Talking Mats - case study evidence

Published in Case studies on 15 Aug 2011

Talking Mats and Reviews

An outreach worker at the Centre was working with a young boy who was experiencing significant difficulties at school including aggression and non-compliance. He was being excluded and had also spent considerable periods of time being looked after away from home by other family members. During meetings which the boy was not part of it became clear that his own views and voice was not being heard. With this in mind the outreach worker completed a Talking Mat with him.

The worker then spent time with the boy talking with him about the different aspects of his life and using pictures, asked him to place them on the mat depending on how he felt about them (a tick for 'like', a question mark for 'not sure' and a cross for 'dislike'). The boy was able to quickly grasp the concept and was able to express a wish to live with his uncle not his mum and that he liked school but hated being shouted at. The worker was then able to ask his permission to take this to the next meeting to ensure that all the important people in his life knew what he was thinking and feeling. Following the next meeting the worker drew a picture to show the boy who was at the meeting and used speech bubbles to give him an idea of what was discussed.

This boy has since blossomed in his confidence and has really started to trust the worker. Feedback from the professionals has been that he appears to find communication easier and although he continues to have significant difficulties they have not been to the same extent. A hearing recently took place and the child was excused because of the content of some of the discussion. However, again the worker completed a Talking Mat with the boy and this time he chose to use speech bubbles and words instead of pictures. The worker was then able to take this mat into the hearing and ensure again that his voice was heard. Panel members fed back that they had not seen such a tool before and found it refreshing to have the child's views included in this way even though he wasn't in attendance.

Talking Mats and the Children's Hearing system

This example involves a child with significant additional support needs and both parents with complex learning difficulties.

There had been ongoing concerns about the parents' ability to meet their child's needs and keep her safe. A Children's Hearing was called and legal grounds for the Hearing were read out to the parents for them to agree or disagree with. Staff were aware that the parents were agreeing to quite complex information and were concerned they may not fully understand it. A decision was made that the grounds would need to go the Sheriff Court. Two staff members who know the family well felt that this was a perfect opportunity to use Talking Mats to support the parents to fully understand the process of the Hearing and the legal grounds. A mat was worked through with each parent separately so they could indicate which grounds they agreed with, didn't agree with or didn't understand. Each of the grounds were also explained using visual tools. What was clear was that both parents had been very distressed by the process and their learning difficulties had exacerbated this. It came to light they had not understood any of what was asked of them during the Hearing. Using Talking Mats both parents were able to be clear about what they agreed and disagreed with and to explain their feelings. When they were called to the Sheriff Court they were able to use the information gathered through using the mats to provide feedback.

Talking Mats were also used to explain to the parents about what a supervision order was and what the conditions were. Again, visual tools were used to explain to the family what the consequences would be if they didn't comply with the conditions. The appeal procedure was also explained in detail. The father had arrived at the meeting very tense and explained that he was angry and wanted to see his lawyer. However, once the mat had been completed he appeared much more calm and was able to share with the worker that while he wasn't happy he was not allowed to be on his own with his little girl he understood why and did not want to appeal the decision. Feedback from the family, the social worker and the Children's Hearing Service has been very positive and workers have been asked to meet with other Reporters from the Hearing System to talk to them more about Talking Mats. The family have said that they have found the mats helpful and that they understand and agree with what has happened to them and their child so far.

Talking Mats and Very Young Children

A Talking Mat was used in a different way with a child of twenty months. The child lives in a chaotic home environment with relationship breakdowns and concern around mum's drug use, her mental health and ability to identify, understand and meet his needs. The child would often present as highly anxious but would shut down and disassociate at times of stress. This made assessing and understanding his likes and dislikes very difficult for the staff. It was agreed that through observations and photographs staff would try to plot a mat showing the child's reactions to different activities and events. Along with the photographs the worker wrote statements to give more information about what was happening and the child's reactions.

It was apparent that although his communication was limited there were clearly times where he demonstrated unhappiness or distress. The most significant of this was when mum was late in collecting him from the centre. He would always seek out the same cuddly toy and hold it tight whilst constantly saying 'mummy, daddy'. He would at the same time sometimes have a frown and a worried expression. He found sensory, tactile and messy play difficult and would avoid it or show dislike. Again it was possible to plot this on the mat using the photographs and worker's written statements. The photographs were duplicated and mum was asked to plot these on the mat to see how she recognised her child's likes and dislikes. Mum had started the session angry and defensive but seemed to calm down and focus on her child as she plotted the photographs against his likes and dislikes. At at end of the exercise Mum and the worker had almost identical mats. Staff felt this empowered Mum in feeling that she knew her child well. It was also an example of partnership working as it enabled the worker and mum to work together to think about strategies to alleviate the child's distress. This work is in the early stages but the Centre hope to develop it much more and use it as a tool to work with parents to focus on their child's views, wishes and hopes.

Talking Mats and Family Work

Workers were supporting a three year old boy who's mum was challenging and had personality disorder. The worker had been facilitating some nondirective play work with the child and asked for support in how she could empower him to share some of his feelings about his mum's anger with her. The Centre worked to create an environment for the child in which he felt safe to firstly seek his views about the play work and what he had enjoyed, not enjoyed or was unsure about.

What was interesting was that the child himself brought his mum into the Talking Mat discussion and shared with the worker that his mum's shouting made him very sad. The next step was to try and encourage the child to share his mat with this mum. Again what was interesting was that before the worker could suggest it to the child he had asked if he could show it to his mum. The worker was supported to think about how to keep the child safe within this situation and how best to facilitate the conversation between the child and his mum. Thought was given to the set up of the room and where the worker should position herself. The child was involved in this and he wanted two chairs side by side for him and his mum and for the worker to sit close behind him. The child was then able to talk to his mum about all the things he had been doing with the worker and used the mat to show her what had been difficult for him such as trying to get off and on the big rocking horse.

When it came to the picture of his mum (drawn by the worker) he told Mum that it was a picture of her. He then said in a very quiet voice "when you shout it makes me sad". Mum became negative and defensive: "I only shout when you are naughty". Again the child used his mat and repeated in a much louder voice "no mummy, when you shout it makes me sad". His change of tone seemed to have an impact on his mum and she was able to talk with him about his feelings, really listen to him and show him through touch that she had heard him. It seemed that having the mat in front of him empowered and supported him to talk with his mum about something really scary but important for him.

Talking Mats: a practitioner's perspective

A key part of the role of working with children is gathering their views and feelings. This can be challenging in daily practice, not just from time constraints but being able to clearly evidence you have gathered their views and their understanding of what has been asked of them. Children can find it difficult to talk about very emotional topics, Talking Mats are a fantastic way of helping even very young children have their say in a non-threatening way.

Preparation is crucial, and well worth the time and effort involved. A number of practitioners in the neighbourhood are beginning to use this tool and build up resources of pictures that can be used. Over time this will help cut down on some of the preparation time as these resources can be shared. By ensuring that I had adequately prepared for this activity I was able to feel more confident in using it for the first time.

I used this tool to gather the views of a three year old child, who was showing signs of real distress during contact with her mother who has personality disorder. It was relatively straightforward to put my observations of the child's behaviour in reports to the Children's Hearing and draw conclusions from this, however this was not allowing the child to have their say.

Being able to share a Talking Mat with the parents helped everyone involved gain a clear and understandable insight into this child's views. Using the talking mat as a structure for discussing a very distressing subject with the parents helped make the meeting more productive and manageable. For the first time, the 'transference' of the mother's feelings was also more manageable and contained, and I was not expecting this positive outcome. From the mother's perspective it was very difficult to hear and see what her child was sharing, however for the first time this Mum with personality disorder was able to gain an insight into how her child's feelings and views were different from her own. The Talking Mat will also be shared at the Children's Hearing, to enable the Panel members to hear and see the child's views.

To ensure the child understood what was being asked of them I used a 'food' themed Talking Mat. Information was gathered from the carer to ensure pictures of food the child liked and disliked were included, as this would act as a control to monitor their understanding. The child was also asked to name the emotion 'smileys' so that this reflected her views. This worked really well with the child clearly demonstrating her understanding. The session itself did not take long but was really helpful in beginning one-to-one work with the child in a relaxed way.

The second session was always going to be more challenging as this would focus on contact, both for the child who had a strong negative reaction to contact and for myself using this tool for the first time. A stage by stage picture sequence was shared from being at home with the carer, to being collected, arriving at contact, during contact, journey home, being back with carer and bed time.

As a practitioner I found that my observations of the child's contrasting behaviour in the two tasks heightened my understanding of how much the child was struggling with her emotions when talking about their mother. In the initial session the child was confidant, chatty, able to concentrate and fully focused on the task. By marked contrast as soon as the subject of contact was discussed the child's behaviour changed, and they wanted the session ended after 20 minutes. During the sessions I also asked the child's permission to take photographs (having received permission from her carer beforehand). In terms of evidence to present to parents, Children's Hearings etc, this provided a graphic illustration of the contrasting behaviour and presentation of the child during the two sessions, as well as evidence that this is the child's own work.

This direct work and photographs were shared with the Panel members at the Children's Hearing following a discussion of my social work report. Panel members were given an opportunity to examine each piece of work and the corresponding photographs and to ask questions. This provided a very focused opportunity for a full discussion about the child's needs, views and wishes. From feedback from the Panel members it was clear that they appreciated having the opportunity to see and hear about the child's views, however more importantly it helped them gain a deeper understanding of how the child felt about contact and was a vital part of their decision making process. The Panel Chair in his summoning up commented on the benefits of using the Talking Mat and photographs in helping them make the right, but very difficult decision to end the child's contact with her mother.

Talking Mats will become part of the toolkit I use in working with children and their families on a regular basis, and is well worth the time and effort involved in the preparation stage.