Christopher McNab – NHS and Probation Service specialist speech and language therapist

As a NHS specialist speech and language therapist, working across London and in the probation service, much of my career has been focused on introducing and developing speech and language therapy support for 18 – 25-year-olds with communication difficulties, across different clinical populations.  

Many of the people I see in the Probation Service are neurodivergent or are experiencing challenges relating to their mental health. While some have diagnoses, a lot don’t. I support them to explore this and develop their self-understanding. And, if someone wants to pursue a formal diagnosis, I can liaise with colleagues in the community, make referrals and support them through the process. 

The most rewarding part of my job is seeing the difference I make to the lives of the people I work with. Initially, these can be small changes, but they can have big, positive impacts. 

Most people I work with haven’t had previous support from a speech and language therapist and their communication needs have been overlooked or ignored when they were in education. In many cases, this has contributed to the reasons they’re accessing the Probation Service.

There are very few speech and language therapists working in the Probation Service in the UK, which is a shame, as people with speech, language and communication differences accessing the criminal justice system can experience a lot of barriers. For example, if someone doesn’t understand their court ordered probation licence conditions it can result in breaking these without knowing. Not understanding the system can mean people have difficulty accessing the support available to help them in their rehabilitation. People with difficulty expressing themselves can experience relationship breakdowns, reducing support networks and increasing the risk of re-offending, while individuals with social communication differences are often misunderstood by others and not provided with the correct support and experience worse outcomes.

When someone starts accessing the Probation Service, I’ll meet them to assess their communication skills. It’s important this is done sooner rather than later as unidentified strengths and differences can impact a person’s ability to access the probation service, other support, and successfully complete their time on probation. I offer further support to those who want it.

The communication needs I encounter are typically across expressive, receptive, social and non-verbal communication as well as attention and differences linked to neurodiversity and mental health conditions. These needs present in a variety of ways, including: difficulties interacting with others resulting in communication breakdowns, not being able to express thoughts and feelings clearly, confusion around accessing the justice system/ probation, and difficulties organising and managing appointments and other mandatory requirements.

The support I offer is led by the service user and jointly agreed. They choose their goal/s and I support them, typically in one-to-one therapy sessions. This can involve introducing and practicing strategies, developing skills, psycho-education, exploring other support available, and ensuring other services are aware of how they can also support the individual.

Some of the areas I support people with include self-advocacy, emotional regulation, forming and maintaining relationships and ensuring information is accessible with the overall goal of supporting their wellbeing and achieving their personal goals.

It can be challenging working within a system that expects those with language and communication needs to access it with few adaptions made. There needs to be more understanding nationally of the unique experiences of people on probation and the often-complex nature of their situations, including the impact of speech, language and communication needs on their lives. It would be amazing to see more speech and language therapists working in Probation Services and supporting this population across the UK.”