Hearing Voices is Actually Like Being in an Abusive Relationship

Hearing voices is one of the most shocking mental experiences that a person can have because it immediately raises the question: Am I mad? Beyond this, voices are highly abusive, and attack the person’s self-worth. As such they are totally and instantly disruptive in the person’s life.

In my whole career as a clinical psychologist, I have never come across any other group of people who are so consistently battered by their mental experiences. However, following closely are those nearest to the person who is experiencing voices and who ultimately become their carers. Shock, confusion, anger and ultimately grief and hopelessness assail the carer.

Hearing voices will need specialist attention and here we discover the third group of people who are often floored by voice-hearing; the clinicians and other workers who get involved. There were many occasions that training was requested for clinicians in this area so that they could be equipped with some tools to assist their clients.

On the Frontline with voices speaks to all three groups and it is constructed to do so from within each group’s frame of reference.

One further objective of my book is to fit with early intervention, as the longer voices are present, the more they become embedded and the more they disrupt the person’s life. It is also true that within the context in which they commonly occur, it all becomes a family breaker and may in fact cause stress related mental health problems in carers as well.

For me it has always been a privilege to work with people troubled by voices as the experience is no less than someone trying to survive an abusive relationship. This then is my point of departure; strategies to deal with an abusive relationship so that the person can once again take up their rightful place in society.

Keith Butler 
Speechmark author of On the Frontline with Voices - A Grassroots Handbook for Voice-hearers, Carers and Clinicians

Preparation is all important

The Pre-verbal Skills of Language

Whether we are baking a cake or building a house, we all know that good preparation is critical to the desired outcome of the project. For a cake to be delicious, the ingredients need to be measured correctly and strong, solid foundations are essential to ensure the stability of a house.

 

The same applies to language development. For a child to develop language that is functional and communicative, they firstly need to acquire the pre-verbal skills, the skills that provide the foundations on which language is built. 

It is easy to assume that if a child is able to speak, they have already acquired the pre-verbal skills but this is not necessarily the case. A child can often use words but not use these words to communicate effectively with others. Being aware of the pre-verbal skills and assisting their development is very important for the development of a child’s language. This can be done by;

• Encouraging the child to look at you or in your direction, even briefly, when they speak to you or want to show you something.
• Gradually developing the child’s ability to focus and concentrate on a range of activities; those he enjoys as well as activities chosen by other people, such as a parent or teacher.
• Drawing the child’s attention to objects around them and showing them how to look at things both inside and outside, rather then just looking at objects directly in front of them.
• Teaching the child to listen to the sounds in their environment such as planes, printers, dogs barking.
• Encouraging the child to copy actions and sounds made which is done most effectively through play and action songs.
• Assisting the child to wait and take turns, which is a skill that can be taught at the playground or at home, waiting for a favourite activity or at school or pre-school during group activities with other children.
• Developing the child’s awareness and control of their face and mouth muscles by playing games in front of the mirror, encouraging them to copy different facial expressions and tongue and lip movements.

Have fun with these activities and remember it is always better to spend a short amount of time doing these activities regularly rather than hours every now and again.

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Francesca Bierens Speechmark author of Assisting Students with Language Delays in the Classroom

Tell a Story, to Get a Story…

Having just completed a fun, productive and interactive presentation on storytelling at a RCSLT Clinical Excellence Network workshop for children with language impairments, I asked the audience to reflect on all the information they had received at the workshop, and identify 3 changes or actions that they would put in place at work the next day.

One speech and language therapist said that she would tell her client a story. I was intrigued by that and asked her to say a little more about that. She continued, that she was often asking the children with whom she works to tell her stories, and whilst she would read stories from a book, she never simply told them a story during her storytelling sessions.

What an interesting observation and a great change to commit to making - and one that can so easily be put into practice. At the workshop, I had shared strategies to facilitate the elicitation of storytelling in children and young people with language and communication difficulties, and one strategy that I have found really effective is simply to take my turn first and share a story with the group, whether it be a personal story about something I have done over the weekend, or a wonderfully wacky and obviously fictional story about a princess, dragon or fire-eater! This gives the students the time to get comfortable, to settle down in the session and enjoy the delights of storytelling, whilst at the same time, also, getting to know a little more about me, their therapist.

It provides the children with practice in a range of essential skills related to storytelling, including listening, using appropriate body language and facial expression to show interest, or, when needed, even confusion, as well as asking focused and appropriate questions. It also, of course, gives me the valuable opportunity to model storytelling and provide them with a helpful template on which to base their stories, if required. Of course my story will have a definite beginning, middle and end, on which the children can map their stories.

Have a go and see for yourself, if you have a group of children reticent at telling stories, try and start by telling stories yourself. Involve the children in different ways, perhaps they can clap loudly or roar every time they hear you mention the monster; or they can count the number of characters in your story. Make your story exciting, fun and interesting, use props like swords and other attention-grabbing objects, and dress up like the characters in your story. Be the wizard, the witch or the dragon. And by the time you are at the end of the story, you may very well found that you are no longer the sole storyteller, but one part of a very satisfied collaborative enterprise.

Go on, try it, tell a story, or even two, to get a story… 

Victoria Joffe, Professor, Enhancement of Child and Adolescent Language and Learning

School of Health Sciences, City University London

Speechmark author of: Vocabulary Enrichment Programme, Narrative Intervention Programme, Favourite Idioms and More Favourite Idioms

Finding Ways to Develop the School Ethos

The 35 lesson plans provided in the No Outsiders book are only half the story; they will have little impact unless we create a whole school ethos where the moral code is reinforced and brought to life. The No Outsiders ethos must be seen to be relevant and real for children to sign up to it and the first three chapters in the book explain how to do this.

We look for examples to use in assemblies and class discussions to show that it’s not just us in our school believing in No Outsiders; lots of people in the UK and around the world also believe in No Outsiders and their actions every day demonstrate this.

The photo (above right), taken from the BBC newsbeat website, shows two unknown men helping out people affected by floods over Christmas. I have used this photo in assembly all week as it encapsulates the No Outsiders spirit perfectly.

I start by asking the children what is happening in the photo and the usually say, “They are helping the old man” so I ask why do you think he needs help? The two men on either side are wearing coats and hoods; it looks like one of them has rain on his hat; where do you think they might be? Has anywhere in the UK had lots of rain recently?

We talk about the floods in Northern England and how it affected people then I ask, so what are the men doing here? I tell them these men visited houses in Blackburn that had been flooded and offered help. They found this stranded man who had no lunch so they made him boiled eggs.

I then ask the children, how are the men in this photo different from each other? Children have answered the men have different skin colour, the two men on other side are Muslim and the man in the middle is not (to which I reply yes, that may be so but we can’t always know someone’s faith by looking at them; you can be white and Muslim, and the two men on either side may not identify as Muslim). I press on asking for more differences; are they the same age? Are there any disabilities evident?

Then I ask the children to consider, did the two men decide before setting out, that they would only help men? Or that they would only help people who were Muslim? Or that they would not help people who were gay? Or that they would only help people who were elderly?

We all agree that the two men clearly would have agreed to help anybody and everybody. The reason is because the two men, like us, believe there should be no outsiders. They didn’t care if the man they helped was white, elderly, wore glasses, had a different faith, didn’t care about his sexual orientation or indeed whether he was male or female! That is what is so great about living in the UK today – we are all different and we all help each other. It’s a wonderful place to be!

Andrew Moffat

Speechmark author of No Outsiders in our school: Teaching the Equality Act inprimary Schools

Look how well they are getting along; but it’s just a box of Lego®!

We all have a building story; the grand design of creating our own miniature house or the momentary glow of success on discovering the extra set of wheels which completes our innovative vehicle design. Sometimes though, the magic of that box of bricks can have the potential for so much more.

Lego® therapy has been around for a while now. Daniel LeGoff and later Dr Gina Gómez de la Cuesta and Simon Baron-Cohen from the Autism Research Centre, Cambridge,  have shown that within a more structured environment, the use of building blocks and sets can be utilised to improve the social and communication skills of young people with Autism. Recently more and more educational, health and social care settings are realising the benefits of this great programme. Just this week, there’s been news of a special school in Blackpool setting up an after school club.

Using it in a number of settings over the years has been interesting and inspiring. Whether as a one-to-one session to teach and build confidence in social communication, or as a whole class tool to encourage speaking and listening in a literacy lesson, this structured use of model building has had the ability to unlock potential in many young people who prefer a more logical approach to collaborative play.

For the ‘logical thinker’, many aspects of social interaction and communication are strange. ‘To hug or not to hug……..’ This is actually the question. Take a moment to consider what the ‘rules’ are around hugging. Do we hug everyone we know? Do we hug all our friends? Do we sometimes hug in certain places but not others? This single area of socially acceptable behaviour presents one with the prospect of crossing a social minefield. It is just one area of social etiquette which, as a ‘social thinker’ we (usually) successfully navigate, managing to avoid any major explosions. The logical ones amongst us, however, find themselves blundering wildly through; desperately attempting to avoid mistimed contact, awkward polite back pats and the painful minutes entangled in the unanticipated, uninvited clutches of a well-meaning associate.

The activities within the book ‘Building Blocks for Communication’ have been developed with the logical thinker in mind, although all thinking types will no doubt benefit. They have been developed and tried and tested through close work in a number of settings with some incredible people. Used in mainstream classes, Nurture Groups, by Family Support Practitioners and parents at home, and also, with careful planning, in social communication intervention groups, these activities have been designed to be adaptable for many ages and abilities.

The training courses running alongside the publication often produce many more ideas for new and innovative activities. So, get your logical thinking caps on, get out that box of bricks and start presenting abstract concepts in a more structured way! 

Amy Eleftheriades, Alpha Inclusion.
Speechmark author of ‘Building Blocks for Communication’

A look at creative storytelling with people with dementia

Clinicians and carers working with people with dementia would be familiar with approaches such as reminiscence therapy, but may be less au fait with the use of creative storytelling. 

The creative storytelling approaches used encourage people with dementia to tell stories based on a picture or photo. One of the important aspects of this technique, is that there is no “right or wrong”. Indeed this method allows and welcomes storytelling of all types – including made up stories. 

The benefits that clinicians using this approach noted included: 

·         An opportunity for people with dementia to engage in conversation 

·         An opportunity for verbal expression not bound by “rules” 

·         Individuals were observed to have increased confidence, quality of life and positively altered behavior 

The TimeSlips approach by Basting is a more structured format. Researchers from the University of Missouri found that participation in the TimeSlips storytelling programme improved communication between patients with Alzheimer’s Disease and had a generally positive effect on patients. Working in 20 care homes, researchers studied the effect of storytelling among residents with Alzheimers. Using a method developed by the TimeSlips Creative Storytelling Project, residents were encouraged to tell stories inspired by photographs. Working as a group, patients created a narrative inspired by the picture. The method replaces the pressure to remember with encouragement to imagine.

In examples where it was used in care homes, the whole community was reported to benefit. Read more about one particular study here .

Speechmark ColorCards lend themselves nicely to this approach – From Everyday Objects to What Can You See? With these ColorCards, photo based stimuli, it able's you to make your own storytelling aids in the care home; images that provoke discussion or images from a particular time in that person’s history.