenting these phenomena and encouraging practitioners to think about practices that have become so embedded that we have ceased to examine what is really happening in these powerful interactions. However, notwithstanding the contribution of evidence based practice in recent years, we need to be wary of being too dependent on the research literature. For me, the most powerful prompt to re-evaluate my practice came from two ad hoc personal interactions. The first with a social work colleague who many years ago told me: ‘when someone is told they have ‘no rehab’ potential’, they feel like they have scored ‘null points’ for life’. The second was hearing the experiences of my school friend’s husband, David. David had an aggressive brain tumour in 2005, (http://www.braintumourresearch.org/david-grant_725 ). When diagnosed he was told his life expectancy was about 15 months. A decade later, David is still here. He’s only recently retired from fulltime work and remains both independent and active, contributing to student education, cancer charity and policy work.

When I first heard David talking about his goals I remember worrying that he lacked insight about the gravity of his condition. David’s goals were big, ambitious and emotionally laden; things like, ‘I’m going to walk my daughter to school on her first day at school’. As a friend, I struggled with how to react. I felt empathy for any therapists who might have been trying to rein him in and recalibrate his expectations. Actually, it was me who had to recalibrate; David did not and does not lack insight. He is absolutely realistic about the gravity of his condition, but this does not mean he cannot also be active and hopeful. The importance of supporting and nurturing hope features little in health and social care education but is an area gathering attention. Returning to the research for a moment, there’s evidence that, just like David, patients can remain hopeful but equally grasp the seriousness of their condition. Bright and her colleagues reviewed the literature about hope in relation to stroke and suggest that while there’s some evidence that health and social care professionals can have a positive role in fostering hope, they are just as likely to dash hopes, to justify this as setting realistic expectations and what’s more, seldom see fostering hope as their role.

Clearly there is a balance to be struck, but I have always thought that there is huge merit in the phrase David recalls his oncologist using: ‘David, you have a very nasty brain tumour, but a small minority of people do very well; join them!’. After all, how do the health and social care professionals ‘know’ what a realistic expectation is?  For a couple of decades now we have been encouraged to look at the evidence, the statistics and empirical research; to embrace evidence based practice. There is of course value in such evidence, but it doesn’t tell us the whole story. David, for example, is excluded from brain tumour survivor research because …… well, he’s survived too long! The occupational therapist and writer in the field of rehabilitation, Karen Whalley Hammel, encourages us to tease apart the ties between knowledge and power. As far back as 1999, Coulter wrote in the British Medical Journal: ‘….while the professional is knowledgeable about the individual’s condition, only service users and carers know about their experiences, circumstances, habits, preferences and values; the partnership approach to care should be based on mutual respect.’ There are echoes here of George Kelly’s characterisation of two experts in the room. A decade and a half later we still talk about patient-centredness as if it is a new concept and campaigns such as Kate Granger’s (http://hellomynameis.org.uk/), suggest there is still a way to go and that there are small things that can make an enormous difference.

I’m encouraged that increasingly I see issues of hope and person-focus thoughtfully discussed by both therapists in training and those more established in practice and I find myself thinking: ‘Is an experienced practitioner the one with the most up-to-date disease-specific research knowledge or the wise one, open to possibility, practising their craft with care and respect and above all with a focus on the individual?’

Deborah Harding
Senior Lecturer, Rehabilitation
Faculty of Health and Social Care Sciences
St George’s, University of London
Email: d.harding@sgul.kingston.ac.uk
Twitter: @HardingDebs

Sadly – not all academic journals are open access yet, but for those who are interested here are the references for any literature I have cited:

Bright, F.A.S., Kayes, N.M., McCann, C.M. and McPherson, K.M. (2011) Understanding hope after stroke: A systematic review of the literature using concept analysis.  Topics in Stroke Rehabilitation. 18(5): 490-508

Coulter, A. (1999) Paternalism or partnership? Patients have grown up – and there’s no going back. British Medical Journal, 3 19: 719–20

Ellis-Hills, C., Payne, S. And Ward, C. (2008) Using stroke to explore the Life Thread Model: An alternative approach to understanding rehabilitation following an acquired disability. Disability and Rehabilitation, 30(2): 150-159

Kelly, G. (1963) A theory of personality: The psychology of personal constructs. New York : Norton

Levack, W., Dean, S.G., Siegert, R.J. & McPherson, K.M. (2011) ‘Navigating patient-centred goal setting in inpatient stroke rehabilitation: How clinicians control the process to meet perceived professional responsibilities’, Patient Education and Counseling. 85(2): 206-213

Whalley Hammel, K., (2006) Perspectives on Disability and Rehabilitation: contesting assumptions; challenging practice. London: Churchill Livingston

Insider accounts: Living with communication disability

As a student Speech and Language Therapist (SLT) nearing the end of your training, you begin to feel a bit like you might know a few things. After four years of placements and the range of experiences you have amassed through interaction with a variety of clients and their families, you start to think ‘Ok, I’m beginning to get the hang of this.’ Your tentative steps become surer as you get to grips with assessments and hypotheses and management plans and the wonderful array of devices in the SLT toolkit. But, as a fledgling clinician it is also important to sometimes silence the internal noise of ‘What does this test result mean?’, ‘Which therapy approach do I think is best?’, ‘How many intervention sessions should I give this client?’ And just listen.

In a lecture called ‘Insider accounts: Living with communication disability’, Cathy Sparkes and Sam Simpson provided us with this opportunity. They invited a group of their clients with a range of communication disabilities to come in and talk to all the final year student SLTs at UCL. With our assessor’s hats firmly off, we were able to sit back and listen to people’s lived experiences. All the speakers were very generous with their stories, sharing the painful, puzzling and even playful moments of coming to terms with their respective communication disabilities, both acquired and lifelong, and moving forward with their lives. Many accounts were the result of a number of years of experience and reflection, and it was partly this that made the session so unique for us.

As an SLT, you are generally involved for a very small snapshot of a client’s journey – a few months, maybe a year if you’re lucky. To borrow an analogy, you are ‘a stripe in the scarf of their story’ [1]. But this experience enabled us to more fully appreciate the stripes that come later on, when our input may have finished and our clients have had to renegotiate what it means to live in the world. Furthermore, the speakers were able to give us access to what some of our clients might be feeling now, as we’re meeting them in the early stages after a stroke or brain injury. For example, it may be easy for us to categorise our clients in the light of what they can outwardly communicate. However, the Comprehensive Aphasia Test does not allow us to measure the presence or otherwise of someone’s inner voice – you know, the one that narrates your thoughts and feelings – I had never before considered that loss of spoken language might also lead to inner silence, as so articulately described by one of our speakers.

It was a thought-provoking and at times, moving morning, and overwhelming feedback from the students was that we felt our practice would be changed as a result. The session reminded us to always dig deeper than what we might be presented with on the surface, step outside of our therapeutic comfort zones to provide flexible and individualised support to our clients, and of course, to listen.

Kat UCL Student - 1

 

Katherine Newton
Student Speech and Language Therapist, UCL

[1] McIntosh J., Charles N., Lyon B. & James K. (2011). The Strands of Speech and Language Therapy: Weaving a Therapy Plan for Neurorehabilitation. Milton Keynes: Speechmark

Reflections on my first BSA Conference: inspiration, connection, courage and community

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A week later and I am still feeling buoyed up by the positivity of the British Stammering Association’s National 2014 Conference, held in association with the Scottish Stammering Network in Glasgow. I was not sure what to expect as I made the long train journey north on Friday 22nd August, arriving just in time to attend the City Hall drinks – a grand and fitting social event to mark the beginning of the conference.

Conversations flowed as readily as the wine – with old friendships quickly renewed and new friendships founded. I was struck by the warmth, energy and harmonious chatter as the evening progressed – and which set the tone for the rest of the weekend. People mixed and mingled freely at mealtimes, between presentations and late into the night. It soon became apparent that the social aspect was an integral part of the conference’s success for many of the delegates – as the early morning photos at George’s Square clearly testify!

Significant highlights for me included:

  • Iain Wilkie’s keynote on ‘Transforming Employability’. Drawing on research highlighting employers’ ignorance and misunderstanding of stammering, Iain outlined the evolution of Ernst and Young’s ‘Stammering Network’ since its inception in 2011, which led to the launch of the ‘Employers Stammering Network’ (ESN), a BSA supported initiative, in 2013. Combining personal and corporate narratives interspersed with thought-provoking quotations, Iain advocated a cultural shift towards diversity and inclusiveness underpinned by flexible support processes involving the shared commitment of both employers and employees. To this end he invited all present to open up dialogues about stammering at work in the understanding that ‘there is no courageous conversation without vulnerability’. More information can be found on the BSA website: www.stammering.org/help-information/professionals-and-business/businesses/unlocking-talent-employers-stammering-network
  • Co-presenting with Katy Bailey (www.free-speech.org.uk) on the relevance of the social model of disability for stammering and employment. Relocating the problem of stammering in society and offering participants a chance to identify the physical and attitudinal barriers experienced in the workplace enabled us to explore how prevailing norms, language and stereotypes can go unchallenged and become insidiously internalised. Practical ways of managing these oppressive external and internal barriers were then discussed. Here is our handout if you are interested in finding out more.
  • Dr Allan McGroarty’s reflections on ‘Dr Quack and his stammer cure: quick fixes, bogus treatments and charlatans’. An amusing and informative review on how to spot a ‘Quack’ following the growth of the Internet and social media. Allan concluded by reflecting on the important role that the stammering and professional communities need to play in questioning and challenging false claims about stammering therapy in the public domain.
  • RSM Jimmy Lang’s motivational speech on ‘Reaching the Top’. The sheer grit, determination and resilience that Jimmy has applied to progressing his career in the army are truly impressive. Furthermore, his willingness and commitment to using his experience and influence to benefit others has resulted in the Defence College of Health Education & Training (DCHET) joining the ESN and developing clearer systems and support processes for other military personnel who stammer. Jimmy’s personal story offered a direct and powerful challenge to the ‘why try?’ effect often reported in the research (Corrigan et al., 2009; Boyle, 2013) due to the internalisation of public stigma. Exposure to Jimmy’s encouraging and constructive ‘can do’ attitude was particularly timely for the student I sat next to, who was contemplating a career in speech and language therapy and questioning the implications having a stammer would have.
  • Convincing reports on the BSA impact at the AGM, with a persuasive video testimonial on the successful Facebook page, underscored the need for greater involvement in fundraising in order to safeguard the future of the BSA: “Ask not what the BSA can do for you, ask what you can do for the BSA!”
  • The Gala dinner at the spectacular Science Centre followed by a highly entertaining impromptu exploration of Glasgow’s nightlife.
  • Bob Adam’s and Trev Bradley’s dynamic, engaging and practical workshop on ‘staying safe on the streets’ – a salient reminder given the unfortunate mugging of one of the conference delegates in the early hours of Sunday morning.
  • The infamous ‘Open Mike’ session where delegates queued for the entire 90-minute session to speak out in front of the bigger group – many for the first time, some to share their conference reflections, others to signpost a helpful resource (e.g. the Opening Doors employment course run jointly by City Lit and the BSA) and one person to get some practice in before his daughter’s wedding later this year!

A heartfelt thank you to everyone who made the 2014 conference possible, especially David Lilburn and John Mann, and to everyone who came and contributed to such a lively and memorable weekend.

In the online feedback, I was set the task of capturing the essence of the conference in four words. They would have to be: inspiration, connection, courage and community.

The next BSA conference is scheduled for 2016 – I’d highly recommend making a note in your diary now!

Sam

Boyle, M. (2013) Assessment of stigma associated with stuttering: Development and evaluation of the Self-Stigma of Stuttering Scale (4S). Journal of Speech, Language, and Hearing Research, 56, 1517-1529.

Corrigan P., Larson J. & Rusch N. (2009) Self-stigma and the “why-try” effect: impact on life goals and evidence-based practices. World Psychiatry, 8, 75-81.

 

 

Stammering and the social model of disability: challenge and opportunity

Where does the real problem of stammering lie?

How does society communicate its values and norms about fluency and how does this affect people who stammer?

How does the SLT tread the delicate path between helping their client manage their stammering more effectively (and increase ease of communication) without reinforcing unhelpful ideas about stammering (and fluency)?

These are just some of the questions Katy Bailey, Sam Simpson and I posed in a joint presentation to the Oxford Dysfluency Conference on 19 July 2014.

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At the presentation’s heart was a conviction we all share that the social model of disability has much to tell us – people who stammer, speech and language therapists, and wider society – about stammering, and how by working together we can challenge and overcome some of the stigma out there and self-oppression in here which can make life so difficult for those of us who stammer.

Katy began by tracing the origins and development of the social model in the disabled people’s movement which disputed the traditional medical conception of disability as the individual’s problem requiring impairment expertise, cure, therapy and care. Instead, the social model locates the ‘problem’ of disability in society: in the physical barriers, but also in the negative stereotypes and prejudices which can push disabled people to the margins of society, whilst upholding powerful notions of ‘normality’. The physical barrier of a voicemail which does not let me finish saying my name may be familiar to people who stammer, but far more insidious and interesting for me is the stigma around stammering which operates along psychological and emotional pathways, and is there, Katy argues, in the struggle of stammering itself.

Sam then recounted her own development as a speech and language therapist and the disturbing realisation that she was training within a tradition firmly underpinned by the medical model in which she, the ‘impairment expert’ was expected to ‘fix’ and restore the client to normality (fluency), without any awareness of the social norms and stigma the therapy was reinforcing. Times have moved on since then – Sam’s book which she co-edited with Carolyn Cheasman and Rachel Everard, Stammering Therapy from the Inside is evidence enough – but there is still plenty of stammering therapy for which fluency is the overriding preoccupation, and which fails to take the client’s voice into account, and to grasp the broader factors of self-identity, society and social stigma.

Finally, I assessed some of the cultural pressures we face: the performance-driven and perfectionist zeitgeist in which we live and the haunting and destructive appeal of the ‘fluency god’ which I am happy to say more and more people who stammer are starting to renounce. That certainly seems to be the impression I get from a range of blogs, podcasts and websites: StutterTalk, Stuttering is Cool, British Stammering Association, Free Speech, Diary of a Stutterer and the latest, Did I Stutter? project. If you haven’t done so already, check them out! The internet and social media has been a wonderful way of bringing people who stammer together, to share our stories, insights and experiences, and to provide some collective resistance to the powerful social norms which tell us either to keep quiet and get it fixed, or at least to keep up the façade of fluency. This is the good news. And the other piece of good news is that speech and language therapists also have an important part to play in helping people who stammer overcome these barriers. Approaches such as mindfulness and cognitive behaviour therapy enable us to look at our thoughts around stammering differently, and foster healthier and more self-accepting thoughts and behaviours. There is much good work to build on, and more opportunity to continue this conversation between therapists, clients and self-help groups on how we can all work together to help people who stammer on our ongoing journey from oppression to liberation.

St John Harris
website: www.free-speech.org.uk

email: stjohn.harris@free-speech.org.uk
twitter: @StJohnHarris

Helping people with aphasia have better conversations

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Aphasia is the name given to a condition where speaking, understanding, reading and writing are damaged. If you experience aphasia, it can be devastating. Speaking is a bit like blinking – it is something you take for granted until that bit of grit lands in your eye, then you realise just how much you rely on it. In the UK around 152,000 people have a stroke each year, and one third of them will be left with aphasia.

Living well with long-term aphasia has been linked to an ability to maintain close friendships and relationships as well as a sense of control and independence over one’s life (Brown, Davidson, Worrall, & Howe, 2013; Cruice, Worrall, & Hickson, 2006). The ability to have a conversation is central to this. Just think about how many conversations you have with different people every day. Whether it’s having a good gossip with neighbours, chatting to our children about their day at school or speaking with friends and colleagues, we need to be able to speak and understand to have those conversations. Aphasia can make conversation almost impossible, devastating the quality of people’s lives, and the lives of those nearest and dearest to them.

For this reason I applied to the Stroke Association to do a PhD to further explore how we, as speech and language therapists, help people with aphasia develop skills and strategies to have more enjoyable conversations.

Left aligned logoPrior to my PhD I was part of a UCL based research group that developed the ‘Better Conversations with Aphasia’ (BCA) therapy (Beeke et al., 2013). BCA helps people with aphasia and a regular conversation partner of their choice learn about how conversations work in general, and then explore how their conversations are working. The aim being for them to then make informed decisions about how they may (or may not) want to change the ways they currently accommodate aphasia within their conversations. Watching videos of their own conversations, and the conversations of others is key to this approach. However, some clinical settings access and permission to use video with clients is not always easy. For this reason, I am keen to find out how speech and language therapists working clinically work on communication strategies with people with aphasia and their partners. My end goal is to then compare ‘typical’ clinical practices to the BCA approach, to better understand how different therapy techniques might change peoples’ communication strategy use.

If you would like to find out more, or you have aphasia and are interested in taking part in my PhD project, please visit my blog http://www.firleb.wordpress.com. You can also follow me on twitter @firleb.

There is also a free, aphasia friendly, e-learning tool for people with aphasia, their family and speech and language therapists, which can be accessed via this link: https://extendstore.ucl.ac.uk/product?catalog=UCLXBCA

All you need to do is register and then you can access it.

Firle Beckley

PhD Student University College London/Stroke Association Junior Research Fellow

Beeke, S., Sirman, N., Beckley, F., Maxim, J., Edwards, S., Swinburn, K., & Best, W. (2013). Better Conversations with Aphasia: an e-learning resource. UCLeXtend.

Brown, K., Davidson, B., Worrall, L. E., & Howe, T. (2013). “Making a good time”: the role of friendship in living successfully with aphasia. International Journal of Speech-Language Pathology, 15(2), 165–75. doi:10.3109/17549507.2012.692814

Cruice, M., Worrall, L., & Hickson, L. (2006). Perspectives of Quality of Life by People with Aphasia and Their family: Suggestions for Successful Living. Topics in Stroke Rehabilitation, 13(1), 14–24. Retrieved from http://thomasland.metapress.com/index/4jw57vg8g6x31qvj.pdf

 

Living with a communication disability: insider accounts

image001 ‘Nothing ever becomes real till it is experienced’
John Keats
One of the greatest challenges in acquiring any new skill is taking the knowledge you have gained and applying it to the real world in a meaningful and positive way. Bridging the gap between theory and experience is something I, as a student speech and language therapist, have had to contend with. Speech and language therapists work with a wide range of clients at various stages of their lives and recovery, and whilst training there are limits on the range of clients you are able to work with due to various factors, such as timing and placement provision. The reality of being a newly qualified speech and language therapist is being faced with client groups that you have no previous experience of working with. Although you have the theoretical knowledge and transferable skills this prospect can feel daunting.

Sam Simpson and Cathy Sparkes have recognised the importance of learning through experience and how talking to people with a communication disability can enhance the developing skills of student speech and language therapists. ‘Living with a communication disability: insider accounts’ was one of a series of lectures Sam and Cathy gave to speech and language therapy students at University College London this year. It provided an open forum for students to meet clients with a range of communication disabilities, to hear their stories and ask them questions. This experience differed from meeting clients in a placement setting as our role was not to assess, provide therapy or to advise them, but to listen to their personal narrative and use their experience to reflect on our practice as speech and language therapists in training.

Clients sharing their stories in an open and honest way made me reflect on the extent to which communication disability impacts a person’s life. What stood out to me were how the clients’ communication difficulties impacted their identity and role within society. Examples included difficulties returning to their previous occupation and maintaining social networks and relationships. Viewing the client holistically has been embedded into our training, but I believe meeting clients and hearing their first-hand accounts has made me reflect on my perception of what speech and language therapy can offer. As a student I am guilty often of getting overwhelmed with theory and the process of therapy, which can narrow my view of the client. This experience has taught me to view every client I meet holistically and to consider the wide-ranging and varied impact a communication disability can have on an individual. I hope to carry this experience with me beyond my training into my clinical work as a constant reminder of the importance of the person at the centre of the communication disability.

Lindsey Beer

Therapy: admitting defeat or an accomplishment?

It took 18 years of living with my stammer before I finally decided to seek help in the form of stammering therapy with Sam at intandem. 

So, why did it take me so long? 

Well, the answer was because I did not want to admit I had a stammer. By pretending it wasn’t there meant that it somehow wasn’t a problem and that it would just disappear… Of course it did not. If I admitted defeat maybe it would rear its head even more? Was I embarrassed by the idea of having a stammer…? Sure! 

Throughout the years my fluency has gone through high and lows. Approximately a year ago I felt I was really struggling. I had become a lot more conscious of my stammer and was even more keen to hide it. The negative feelings surrounding my stammer had increased, which in turn made me stammer more. I felt like I was on a downward spiral and through all the battling I could see no way out.  april14   So, I ‘admitted defeat’ and sought help. 

A year on, my thoughts and attitudes towards my stammer have changed quite radically. One of the key turning points for me was ‘self advertising’, which involved telling friends, family and others that I stammered. Through Sam I had an opportunity to put this into practice by speaking of my experiences to groups of speech and language therapy students: the first time I would give a speech to an audience who all knew I stammered. The scenario was quite alien and I was not sure how I would respond. 

The experience proved more rewarding than I could have ever imagined! The audience’s knowledge of my speech actually reduced the pressure to try not to stammer. If I felt a stammer coming I was more willing to let it out. Quite quickly and without realising I became more relaxed, a lot more fluent and public speaking actually became enjoyable. 

Now a year into speech therapy I have developed a more realistic view of others’ perceptions of my stammer and also put my own stammer into perspective. Rather than battling to avoid stammering I am now more willing to stammer openly. The end result (one which I was always looking for) has been an improvement in my fluency, however it is the underlying feeling of speaking without fear and being freer to engage in the things that I want that has made the biggest difference. 

So, in hindsight, ‘admitting defeat’ feels more like an accomplishment, and much, much more! 

Kal

Collaboration

“Coming together is a beginning, staying together is progress, and working together is success” Henry Ford

2014 marks intandem‘s 10-year anniversary. Throughout this time, collaboration has been at the heart of all our work – both with each other and with others. 2013 was a year of experiments and we worked hard to establish even more connections and links within and outside our professional groups, using a range of approaches. As a result our networks and those we have reached and influenced have increased considerably. Here are some highlights from 2013 and some aspirations for 2014…

Twitter: @_intandem
One of our new ventures in 2013 was setting up a twitter account. We have written over 100 tweets and now have over 70 followers – including clients, therapists, counsellors, researchers, organisations, charities, students, and projects. We are using twitter to let people know what we are up to as well as signposting other events and ideas. Twitter offers a different way of interacting with individuals and groups and one that we hope we are getting better at with practice. We are starting to build a community of collaborators, which we consider a positive way forward.

Blog: www.intandem.co.uk/blog
2013 also saw the start of our monthly blog. Together with a range of guest bloggers, we have been able to use this as a regular platform to share ideas, reflections and insights as well as to signpost projects. Topics have included: different group experiences, vulnerability, acceptance, community & celebration, supervision and last, but not least, the launch of Stammering Therapy from the Inside: New Perspectives on Working with Young People and Adults. We have had a very positive response to each blog post and look forward to welcoming a range of new collaborators throughout 2014. Watch this space!

Culture Club
Another new intandem project for 2013 involved setting up a group opportunity for people with experience of stroke, tumour, head injury or brain surgery who are interested in music, film, theatre, comedy and art (Read here for more information). This open group of men and women meet every two months in the comfort of a local hotel café. Feedback to date has been resoundingly positive with a shared enjoyment of events, new ideas, humour and support. We plan to continue with this group throughout 2014 – check out the dates on our website here.

Relationship Group
Working with young people with experience of brain injury, who want to develop new friendships and relationships, has brought intandem to experimenting with a new group. We are looking forward to collaborating with Flame Introductions, a personal introduction agency who specialise in supporting people with mild disabilities and who you may have seen on the TV programme The Undateables. Our first joint meeting will be in March. Do get in touch if you are interested, as we are keen to open this group up to others.

Stammering Open Space
This open group has gone from strength to strength over the course of 2013 and now has a well-established core membership. (Read here for more information). Again feedback has been highly positive with a shared appreciation of the support and challenge, lively debate and exchange of ideas that the group offers. 2014 dates can be found here.

Courses
In our continued attempt to raise the profile of supervision within the profession we ran regular RCSLT registered Supervision 1 & 2 courses in England and Wales throughout the year. 2013 also saw us collaborating with UCL to offer a bespoke supervision course for new graduates. We recognise the unique needs of those entering the profession in the current climate. Through the course, we aimed to equip the students with the knowledge and skills to reach out for good support and supervision throughout their careers. Our shared commitment to offering support and training to therapists, coaches and other healthcare professionals interested in developing their counselling skills, resulted in our running a number of training days across the year, both independently and in collaboration with the Personal Construct Psychology Association and City Lit. intandem was also involved in organising a day of talks at City Lit to mark the publication of ‘Stammering Therapy from the Inside’, as well as co-ordinating a local book launch. Our 2014 programme of courses can be found here. Do check out what is new and let us know if you are interested in taking part.

We have enjoyed a year of experimentation and collaboration. Thanks to everyone we have worked with and met along the way! Here’s to 2014 – as we reach out to new possibilities ahead.

Cathy & Sam
January 2014