MY TOP RESOURCES

JULIET CONDON IS A SPEECH AND LANGUAGE THERAPIST WITH COVENTRY AND WARWICKSHIRE PARTNERSHIP TRUST, E-MAIL JULIET.CONDON@NHS.NET.
When I began this article I was a newly qualified therapist! A year further down the line, its been interesting to look back and see what Ive learned. I graduated from Queen Margaret University, Edinburgh in July 2005 and work in the field of adult learning disabilities. I am mostly in the community, providing speech and language therapy to day centres and residential homes. A large part of what I do involves the wider multidisciplinary team and working alongside care home staff. We provide a lot of training to raise staff awareness of different communication issues and ways that they can adapt the environment (total communication). I also spend two sessions a week in the forensic service a unique, interesting and challenging opportunity for a new graduate. I am involved in direct assessment and therapy with clients in medium and low secure units as well as helping the team provide a wider service including training to the on-site staff. I really enjoy my job as it is so diverse and interesting. It is great working as part of a large and dynamic team there is always some new project to get involved in! 1. PEER SUPPORT I am very lucky to have started work with three other newly qualified therapists. This may be fairly unusual but talking things through with your peers and course mates is useful and vital for your sanity. Peers reassure you that you are not alone in your worries about being a newly qualified therapist - and they also provide valuable information. You are all learning about the job at an amazing rate and each person is picking up different pieces of information about services, the Trust you work in, therapy methods to try and so on. We have regular meetings with other newly qualified therapists in our Trust to discuss common concerns such as pay scales and pensions, and to have talks from specialist therapists. 2. INITIAL SCREENING ASSESSMENT BAG This assessment tool made up by therapists in our team contains real objects (eg. comb, sock) and laminated photographs of the same objects and matching symbols. We use it to assess a clients ability to match, select and name the various objects, photos or symbols. We have selected objects that are adult appropriate and used in daily living. The assessment can be used at whatever level seems appropriate. 3. INTERNET A vital source of information on medical conditions and so on is the National Library for Health, www.library.nhs.uk. If you work in the NHS you can go to My Library, then My Update and they will send you a regular email with news and articles related to your field. I also use the web to keep up-to-date with Trust information, relevant charities and associations and client orientated websites such as www.sensoryworld.org. In addition the internet is invaluable for finding photographs for use in accessible information - for example I would go to http://images.google. com/ to find pictures of a laundry basket for a visual timetable. (Just be aware of legal issues see www.ucl.ac.uk/learningtechnology/legal/ copyright/copyright.pdf.) 4. ACTING THE PART MAKES YOU THE PART Rising to the challenge of being a new therapist is never easy. Even before you start your first job, feelings of panic set in how will I actually do the job? And when you do start how do I do this? Ive never done this before how will I know what to do? The answer is that everybody is still learning - and thats whats great about being a speech and language therapist. Having talked to various friends in the same boat and also those in new jobs but different careers its clear that you have to put on your therapy hat and be a speech and language therapist! You may feel like you are pretending, or that everyone will realise that I dont know what Im doing but actually other peoples expectations of you can help. Staff / clients / carers / professionals see you as a therapist they expect you to be the expert and have the knowledge to do your job. And the truth is you do have this knowledge, albeit a growing one. Youve had the specialist training. Now its time to get out there and share it with others. So rise to the expectation - and before you know it, youre really doing the job. 5. EKOS GREENSHEETS Our team uses the East Kent Outcomes System for therapy aims. Each episode of care is planned and written out on a greensheet, a one-page green form with boxes to fill in. For each episode 1-3 overall aims are set. These are then broken down into measurable objectives. Baselines are recorded and then you set out the stages of intervention that you plan to carry out with the client. You plan a time period for the episode and a date to evaluate whether your aims have been met. As a new therapist I find this system essential in defining therapy goals and keeping aims in mind over long episodes of care. I have used similar systems on placement (for example Kate Malcomesss Care Aims, www.careaims.com); whichever one you use, they are a useful aid to recording and planning care. Johnson, M. & Elias, A. (2002) East Kent Outcome System for Speech and Language Therapy. East Kent Coastal Primary Care Trust. 6. SYMBOL PACKAGES In the adults with learning disabilities service we are always creating new and varied types of resources and accessible information for clients. To name but a few: communication passports, chat books, visual timetables, personalised keyrings, accessible appointment letters, accessible reports, information booklets (The Mental Capacity Act, Guide to Benefits) and so on All of this would be nigh on impossible without the aid of our many and varied symbol packages such as Widgit, Communicate: In Print (both www.widgit.com) and Change Picture Bank (www.changepeople.co.uk). 7. ASSISTANTS Where would we be without our three - yes three! - speech and language therapy assistants? Not only do we churn out vast amounts of work for them to create and put our wild ideas into laminated reality, but they have their own caseloads, specialist experience and extensive knowledge of the client group. They deliver training and therapy and one also wears a dual hat as our communication aromatherapy assistant, particularly useful for clients with profound and multiple learning difficulties. See www.rcslt.org/docs/free-pub/standards_ practitioners.pdf for standards for working with assistants. 8. CLINICAL SUPERVISION We have various forms including 1:1 with our manager and group supervision where we discuss caseload queries and swap ideas for therapy or how to deal with complex cases. We also have forensic supervision with a member of the psychology department who has lots of experience in this area. In addition we organise group continuing professional development meetings and take it in turns to research and present particular topics for discussion. Its really useful to have dedicated time for supervision to discuss any problems and share ideas. We are lucky to have a very supportive team so can ask for individual help at any time. (If your workplace supervision is inadequate it could be worth making your own arrangements through an independent provider such as www.intandem.co.uk.) 9. SENSORY ASSESSMENT BOX We have this as a growing resource and its constantly added to as members of the team spot new and exciting things. We use sensory items in both assessment and therapy especially with service users with profound and multiple learning difficulties. A record sheet is used alongside the items to record client responses, whether positive or negative, so that likes / dislikes can be ascertained. It is also useful to assess reactions to visual, auditory and tactile stimuli. Items in the box include bubble wrap, voile material, metallic wrapping paper, bean bags, flashing light balls, vibrating stick, items that make noises and a big parachute. These are also useful for supporting sensory stories. Helpful websites include www.dundee.ac.uk/ pamis/projects/sensory.htm, www.bild.org.uk/storytelling and www.pri-liberator.co.uk. 10. CAFFEINE AND CHOCOLATE DIGESTIVES Essential to any job, and especially one which involves lots of meetings:) A spare packet of biscuits in a drawer can a) liven up a meeting b) motivate people on training c) console a colleague d) keep you sane.