1
Introduction
For a long time I have been waiting for someone to write a book containing all sorts of cheap but useful ideas for enlivening and extending Speech and Language Therapy (SLT) sessions.
In my clinic I have always had many boxes of lovely photo cards and games. However, there is sometimes not quite the right resource for a particular client or group, or if there is, it is beyond the SLT purse. With all the talented therapy writers and resource makers creating great books and games I was sure that someone would write something for the therapist on a budget. Nobody did, so I have found myself attempting to fill this gap, and here is a collection of ideas that should provide you with new resources for very little money.
Good practice involves careful diagnosis and planning. To augment the well-established and structured programmes of therapy that speech and language therapists use, I have discovered four principles that can make for better therapeutic outcomes:
- Most clients will respond more effectively if they feel they 'own' their therapy by being involved in making the materials they will use, so that the creative process becomes part of the therapy.
- Sitting alongside clients making an item lends an atmosphere of working at their therapy together, giving guidance. This seating arrangement also reduces the chances of too much eye contact, which is helpful for some people who have a diagnosis on the autism spectrum.
- Therapy is vastly improved when it is good fun, and preferably humorous. Clients will usually want to attend their next session if they have left the previous one with the warm glow of having had a good laugh. (And don't neglect yourself - if you have had fun in a session you will be a happier therapist!)
- Sometimes clients make for themselves (or with a little help) something they like and want to keep. Such an item will be a pleasant reminder of something learned during their therapy, and might encourage them to return to therapy after a break.
I have always wished that cartoon drawing had been a module of my SLT training, and that Blue Peter studies had been another, but actually you donât need to be a great artist or craftsperson to create these games and activities. Also, you donât need huge quantities of spare time to make most of the items, especially if you can get organised with the equipment you need all in one go. I have provided a basic shopping list to help you get started.
Some of the games and activities address particular communication themes, for example, listening techniques or friendship skills, while others cover several areas simultaneously. I have divided the book into chapters according to either the skill area being addressed or the way in which the items can be used.
It is worth noting that although many of the activities and games note an appropriate age level, most of them can in fact be adapted for different groups just by presenting them in different ways â for example, a board game, however simple, can appeal to adults if the decoration is mature, or tailored to a particular interest. You have control over this process, so there is another advantage to producing your own equipment rather than buying readymade items.
This book is essentially a body of practical ideas for you to use in your therapy, based on my experiences. Most chapters are concerned with an aspect of therapy, and begin with an introduction. Some references are included, and these indicate some of my own background reading, as well as forming a body of recommended reading, should you wish to further your knowledge in any particular area.
Above all, this book seeks to inspire you with confidence to invent your own games and activities, tailored to your clients and clinical settings.
Standard items to have in your cupboard
- A4 and A5 paper and coloured card.
- Pens, felt tip pens, pencils and sharpener.
- Right- and left-handed scissors.
- Glues (Pritt Stick and PVA), Sellotape and Blu-Tack.
- Ruler.
- Blank business cards, index cards and blank postcards.
- âTaskmasterâ blank playing cards.
- Flipchart paper rolls (needed for larger sheets, so ends of rolls are fine).
Also useful
- Box of odd, unwanted (even broken but safe) plastic, metal or wooden items or parts of items.
- Box of scraps of different fabrics.
- Watercolour paints in tubes.
- Upholstererâs foam of 75mm thickness, preferably cut into 75mm cubes.
- Planned timber, 50mm by 50mm, preferably cut into 50mm lengths to form cubes.
- Empty plastic drinks bottles.
- Lining paper, sold in DIY shops alongside wallpaper. It is flat and white or cream, and quite strong.
- Wire coat hangers and picture hooks for displaying your clientsâ work and decorating the room.
- Defunct boxes of Scrabble, often to be found at car boot sales and on markets â itâs the tiles you are after, and it doesnât necessarily matter if it is not a full set.
- The cheapest possible baking parchment you can find. Donât confuse baking parchment with greaseproof paper; baking parchment will not stick, whereas greaseproof will.
Save
- Shoe boxes â for storage.
- Packaging trays from packs of small plants, or similar from some types of biscuits and chocolates.
- Jokes from crackers (however groan-making you think they are!).
- Dented or otherwise damaged toy cars.
Facilities needed or desirable
- Wall space.
- A shelf where you can leave items that your clients have made while the glue or paint dries.
- Fibreboard notice boards.
- Blackboard.
- Access to a PC and photocopier.
- Access to a paper guillotine.
2
Self-awareness and self-esteem
Raising someoneâs self-esteem can be a long and uphill task, but here you will have beads, paint, tee-shirts and paper chains to help you!
Therapists often see clients who have experienced years of not being understood, or of misunderstanding others. Such clients may arrive at our clinics not only with their given, named and particular diagnoses but also having grafted on their own coping strategies, with varying degrees of success.
Sometimes a clientâs strategies may include avoiding situations where they might have to communicate with others, retreating into timidity or silence and isolation. Perhaps they are now disillusioned with the whole idea of talking with others, and regard themselves as poor communicators, and/or not worth talking to. They may have decided that, for example, it would be better not to put up their hand to answer a question in class, or older clients may prefer not to try to offer an opinion in a conversation, or to take the first tentative steps in forming a relationship.
On the other hand, they may try putting on a brave face, ignoring other peopleâs comments, and attempting to convey that their ways are equal or superior to everyone elseâs.
This may well be misinterpreted by others as arrogance, with again the result of them becoming isolated.
Occasionally we encounter the type of client who has adopted a role of being the class or community clown, and while sometimes this role can be carried off successfully, there is often the risk of being laughed at rather than with, which can lead to a situation where they are bullied.
In some cases these feelings of worthlessness, the social isolation, the desire not to communicate with others or being bullied may become so severe that help from other professionals - counsellors, psychotherapists, and so on - may be needed. We need to be sensitive and make appropriate referrals when necessary.
However, here are some ideas to help when the case is not so severe, or for after or alongside other therapies.
'All about me' boxes
This is a self-awareness activity. It is best done over several sessions, taking time to complete the boxes to a good finish and talk them through. You can carry out this activity with just one client, or in a group.
A word of warning: this activity should be carried out in a light-hearted atmosphere, you are not trying to be a psychotherapist.
My advice is to make a box about yourself before the session, which you are prepared to open to reveal the contents. However, you should state clearly to your clients that they will not have to reveal the contents of their boxes to others if they do not wish to.
Materials needed
- Small (about 75mm x 75mm x 25mm) plain-coloured cardboard boxes, available from craft shops. The best sorts have a frame within the lid. If you really cannot run to that expense, then the small individual cereal boxes sold in packs are a good substitute, but you or your clients will need to paint them white before decorating, and make a neat opening at one end (and of course you have to remove the contents first!).
- A photo of your client.
- Felt tip pens.
- Small pieces of paper or card.
- Sticky tape.
- Varnish.
- Magazines.
Making your boxes
Use felt tip pens to decorate the outside of the box. Decorations can include images and words to show the world what this person is good at, or likes to do, and should include their first name. If your client is happy to do so, they will stick their photo on the lid of the box, within the frame. This part is on view, for others to inspect.
Some clients prefer to stick on pictures from magazines rather than their own drawings, so you or they will need to supply magazines which interest them â football, fishing, sewing, fashion magazines and so forth are all easily available. If they would like to use that approach, then â in an art of decorating known as decoupage â pictures can be cut or torn out, then stuck on the box, perhaps building up and overlapping the images. Then the box will need to be varnished (acrylic gel varnish is good), using several coats, so that the âstuck onâ, multiple sources, appearance is lost.
Inside the box your client will place small pieces of paper or card with words on to describe their secrets, fears, disappointments, dreams, and so on. Some clients may like to have some help in writing down their thoughts, and some may like to chat about the contents with you. It is important for the clients to be sure that the boxes are kept in a secure place, and that you will not look inside without their permission. When they have completely finished making the boxes they may like to seal them with tape, or perhaps with attractive stickers.
Variation
This is good for a group setting. Together, each client begins writing on the pieces of paper or card that will go inside their box, starting with some less âsensitiveâ topics, for example, preferences (favoured holiday resorts, music, types of food, best ever film, etc), or aspects of the clientsâ biographies (birthday, place where their childhood was spent, schooling, etc). If they are all willing, try this: pool all of the cards, and take turns to pick one out and guess who wrote it, before placing it in its ownerâs box. This can form a pleasant âgetting-to-know-youâ session in the clinic. Later, cards with more private thoughts can be placed in the box without others seeing.
Please note: try to create an atmosphere where clients are happy to chat about the contents of their boxes, but be aware that occasionally disclosures are made that might need to be referred to another professional. My advice is to warn clients that anything said in the session by one member of the group must not be repeated by another member outside of the session. You yourself, however, should not promise to keep secrets, because you might hear a disclosure that needs action urgently from another professional.
'How I help people' poster
This is useful for self-esteem building, also self-awareness or awareness of others, and as a background to friendship skills, and it can make a good wall decoration.
Materials needed
- Paper.
- Photocopier.
- Pens.
- White stickers.
Making the poster
Place your own, or your clientâs, hand on the platen of the photocopier. Now close the lid and preferably cover it with a cloth to exclude as much daylight as possible. Take a photocopy and then copy this several times once you are satisfied with the image, as these copies are useful for several different p...