How it came about: the forthcoming RCSLT MCA pages.

Some of the authors in action.

I am so pleased that the Royal College of Speech and Language Therapy will be putting up some new pages (and a position paper!) on the role of SLT in decision making and mental capacity issues. It’s been quite a journey and the light is shining at the end of the tunnel. Let me start from the beginning:

Two and a bit years ago I submitted the manuscript for my last book on the role of the SLT in decision-making and issues related to the mental capacity act. One of the contributors- an SLT called Mark Jayes was also a fellow PhD NIHR trainee. His PhD focused on capacity and mine on language led dementia, and we both felt that our profession could benefit from more guidance in the area of mental capacity. Thus we contacted RCSLT to find out how to propose a new position paper on the topic.

Firstly we needed to complete and submit an application proposing the new guideline. This needed to evidence the relevance and importance of such a guideline. Once submitted we had a couple of conference calls with the team at RCSLT to discuss when and how to take the issue forward. Consequently a scoping meeting was planned to gain input from a wider group of SLTs and identify the breadth of the project.

The scoping meeting was held at the start of 2017 after RCSLT had advertised for interested parties. At this meeting RCSLT employees proposed the new mental capacity pages. The group agreed these sounded great but all attendees (there were about 10 SLTs from across the UK) felt a position paper essential to enabling clinicians to justify service provision and expansion.

Consequently an advert was published inviting applications for lead and supporting authors. The meetings to start writing the pages began in the summer of 2017. MarkJayes has been acting as lead author- putting together a wonderfully comprehensive and useful set web pages over a series of three meetings and numerous email liaison. The pages follow the RCSLT format but will include information summarising the significant issues relevant to SLTs, discussing the roles of the SLT, explaining key terms, case examples for discussion, providing links to useful articles, books and resources. The pages are being rigorously reviewed by a broader group of SLTs (and some other professionals including a lawyer).

We are now commencing work on the position paper. This doesn’t seem too complex or daunting now the web pages are being finalised. The position paper feels essential to clinical practice. Many SLTs report feeling unsure of their role in this area. These pages are being developed to increase confidence within the profession, demonstrate the breadth of our role and support service development.

The RCSLT web pages will go live (all things being well) in June this year. So watch this space – or perhaps watch the RCSLT website. But I will let you know, as I am rather excited about his project!

Thank goodness for supervision…

I recently read an excellent blog on ‘why supervisions can be hard’ by a former PhD student at Nottingham University. She describes how complex and fraught supervision can be. She starts off by explaining that she had never been asked to sit in front of someone for a full hour and discuss what she thinks. She highlights that the rules for supervision are not explicit before you start, that the relationship with your supervisor is both personal and professional, that you expose yourself during supervision- and its a little scary sometimes (https://patthomson.net/2014/02/20/why-supervisions-can-be-hard/).

 

I started my clinical training as an SLT straight out of school – having just turned 18. And ever since then I have either received some kind of supervision of provided some kind of supervision. I have had individual supervision and peer supervision (in a group). I have been supervised by SLTs, by managers, by nurses, by occupational therapists, by physiotherapists and by psychologists. I have had amazing supervision and not so amazing supervision. I have given supervision to SLTs, nurses, students and psychology assistants. I am sure I haven’t always given great supervision. Long ago, at the very start of my career someone told me that as the supervisee it is up to me to get from supervision what I need. I have also learnt that different people have been able to offer different things in supervision. Some supervisors have offered me clinical ideas, knowledge and problem solving support, others managerial, operational and strategic ideas and others emotional support. With some supervisors I have been able to ask for help with day to day concerns, with others this would not have been appropriate and actually I needed to demonstrate my knowledge and skills in order to gain their confidence in order to push myself or a service forward. Some of these are less tangible but all are useful. And through having so much supervision I have learnt about my own needs and preferences in this area.

 

As I moved from healthcare delivery into academia I breathed a sigh of relief to know that I would still be having supervision. That this supervision was all mine- no sharing it with anyone else, no politicising it, no focus on the broader service I work in. Before I started my PhD I was lucky enough to  a) know my supervisor from my undergraduate degree b) have a period of time immediately before my PhD where we worked together to put my funding application in and consequently developed a working relationship. Putting all these factors together meant that I approached my supervision with a positive outlook. And my supervisor is wonderful. She made some clear recommendations about how frequently supervision would occur, that writing an agenda in advance and writing minutes up afterwards would be useful. And she checks all my minutes! And reminds me of anything I have missed, or clarifies anything I haven’t quite gotten right in them. My supervisor has always been extremely transparent and clear about what she expects from me. Yet puts no pressure on me – I am able to use supervision how I see fit. I write the agenda.

 

That is not to say it is always smooth sailing:

– I confess that I have had some moments of paranoia and panic: “What will my supervisor think about my opinion?”, “What will she say about what I have done?”, “Does she think I am stupid!?”. Putting my opinion out there can be daunting. (Of note this is simply imposter syndrome and will NEVER go away, whether I work as an SLT or as academic).

– I realise how genuinely terrible my knowledge of grammar and punctuation is. But my supervisor and I often laugh the root cause of this: I am a child of the 80s, educated in England, so that’s ok. And I think I am getting better at this with her help….

– Getting feedback on written work can be disheartening. I have found that I need to be much more patient in academia. I used to write and send reports that were ‘good enough’ in order to meet a deadline and get a patient what they needed. In academia the focus must be on the quality of the work- and thus I spend a lot longer than I would perhaps want to trying to perfect written work (articles, protocols, ethics applications, thesis chapters). This is a kind of pleasure-pain for me if I am honest- and perhaps should be more fully explored in an entire other blog post!

 

But these are the exact kind of things that my supervisor is there for. She calls me out when I get something wrong so I don’t make a fool of myself. And she buoys me up when I have a good idea. She is excellent at editing – I mean truly excellent. I am learning SO much from her. And I love to learn. I find the work I produce so satisfying. I am reminded of previous posts where I have compared a PhD to a marathon or to being a parent. It is difficult but so worth it. And my supervisor is my running coach and my conscience. Seriously: thank goodness for supervision!