The Dark Art of Speech and Language Therapy

This month marks 2 years since I started my blog and although I don’t post so often these days interest doesn’t seem to have dwindled if the number of hits each week is anything to go by. Although overall I am enjoying this journey, there are times when the sheer size of the job can feel quite overwhelming. The range of valuable roles that a Speech and Language Therapist can play in the context of adult mental health is what keeps this job interesting and challenging all at the same time.

I seldom take the time these days to reflect on the breadth of roles I undertake on a day to day basis but I have a had recent cause to consider exactly that. I was asked last week what my “elevator pitch” for my service would be. If I had 10 seconds to sell myself (in a professional context obviously) what would I say?

Mental health and communication are very closely linked. The way a person communicates can tell us a lot about their mental health or even diagnosis, and conversely a person’s ability to communicate can significantly impact on their mental wellbeing. Equally, mental health workers’ ability to make appropriate adaptations to the way they communicate according to each individual’s need can make or break important therapeutic relationships.

Speech and Language Therapy has been described to me as being a bit of a “dark art” as people aren’t entirely sure what we do, and I believe that is because communication is the foundation of everything we do, not only in mental health, but in life. A Speech and Language Therapy assessment can make sure you get the right treatment by gathering information that leads to the right diagnosis. A Speech and Language Therapist can work alongside your Occupational Therapist to help you get a job. A Speech and Language Therapist can work with you to increase your self-esteem and confidence by improving your communication skills or addressing a specific speech or language difficulty you experience. The list goes on.

So what would my “elevator pitch” be?

Communication is a fundamental human right and forms the basis of all our interactions and relationships. Mental health services need Speech and Language Therapists because without the support we can offer there will be people whom services fail by not adequately addressing their communication needs. Without specialist knowledge from Speech and Language Therapists the risk of individuals becoming stuck in a downward spiral of poor communication and poor mental health increases. Services need Speech and Language Therapists because without effective communication what do we have?

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Keep It Going

This month started with reflection on some key messages of NHS Scotland 2014 and will end with consideration of the event’s main theme: the challenge of sustaining and spreading good and innovative practice. How can we make others aware of the work we are doing to improve our services and ensure that good things are not just happening in isolated pockets within this huge organisation that is our national health service?

There are many ways in which we can promote our work but they do require that wee bit of effort. Thinking differently about a practice development project you are sure no-one would be interested in (you are wrong by the way), creating that poster (not as hard as you think), applying to present it at conferences (please note that this word is plural!), the list goes on, but the newest tool in our kitbag is social media.

If you are one of the people who are sceptical of or unsure about the power social media can wield let’s consider the extend to which messages about positive practice can can be spread using social media platforms.

In my last blog I shared videos which were launched at the event to promote some great work at Yorkhill Children’s Hospital – What Matters to Me has been viewed 1346 times and I’m on My Way a massive 22,240 times.

So far this month I have composed 262 tweets promoting messages, practice and research relevant to my professional interests. These will potentially have been seen by up to 420 people who follow my Twitter account, and almost half of these tweets have been re-tweeted by my followers and their followers, and so on, reaching up to a potential 59,000 people.

To date almost 4300 people from across the globe have read my blog, and over 600 of these people have accessed posts via Twitter. Even more impressive (for me at least) is that tweets mentioning me by name this month have potentially reached over 43,000 – now that’s a good way to build a reputation!

Is this social media thing a good use of our professional time and effort? I think so. Do we need to be more able to see our practice as being worthy of sharing? Absolutely. Can we afford not to? No way!

Autism: Not Child’s Play

World Autism Awareness Day on 2nd April marked the start of a month of activities aiming to develop understanding of autism and Asperger Syndrome. So I have decided to dedicate this month’s blog to talking about the work I do as a Speech and Language Therapist with and for people with autism spectrum conditions.

One of the things that often surprises people is that I work with autistic adults. Autism is something children have isn’t it? Certainly many internet searches and much media coverage could lead to you this conclusion, but strangely enough autistic children grow into autistic adults, and for many people, particularly with Asperger Syndrome, it is not until adulthood that the diagnostic process begins. This doesn’t mean that they have somehow acquired autism, but rather that it is not until adulthood that their differences start to interfere with living a “normal” life. Quirks are no longer considered “a phase he is going through”. Academic promise does not necessarily translate into vocational success. The shy girl who was praised for keeping her room immaculate is now told she has anxiety problems and OCD.  You get the picture.

The autistic adults I meet are accessing mental health services, so on that basis they are usually struggling with their mental wellbeing. Most often this is the result of living either with an undiagnosed autism spectrum condition, or with a poor understanding of the diagnosis they have received earlier in life. As a result, these individuals have not learned why they act, think and communicate in the ways they do, and have failed to develop a positive sense of self. They can feel that they are the only person who experiences these challenges, and have no or few strategies to deal with the confusing and complicated world around them.

As a Speech and Language Therapist I play an important role within our Community Mental Health Teams for not only diagnosing autism spectrum conditions in adults, but also in providing support after that diagnosis and promoting improved mental wellbeing. One of the most exciting developments I am currently involved with is a post-diagnostic group aiming not only to educate but also empower, and to create a supportive social network of people with Asperger Syndrome in a local area. It is early days yet with this pilot project but the feedback from participants so far is good and relationships are beginning to develop. Ultimately, people living with autism spectrum conditions will learn the most from other autistic people because they will always know more about how it really feels and what really works, but if I can play a part in helping people make those connections then I can be proud of doing my job well.

Simply the Best: Nurture

My 3 best things about being a mental health SLT this week appear to have a nurturing theme – conversations that nurture understanding, nurturing the learning of others, and nurturing skills and self-reliance…

1. Talk to Me – When a client walks in to clinic distressed and is able to walk out calmer and with a sense of direction and achievement I know what I do is worthwhile. There are times when we need to talk through our difficulties in order to sort things out and to feel better but this is much more difficult if you also have a communication difficulty. When you cannot find the words to express how you feel or explain why you are feeling that way, others find it that much harder to help you find the right solution. When you cannot organise information in a meaningful way you can feel that others are not listening to you or even find that you get yourself even more confused than before. John* arrived for his appointment this week in a very flustered state. He had been feeling overwhelmed in recent weeks and this was impacting on his ability to discuss his worries with his family and friends. By creating a structure around the conversation and providing appropriate feedback, John was able to organise his thoughts and we were able to work through his problems, and he left his appointment much happier and calmer than before.

2. Look to the Future – As part of my job I am involved in the clinical education of student Speech and Language Therapists from Queen Margaret University. My current student is approaching the end of her placement and it makes me so happy to watch her confidence grow and her skills develop. This is one of the very few adult mental health placements available in Scotland currently and it is wonderful to be involved in developing clinical interest and skills for this client group in our emerging workforce.

3. First Steps – Our new group for clients who have recently been diagnosed with Asperger Syndrome started this week. The purpose of the group is to provide information about Asperger Syndrome; helping these individuals to have better understanding about the ways in which they communicate, think and act differently from others, to develop coping strategies, and to establish relationships and gain support from peers who are “the same as me”. First sessions are difficult for everyone – especially people with Asperger Syndrome – but by creating an Asperger friendly environment and pacing information and demands correctly our group was a great success.

John* is a pseudonym to protect client confidentiality

Communication at Risk?

I am delighted to be able to share this blog by another mentalhealthslt about her role working with people with dementia. Joy has been an inspiration and an invaluable source of information for me (and I know to others) on my professional journey as a Speech and Language Therapist in Mental Health. Joy has also agreed to contribute to future blogs on mentalhealthslt so look out for more in the future…

Communication at Risk?

Speech and Language Therapy in Dementia #SLTDementia

Joy Harris           

 

P1I have always felt privileged that I have a job which is never dull and has challenge and reward in equal measure. There is no such thing as a typical week. I work with people newly diagnosed with dementia who have significant communication difficulties. These are most often people diagnosed with a Fronto- temporal type dementia or with language deficits associated with an atypical Alzheimer’s .I have an additional role of Clinical lead for Dementia in Lothian. This means that I constantly juggle day to day clinical work with more strategic work on developing the awareness of the speech and language therapy role in dementia and increasing the knowledge and skills of speech and language therapy . I am most passionate about increasing our role in facilitating communication in people with…

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What Counts?

Apologies for my recent silence – October has been a busy but very productive month for raising the profile of Speech and Language Therapy in mental health settings.

The month started off with 2 conferences in Edinburgh for Allied Health Professionals from across Scotland, the UK and the world. I was pleased to have a poster accepted for the Scottish conference and honoured to be asked to present a workshop at the International conference. My topic for both was person-centred care and I shared the outcomes and learning from the staff training and support programme I have been piloting with a team of local social care staff.

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I am proud to say that my poster won joint first prize as voted for by delegates attending the conference, and even prouder that my workshop was attended by the CEO and Chair of Royal College of Speech and Language Therapists!

Our outcomes are so important but sometimes it can be difficult to measure what is truly important. As Albert Einstein is reported to have said, “Not everything that can be counted counts, and not everything that counts can be counted”. In an age where we are driven to seek the evidence to underpin our practice where can we find the evidence about what really counts for the people in our care?

With this in mind, the RCSLT Mental Health Clinical Excellence Network met in London, Glasgow and Limerick (embracing video-conferencing technology) to discuss “What works for SLTs in Mental Health?”. We had a packed day of presentations from therapists working in the field; sharing information, approaches and tools that have really made a difference for the people they support. While far from the scientific “gold standard” of research evidence, this sharing of anecdotal experience does start the process of unpicking what really counts in the work that we do.

In my work supporting good communication between people with mental health problems and social care staff I have not improved any one person’s speech, language or conversational skills as could be measured on a standardised assessment. However, what we have achieved are significant improvements in people’s quality of life in terms of their participation, independence, involvement, relationships and mental wellbeing – and that, in my opinion, is what really counts.

Singing from the Same Songsheet

What happens when you ask a Speech and Language Therapist to talk to a group of professionals including Mental Health Nurses, Social Workers,  Occupational Therapists, Mental Health Officers, Police Officers, Advocacy Workers and Employment Advisers about how they work with and supporting adults with mental health problems?

Firstly, you get a slightly anxious Susan. I am accustomed to speaking to large groups of people so an audience of around 70 was not the issue. My trepidation came from speaking to such a diverse audience. Usually I have an idea of how receptive or otherwise my audience are likely to be; not so on this occasion. So maybe it was fitting that I was speaking at the home of Captain Robert Falcon Scott’s Discovery as I embarked on this journey into unknown, possibly frosty and potentially treacherous territory!

I need not have worried, as what transpired on the day was an incredible conversation where everyone agreed about the importance of recognising and addressing communication difficulties.  If I was to summarise the message from the audience it would be…

  • we cannot do our jobs without good communication,
  • it is an ongoing challenge to communicate well with the people who use or come into contact with our services,
  • we don’t always get our communication right,
  • so how are you going to help us?

So I need not have worried. It would appear that we are all singing from the same songsheet – my job now is to be good conductor and pull this performance off!