Intensive Interaction fits within a ‘social model’ and not ‘a deficit model’ of impairment

In an eagerly anticipated*/dreaded* continuation of my last blog on Intensive Interaction being an approach that can ameliorate the level of a person’s apparent social impairment ‘in a socially mediated way’ (with the actual degree and form of social impairment itself also being co-created ‘in a socially mediated way’) ... I have been giving some further thought as to where Intensive Interaction sits philosophically within (or is parked alongside) our standard health service responses to people with learning difficulties and/or autism.

I have also spent some time wondering why Intensive Interaction still often isn’t even considered an appropriate ‘type’ of psycho-social intervention for many of the people we work with or support (despite psycho-social interventions being explicitly recommended by the UK National Institute for Health and Care Excellence  in their considered guidance for such service user groups).

One reason I think is that Intensive Interaction differs from most standard health/NHS interventions in that it isn’t seen to directly address a diagnosed or clearly defined problem (or deficit) that is identified as being of, or individualistically belonging to, the person themselves (which is most often the genesis of a referral into health or social care services).

Other interventions (many of them absolutely necessary and appropriate) do directly address some perceived problem (or deficit) in the individual person themselves e.g. psycho-pharmacological treatments, some behavioural interventions, some SLT interventions, physiotherapy treatments and sensory interventions (remember - many of them absolutely necessary and appropriate) do directly address some diagnosed or defined problem (or deficit) that is viewed as wholly residing in the individual ... and the individual is seen as just that, individualised and separate.

These types of treatments are, I believe, founded on a view of the 'person' as a bounded, individualised, cognitive, behavioural and/or sensory processing unit; with such a bounded, individualised cognitive, behavioural and/or sensory processing unit sitting between some kind of externally applied ‘stimulus in’ and some kind of processed and then expressed ‘response out’; i.e. physically, cognitively and psychologically separate, and thus physically, cognitively and psychologically separated from the rest of us.

This bounded view of a ‘person’, and their individualised problem (or deficit), is the one that dictates that each client or service user is required to follow an individualised treatment pathway or package. However this treatment pathway or package contrasts philosophically with a different view (and I think a view held by many of us Intensive Interactors) that human beings are not bounded and individualised, but are instead integrated and socially networked parts of a bigger social whole, and therefore the problem or deficit (and thus the socially mediated impairment) is diffusely situated within the social grouping, not simplistically located within the ‘individual' (i.e. as a personal characteristic of that individual).

However, many health, and I think many social care organisations can only see an individual as an individual … and perhaps this aspect of a systemic and reductionist health philosophy is actually a part of a bigger problem (or deficit) that needs addressing first!

p.s. Educational models of individualised 'learning' can also present with similar philosophical issues when contrasted with socially situated views of knowledge and skill acquisition and expression - perhaps I’ll try to touch on a bit of that in an up-coming blog ... 

Yes I know ... isn't it fascinating*/unfathomable*/too abstract by half!* 

(*delete as appropriate).