1. Using I Can Feel Good at The Wells Road Centre Martine Lascelles Clinical Nurse Specialist Helen Gannaway Highly Specialist Speech and Language Therapist Vicky Romilly, Lead Speech & Language Therapist Hannah Carton Forensic Psychologist in Training

2. The Group Commenced the group in June 2015 Completed July 2016 Initially 4 group members this increased to 5 one individual joined the second module. Facilitators 2 x SLT, 1 x Psychologist in Training, 1 x Nurse Specilaist, Nursing Staff

3. Planning Awareness Training for Staff and Patients Familiarisation with ICFG Manual and Materials. Notice board dedicated to ICFG Planning staff availability for the 12 months. Review of the training manual and assessment material. Review of current groups, how these could be transferred into the ICFG.

4. Aims Deliver a psychological therapy to build on individual strengths, skills, contributing to a reduction in risk behaviours. Delivery approaches to support individual confidences, and motivation. Reflect on approaches/environment/ materials, reviewing how this has influenced skills and understanding. Inform and develop the milieu and staff team.

5. Adapting Pre and Post Measures Considering the Speech, Language and Communication needs of the population. Adapting information in line with the Accessible Information Standard.

6. CAMS-R Measure

7. Adapted CAMS-R Self Report

8. Colour Chart

9. Approaches Comic Strip Conversation

10. Background to the approach A Comic Strip Conversation is a conversation between two or more people which incorporates the use of simple drawings. Comic Strip Conversations use symbols to represent social interactions and abstract aspects of conversation, and colour to represent the emotional content of a statement or message (Gray, 1994).

11. What is a comic strip conversation? Talking about the past, present or the future: Where are you? Who else is there? What are you doing? What happened? What did other people do? What did you say? What did other people say? (use conversation bubble) What did you/other people think when you said that? (use thought bubble) How were you feeling? How might the other person have been feeling?

12. Making Sense DVD Clip

13. What does the evidence tell us? What does our clinical judgement tell us? Gray (1994) Pierson and Glaeser (2005,2007) Gaus, V. PhD. Law et al (2010) Test et al (2011) Attwood (2013)

14. Who might the approach support? The approach was developed for people on the autism spectrum People who have difficulties with prosocial behaviours People with a learning disability / borderline IQ People with a SLCN People with a diagnosis of: psychosis, schizophrenia, anti-social PD, emotionally unstable PD, PTSD/trauma This is not an exhaustive list – more a list of our experience to date

15. Approaches Talking Mats What is a Talking Mat? A talking mat is an interactive resource that uses pictures, symbols, photographs to help people with communication difficulties give their views and express their opinion.

16. Talking Mat

17. Talking Mats Ideas for using Talking Mats To find out how someone feels about major life changes. The talking mat offers a way of exploring feelings on topics that might otherwise be too complex to talk about. It helps people detangle their thoughts and feelings on certain topics and break down information into manageable chunks.

18. Who might the approach support People who appear to be very able verbally but find it hard to integrate lots of ideas. They help to act as a thinking tool. They help people who have difficulty expressing themselves for a range of reasons including: They don’t know what the options are They can’t keep on track They are highly anxious

19. Talking Mats Key considerations Keep it meaningful for the person by using it in relation to the here and now rather than more abstract concepts. Move on to more abstract concepts once the person has an idea of how the mat works. Start with less emotive topics and progress from here.

20. Group Findings Group has just recently completed, pre measures to be repeated and evaluated. Incident reporting to be evaluated. Observations current findings: Group attendees have reduced incidents. Observed use of mindfulness on the ward. Individuals have related to / using skills learnt in aspects of their daily lives.

21. Reflections Time Line of 12 months was do- able with the group, but preferable to extend this to minimum 15 months. Homework individuals were hard to motivate, to maintain attendance at the group, agreed not to use practice sheets out of group. Use of honey moon period ( 2 weeks) worked well for individual who needed time out. Role play, most patients enjoyed this, however for some being seen as a good actor was more important, than the concept of the skill being modelled.

22. Light Bulb Moments Individuals using mindfulness techniques at times of stress on the ward. Group members motivation in attending the groups. Individuals relating to/ recognising skills they have learnt from ICFG, to their offence related treatments. Therapist / Individual shared learning.

23. Where from here? Incorporating into therapeutic groups in secure care Service evaluation Partnerships in research

24. Contact: Martine.Lascelles@nottshc.nhs.uk Helen.gannaway@nottshc.nhs.uk Vicky.romilly@nottshc.nhs.uk makingsense@nottshc.nhs.uk