uniquely challenging working as an slt assistant in forensic mental health fiona williamson rampton...
TRANSCRIPT
Uniquely Challenging
Working as an SLT Assistant in Forensic Mental Health
Fiona Williamson
Rampton Hospital
Introduction
My Background History
Employed in Dec 2000
Full time contracted 35 hrs pw
First (& only) SLT Assistant employed at
Rampton Hospital
Only SLT Assistant working in the High Secure
Hospitals in England (as far as we know)
Initially employed on Assistant pay scale
Following successful re-grading now TI 2 (A4C
Band 4)
Introduction cont’d Working environment
Large Victorian building in a rural setting
Security constraints
Client group
Patients with a primary diagnoses of either Mental
Illness, Personality Disorder or Learning Disability
Secondary diagnoses such as Asperger’s Syndrome
Often limited educational attainment
Exacerbating factors such as effects of medication,
institutionalised behaviour, lack of volition etc
The Speech & Language Therapy Team
SLT Team Manager
Lead SLTWomen’s services
Lead SLT Personality Disorder
Vacant Lead SLT
Learning Disability
Senior SLT Senior SLT Senior SLT x2 Senior SLT
Me!
Roles & Responsibilities
To provide supportive clinical
work, 1:1 or groups to identified
patients. SLT package of care
devised by SLT but delivered
independently
Develop activities to meet
defined intervention needs
Source and prepare resources
to support therapeutic
interventions as required and
requested by SLT team
Write reports for identified
patients under guidance of
supervising Therapist
Plan and manage own
timetable, negotiating with
Head SLT re workload
Participate in regular
supervision with supervising
Therapists and Head of SLT
Opportunities of working at Rampton Hospital
Opportunities to co work with other professions- in
past have co facilitated groups with Occupational
Therapists and Nurses
Opportunity to utilise a wide range of therapeutic
interventions, for example Personal Construct
Psychology
Provides you with a clear insight of the effect
communication difficulties have on an individual and
the relationship between communication and level of
risk
Opportunities of working at Rampton Hospital
Involvement in all aspects of patients care
Ability to follow patient through their treatment
pathway during time spent at Rampton
Opportunity to work with a diverse range of
communication difficulties
Opportunity to work with patients across all
directorates, i.e. Learning Disability, Personality
Disorder, Mental Health & Women
Involvement in patients rehabilitation trips and
transfer to Medium Secure Units
What are the Challenges? Activity
Before I go onto talk about the challenges I’ve
faced, what are the challenges you face in
your roles?
Activity 1:• Break into groups of 5• What are the ‘challenges’ you face?• Feedback to the main group
10 minutes
Challenges of working within this setting Limited understanding/ lack of awareness of
SLT Assistant role
Limited understanding of benefits/purpose of
SLT for this client group within own profession
and others
Dysphagia can ‘overshadow’ other aspects of
our roles
Lack of appropriate training courses both in
house and external
At times feel isolated & without peer support
Challenges of working within this setting – client focused
Issues re perception of SLT
Expectations of ‘curing’
Often intervention is about maintaining skills
rather than developing
Variability in presentation
Difficulties with engagement
Relapses in mental health
Co-morbidity issues e.g. drug misuse
Challenges of working within this setting – client focused
Patients often utilise sessions to discuss issues
Can at times be emotionally draining
Need to ensure remain focused on SLT
intervention & aims
Areas aren’t conducive to therapy
Security policies and risk issues can prohibit ideas
you may have for intervention & resources
How I’ve overcome/dealt with challenges
Kept smiling & a good sense of humour!
Regular clinical and managerial supervision
Thinking ‘outside the box’ for training courses -even though not directly relevant, identify aspects that can be transferred to your client group
Possible solutions -Activity
Activity 2
Looking at your ‘theme’, what ideas or strategies can your group identify to overcome those challenges?
Feedback to the main group
15 minutes
Close and Any Questions?
I am more than happy for people to contact
me if they have any queries or would like
further information: