Intensive Interaction in adult services

Last week I was contacted by a teacher in Queensland (Hi Sue) who had 'only ever worked in schools', and who had local 'adult services' coming to her school to learn about Intensive Interaction. She asked me for 'any wisdom and advice about the challenges and complexity of doing II in Adult Services' - and so I quickly sent her my initial thoughts as copied below. 

However, since then I have thought that there is probably more to this than I have initially suggested - so I thought that putting my thoughts in front of our much wider II community (via this Blog) might start a broader consideration of this issue. Please have a look, and feel free to join the conversation:

• Intensive Interaction within adult services is often mostly about ‘being with’ type social support/inclusion for service users than looking for any educational progression i.e. the services/staff tend to have the shorter term aims of ‘getting on’ with service users in the short term ‘now’, than in looking for longer term cumulative social skill progression over time.

• Intensive Interaction in adult services is often more related to ameliorating (or ‘curing’) identified ‘problem behaviours’ of individuals (i.e. a behaviour that is seen as a personal characteristic of the individual, rather than as a response to inappropriate communication or an unresponsive social environment), rather than it being seen to be a general means of teaching/learning for a whole group/class of children – but even when an individual’s behaviour is the initial driver of considering Intensive Interaction, we try to keep our training or support much more general i.e. Intensive Interaction is about being ‘person-centred’, and thus about creating an individual social environment for the person (one that is appropriate for them).

• Sometimes social isolation for adult service users can be more ingrained (some have spent a lot longer experiencing institutionalised types of care), and the associated behaviours of social isolation can therefore be more severe and more chronic – so I often repeat the point of having realistic expectations for change – although in reality we often still see rapid change in the individual’s social presentation when Intensive Interaction is first used with a person, as they can still sometimes bring latent social skills quickly back from unused latency into their communication repertoire.

• We talk about being ‘stage appropriate’ with a person, and about us getting on a person’s level (we use a stepped model of communication development – Dr James McDonald’s 'Communication Steps') to counteract thoughts about being ‘age appropriate’ in socially engaging with their service user – although often denied, age appropriate thinking still dominates much in defining what is ‘appropriate’ or desirable in adult services.

• We present a positive view of all adult's communication means – and use a ‘Means – Reasons – Opportunities’ model (Money, D. & Thurman, S. 1994) to reinforce that message i.e. these are the three things you need to create positive social communication.

• We promote the ‘Strengths & Needs Analysis & Planning’ (SNAP) positive way of identifying the service user’s communication ‘strengths’ and their associated communication ‘needs’ (this being based on the work of Dr Penny Lacey & Dr Jill Porter).

• We use adult video footage for the staff/trainees to view (mainly taken from the DVD ‘Intensive Interaction in Action’).

• We generally don’t expect much in the way of adult support staff using videoing to record Intensive Interaction sessions with service users (unfortunately in adult services that tends to be the reality) as they tend to have harder issues of consent and information governance to overcome (or this is an excuse they often use more forcefully).

However, despite all these points though, the practices and principles of Intensive Interaction (and the Fundamentals of Communication) are still all the same, even if the service users are chronologically older, and sometimes a bit bigger – whatever a person’s age, their need for a truly responsive social environment is also still the same!

Any additional suggestions or thoughts?