About Ruth

About ARC Academy, ARC Supervision, Communicology SLT Consultancy & Ruth Howes

In my NHS career I was privileged to work, over time, with a wide range of children and adults with communication difficulties. I’ve held a wide range of Leadership, Service Development & Clinical Management roles. Alongside my leadership I always maintained a clinical caseload at a specialist level. I was an RCSLT Specialist Clinical Adviser for over 20 years.

Most recently I have been Lead Author for the RCSLT APPF Project , developing the Assistant Practitioner Professional Framework. This has been an exciting and transformative experience and resulted in this new initiative of ARC Academy providing learning and development support for Assistant Practitioners. This project expanded with funding from HEE to become a significant piece of work and will be launched by RCSLT in early 2023.

For some reason I also signed up with Speechmark to write a book about Clinical Supervision in SLT and so I’ve juggled these 2 projects for the last 15 months. My book is all about Clinical Supervision in SLT and how we create successful supervision and diffuse stress at work. My book is in production and due to be published at the end of October 2022 – Reflective Clinical Supervision in SL Therapy: Strengthening your Supervision Skills.

You will find me on the HCPC Register as P Ruth Howes. (The P stands for Patricia).

My Masters (MA) is in Professional Training & Development. This links with my practice around training parents and carers in delivering therapy strategies in the ‘real world” of play and daily life. It is also what got me started with reflective practice and clinical supervision. I still know that if you ask 8 clinicians what the term Clinical Supervision means that they will all say something slightly different.

Clinical Supervision or Professional Supervision is so important for the health and wellbeing of all practitioners. It is often the thing which is given up first when we are busy. RCSLT and ASLTIP both give guidance on frequency of Clinical Supervision and yet relatively few practitioners access supervision with regularity. We justify it to ourselves in our busy lives, by having a quick phone call or coffee and a chat and ‘ticking that box’, but this doesn’t give us a reflective supervisory conversation. We cannot remove all stress at work but we can diffuse the effect and supervision is one of the strategies for that.

Increasingly as a supervisor for Independent Pracitioners I’ve realised how supervision can link with professional objectives and career development. It is possible to discuss objectives and goals/aspirations and track progress towards achieving these. Some supervisees choose to focus on Business Plans and fine tuning their ideas for new services and directions in their practice. Supervision is individual and the focus in sessions can change over time.

In setting up ARC Supervision – Appreciative, Reflective, Conversations there is an intention to ‘spread the word’ about Supervision and its benefits.

In terms of Clinical Supervision my experience /training has involved:

• MA in Professional Training & Development: modules on Mentorship/Coaching and focusing on Reflective Practice in SLT as action research. This led me to Clinical Supervision as a vehicle for reflective practice for allied health professionals and I began developing training materials for SLTs. 
• Training colleagues in Reflective Clinical Supervision and Situational Supervision in Yorkshire & Lancashire from 2005 to 2019. The focus was always on ‘how to be a good supervisee’ as well as ‘how to supervise others. 
• Situational Supervision was developed during a project in 2017 to support therapists and children’s nurses in accessing and delivering casework based clinical supervision.
• Clinical Support for Assistant Practitioners: a longer training package focusing on the fundamentals of reflective practice was developed to meet the needs of assistant practitioners developed in 2016.
• Appreciative Peer Coaching training and implementation for Children’s Integrated Team of therapists (based on appreciative leadership/mindful leadership & positive therapy (positive psychology approach from Penn State university)
• Restorative Clinical Supervision package Following learning/training package/ introduced to clinical team in 2018
• Advanced Clinical Supervision Training SDD Associates in 2020
• Setting up ARC Supervision in November 2020 and focusing energy on the importance of Appreciative, Reflective Conversations.
• Re-visiting theory,evidence and experience while writing a book for Speechmark about Reflective Clinical Supervision in SLT.

Professional/Clinical & Management Experience:

I have worked as Clinical Lead in the NHS for ASD, SEND and Fluency in my career. I have led a Schools Team, a Children’s SLT Dept of 45 people. and then 2 Integrated Children’s Therapy & Nursing Teams. While a manager/leader I always maintained a clinical SLT caseload. So juggling priorities is a key skill. 

Clinical Teams benefitted from my interest in Positive Psychology and Solution Focused approaches and my commitment to Clinical Supervision. In more recent years my interest in Mindfulness has strengthened and if you do a search on Amazon you will find my indie published books on themes of mindfulness and slow travel.

Expert Clinical Roles:

• Clinical Lead for SEND … Special Educational Needs with a specific interest in Early Years & Primary settings
• Principal SLT for Schools Service & Manager of a Paediatric Service
• Serving RCSLT as a Specialist Clinical Adviser for over 25 years. This role involves providing support for other therapists nationally in ASD, Complex Needs & Managing Services in Educational Settings
• Clinical Lead for Social Communication Difficulties (ASD)
• Specialist clinical skills in Developmental Language Difficulties, Complex Needs, Profound and Multiple Learning Disabilities, Bi-lingualism
• Involvement in setting up a Multi-Professional Joint Assessment Clinic for children to consider a diagnosis of ASD. Working alongside Paediatricians, Child Pychologists & Psychiatrists
• Stammering/Fluency is an area where I developed specialist skills 8 years ago.
• Working in and setting up the provision for a Designated Special Provision for children with ASD in the North of England
• Clinical Team Leadership/Co-ordinatation of Integrated Therapy & Nursing Service (SLTs, OTs, Physios & Special School Nurses)

Sometimes we need some inspiration:

Dancin’ in the Rain … Paddington Bear version for Dull Days!

Paddington danicng in the rain

The world of the future is in our making. Tomorrow is now.

Eleanor Roosevelt

Instead of seeing the rug being pulled from under us, we can learn to dance on the shifting carpet

Thomas F Crum

You can, you should, and if you’re brave enough to start, you will.

Stephen King

Working with Adults

I always worked with a small caseload of Adult clients at a Specialist level, even though my focus as a Leader & Service Manager was with Paediatric Services. In the last 8 years I have been able to concentrate on an adult fluency caseload. I worked in Specialist roles in Stammering & Voice Therapy in the NHS in the north west of the UK and have given management, mentoring, specialist support to other clinicians working in this field.

My approach for adult clients is rooted in training and coaching communication skills so they are ‘real and relevant’ in daily life. Skills need to be learnt, consolidated and established at times when there is a higher ‘stress load’ such as calling the doctor or going on a speed date!

I have also undergone much personal change in the uncertainty of several NHS re-structures where, as a lead/manager my job was always ‘under consideration’. This did have positive outcomes in that I ‘stumbled across’ mindfulness and resilience. This then proved invaluable in supporting clients around reducing anxiety and supporting acceptance of a long term communication difficulties. The similarities with traditional relaxation techniques are obvious, but with mindfulness there is both structure and access to materials (Apps & Websites).

Ruth … in reflective mode … shares her thoughts about how a career changes direction over time

I was incredibly lucky in my NHS career. I have worked in nearly every clinical area in Speech Therapy and specialised in several areas. I’ve received national recognition with winning the Sternberg Award for Innovation in Practice in the 1990s and was privileged to have been an RCSLT Adviser on ASD, Learning Difficulties and Educational Services for over 20 years.

A forward thinking manager, in my early career, sent all her new graduates on a management & leadership course within the first 2 years of qualifying. This 2 week course gave me organisational and support skills which were invaluable. My Leadership career has been in Clinical Service Development as well as Managing People in both SLT and Integrated services.

NHS Innovation funded my MA in Professional Training and Development in the ‘noughties’ and this transformed me as a practitioner and manager/leader. Reflective learning, Mentoring, Coaching and Support and Supervision became my focus.

I can’t admit to enjoying every minute of my work in the last 8 years. The re-structuring led me to confront my own anxieties and insecurities even though I ‘clung on’ in every re-structure as I waved colleagues, who meant a lot to me, goodbye when they faced redundancy. What happened at this point was I discovered Appreciative Leadership & Positive Coaching, Positive Psychology approaches and Mindfulness. Mindful Leadership is a growing field of academic study and the answers are there if we can focus and find them.

Now I live mostly in the middle of France, south of the Loire in South Berry in a small farm cottage with a lovely garden. There is a Gite in the barn. We took a chance and moved here in September 2019. It is a totally different life, but so far there are few regrets. The dream was to eventually offer a relaxed, holiday experience ….with a short, intensive course in Communication Skills. This is a developing project and Covid-19 made it impossible to progress. Instead I set up a Tele-Therapy practice.

The advent of the health crisis led me to realise that Tele-Health is not a second best option and to move my practice via a Tele-Therapy platform.

Using Reflective Models and Guided Questioning:

During the early stages of your supervision I often introduce different models of reflective practice such as John’s, Kolb, Driscoll, Gibbs and we can explore which model is a ‘best fit’ for your individual style so your supervision becomes a CPD activity giving you a toolkit of ways to support yourself (self reflection) in the future. 

It is often about re-telling experiences at work and gaining insight into what’s happening. ARC is rooted in reflective practice but I bring in Solution Focused, Srenghths Bases & Appreciative coaching frameworks too. Below is a model which shows how supervision is about telling stories of practice while guided by a supervisor asking questions, comments and suggesting different outlooks.

Ruth’s Favourite Reflective Supervision References:

Driscoll John: Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals (2009)

Proctor Brigid: Group Supervision: A Guide to Creative Practice (Counselling Supervision Series (2008)

Johns Christopher: Mindful Leadership: A Guide for the Healthcare professions(2015)

Wallbank Sonja: Restorative Reilience Through Supervision: An Organisational Training Manual for Health and Social Care Professionals (2015)

Pennebaker James W: Expressive Writing in Psychological Science (2017)

And a summary article at: https://www.journaling.com/articles/expressive-writing-a-tool-for-transformation-with-dr-james-pennebaker-ph-d/

Appreciative Framework

Safe Space & Time to Reflect