Transcript Running a Conversation Partner Scheme

Running a Conversation
Partner Scheme
nancy.
goodch
ild@ho
wnslow
pct.nhs
.uk
Introductions
Setting the scene
What is a conversation partner
scheme?
• Students and people
with aphasia
– supported
nancy.
goodch
conversation
ild@ho
wnslow
– In their own home pct.nhs
.uk
– An hour a week
• 6-month agreement
• Referrals from local
population
Origins of the scheme
 Inspirational work of Jon
Lyon, Aura Kagan, Nina
Simmmons Mackie and
the LPAA group
•
Origins in London
•
Partners in 11 trial sites - NHS
and Universities
nancy.
goodch
ild@ho
wnslow
pct.nhs
.uk
 South London
Conversation Partners
2001 - 2004 (Henry Smith
Charitable Trust)
•
Now a Conversation Partner
Network
– 15 different organisations at the
Network Meeting, January 2009
– At least 9 other schemes
• 65% of volunteers went
onto study as a health
professional
•
Interest across the Britain,
Scotland, and Eire
Count down January 2009
From all the participants attending the
Network day, the tally was:
– Trainers with aphasia 79
– Students or volunteers 434
– People with aphasia receiving the scheme
234
nancy.
goodch
ild@ho
wnslow
pct.nhs
.uk
• from an original 72 pairs in the London
plot project
• Plus other pilots from the another 9
pilot schemes not attending the day
Key elements of a scheme
• Shared beliefs:
– A value in conversation
– Simple tools to communicate
– Volunteering – 1x week I hour, fixed period
– Supervision
– People with aphasia as trainers, as experts
– Skilled interactions / expertise
– Therapeutic
nancy.
goodch
ild@ho
wnslow
pct.nhs
.uk
Students’ encounters with
aphasia
What we know about conversation
partners
• Training in supported conversation can
significantly improve the practice of those
working with people with aphasia
Kagan (1999) Kagan et al (2001)
• Students develop communication skills
and understanding about themselves as
communicators (Horton and Guyon 2007)
Building on this
• Included conversation partner scheme in new
postgraduate diploma course jointly set up by
University of Greenwich and Canterbury Christ
Church Universities 2007
• Weekly visits for 5 months to person with
aphasia
• Fortnightly support groups facilitated by lecturers
• Reflective logs
• Evaluations of the experience
Students’ experiences
• Learned about aphasia, impact on person with
aphasia and impact on others
“increased insight into how communication
impairment impacts on individual and family”
• Learned about self as communicator
“now I don’t panic at silences”
• Learned about developing professional identity
“I learned not to be so desperate to try and solve
the dilemma”
Wider impact of experience on the
student practitioner
• Introduction to social model of disability
• Introduction to reflective practice
• Sited at beginning of course provides
students with opportunity to
“repeatedly go back to the original
experience, re-evaluate it and associate it
to theoretical principles” (Boud 1985)
Reflective practice”
“Reflective practice allows one to become aware
of one’s experience. One learns to analyse the
sources of one’s own interpretations, to question
and resist the predefined meanings one is
encouraged to adopt. In so doing one can move
to a position of autonomy and responsibility
because one can take personal accountability
for one’s actions.
These actions are shaped by one’s awareness
of self in terms of beliefs and values, feeling and
reactions to many situations”
Graham (1995)
Student reflection
“I never realised that in doing speech and
language therapy I needed to think about
my own beliefs and personal cultural
assumptions”
“excellent learning experience, challenging
and enlightening”
Wider impact
• Introduction to consideration of power
relationships between client and student
• Student is learning from the person with aphasia
“my conversation partner taught me so much”
• Emphasis not on performing as it is later in
course
• Alteration of traditional clinical relationship
• Student not in role of “aspirant expert clinician”
with its attendant unequal power relationships
(Beecham 2005)
Contribution to developing
philosophy of course
• Encouraged “deep” approach to learning,
situated in experience
• Primacy of practice, rather than theory
• Group supervision developed supervision
skills, built trust, group working skills
• Development of professional skills
• Encouraged students to set learning
objectives for selves and measure
outcomes
Students’ reports of change
• Increased confidence in communicating
with someone with limited communication
skills
• Increased confidence in leaving silences
• Increased confidence in responding to
distress
• Being involved with a conversation partner
allowed me to reflect on my own
communication skills
Potential applications
• Other students of health, educational and
social care
• Interest expressed by occupational
therapy, nursing and social work
programmes
• Further developments at University of East
Anglia
‘Reaching further out’ –
Conversation Partner training
& beyond!
Simon Horton, Anne Guyon
(University of East Anglia) &
Tammy Davidson (Norfolk
PCT)
Aims



To outline the scope of ‘Reaching Further
Out’
To explore the impact of the ‘Reaching
Further Out’ project on stakeholders
To discuss the implications for future activity,
sustainability & research
‘Reaching Further Out’


Funded by UEA Alumni
Exploratory workshop
–
–
Facilitated discussion (Sally McVicker, Connect)
Initiate group identity work




Common (communicative) experiences of living with
aphasia
Experiences as a trainer
Name agreement: ‘Conversation Partner Trainers’
Future activity focus
Experiences & activity focus


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
“Training influences how people are treated in the
future”
“Give them an idea of stroke & aphasia”
“Training helps my confidence”
Train other healthcare students & healthcare
workers
–


Physios, OTs, nurses, doctors, social workers – “…better to
catch them young!”
Make a training DVD
Collaborate in future research
‘Supported conversation skills’
training

NHS specialist rehab centre
–

Approx 130 therapy, medical, nursing and
ancillary staff trained
Faculty of Health, UEA
–
–
Nine 3rd Year medical students
Sixteen 2nd Year OT & PT students
Trainee feedback

NHS
–
Significant increase in staff confidence & perceived success



Students
–
“I feel more confident”


–


24% ‘strongly agree’
76% ‘agree’
“I would recommend the training to a colleague”


“[it] was the best training I’ve attended”
“it’s made such a difference – I feel more confident”
72% ‘strongly agree’
24% ‘agree’
“…enjoyed the genuine authentic experience”
“…more sessions please!”
Conversation Partners: other types of
participation

One:one interviews with UEA staff – the
experience of stroke and aphasia
–
–

Developing educational resources for interprofessional learning – video clip scenarios
Making a DVD – UEA Faculty + UEA Summer
School for Yrs 10 & 11
Interprofessional Student Conference (IPL3)
–
–
Expert participation – insider perspectives
Participation facilitated by SLT 2nd Year students
Interlude with Mary & Anne
Being a trainer – satisfaction & a sense
of belonging?
I get a lot of satisfaction from training
Y
12
N
D/K
Training will help student
communication
Training has made me more confident
11
1
11
1
It’s good to be part of the trainers’
group
Our group has achieved a lot
11
10
1
2
We should be doing more to spread the 12
word
“Feedback from trainees please”
“Continue regular training, and run courses for Stroke Association, GPs,
Interlude with David

Naked David…

…and missed-understandings
Future activity & sustainability


Training OT & PT students June 2008-9
CP Trainers group members participating in IPL3
student conference, 2009
–
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Yr 2 SLT students facilitate participation
Research initiatives: SCA – project steering group
membership
New members for CP Trainers group
–
Challenges

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Providing training for trainers
Maintaining links & sustaining the network
Training opportunities
Working with people with aphasia as
volunteer befrienders
within the framework of a
conversation partner scheme
Sally McVicker, Connect
Aims of this talk
• To consider the question: ‘Can a person with
aphasia be a volunteer conversation partner?’
• To consider how this links with the National
stroke Strategy
• To report on the impact and learning of a pilot
scheme
Links to the Stroke strategy
• high quality services, including “expert patient
programmes” and “peer delivered activities” (QM 10)
• seamless transfer of care, including “peer support”
(QM 12)
• access to long- term care and support, including
“access to good peer support” (QM13)
• Participation in community life, including peer support
to “enable and empower individuals” (QM15)
• access to “volunteering both as a means of trialling
return to work and a satisfying alternative to paid
employment” (QM 16)
Setting up a pilot scheme
• A ‘befrienders’ pilot scheme
• Modelled on the Conversation Partner
Scheme (McVicker 2007)
• 10 volunteers with aphasia were:
–
–
–
–
trained
‘matched’
supported
Visits to another person with aphasia
Who volunteered?
Ethnicity of volunteers
Age of volunteers
1
1
2
1
20-40
2
White English
41-55
White Scottish
56-75
White other
6
75+
1
6
Asian British
What did training cover?
• The role of the
conversation partner
/ befriender
• The Volunteering
Process
• Health and Safety
• Conversations with
aphasia
• Roles and
Boundaries
• Support and
Supervision
• Difficult scenarios
Who used the scheme?
• 11 people with aphasia
• Varied in age from 20’s to 90’s
• White British, except 1 Irish and I Asian
lady
• 6 men and 5 women
• Variety of aphasia – very severe to very
mild
Where did the visits take place?
•
Voluntary
– Connect
•
Community
– Home
• Out and about in
London
–
–
–
–
art galleries
the pub
Cathedral
walking…
What did they do?
• ‘You talk about day to
day stuff’
• ‘As a befriender I hope I
offer motivation and
hope’
• ‘it help because you
have been there and it
makes people realise
they are not alone’
• “Going out (Cathedral,
Tate ) made more time”
• ‘listen and listen well’
• ‘personal experience’
The process: differences?
• ‘regular visiting’ varied in timing and
duration
• Supervision
– Feedback sheets – don’t work for all
– Support groups excellent
• more often
• Prime means of supervision and peer support
• Greater flexibility to allow for difference
How is a befriender different to a
conversation partner?
• Not necessarily providing ‘supported
conversation
– Ramps, props – yes
– Key words - tricky
• Befriendees often more ‘eloquent’ though
much less confident than the befriender
• Supporting befriendees with very severe
aphasia was a severe challenge
What were the benefits?
For the volunteers:
• A new role as a
trained volunteer
• Increased
confidence
• positive information
sharing about stroke
For those they visited:
• Information and
support at a critical
time
• Positive role model
– someone
positively living with
stroke
• Confidence
What did the volunteers say?
• “confidence”
• “engaging quite a challenge…rewarding –
getting message across”
• “I see myself fulfilling a role”
• “I don’t want anyone left on their own. I
remember what it is like. Families are kind
but they don’t really understand”
• “it’s a rewarding thing”
What did those they visited say?
• “J. more confidence and willing to try new
things”
• “confidence”
• “Think he enjoyed it”
• “Its really made a difference”
• “Its giving people the message that there is
life after stroke and people shouldn’t be
intimidated”
• “They have given me hope about the
future”
So what is Befriending?
• ‘same as me’
• meeting up
– Being friendly and supportive
– Interacting … Listening
– Sharing experience, empathy…
– Tips and ideas…trying new things
• volunteering…
From the eyes of the volunteers
• “You couldn’t do it”
• “Really is not yours, its ours… The only
way people with aphasia will feel
supported will be by speaking to
another person with aphasia”
• “You are one person, we are 8 people…
seen 8 different people”
Contact us:
Your
sallymcvicker@ukconnect.
org
www.ukconnect.org