As part of the Intensive Interaction Institute’s Modular Training programme, we ask trainees on Module 4 (In-Service Trainer) to read the paper: Berridge, S. & Hutchinson, N. (2019) ‘Staff experience of the implementation of Intensive Interaction within their places of work with people with learning disabilities and/or autism’, Journal of Applied Research in Intellectual Disabilities, 34(1), 1-15.
Having just re-read the paper myself I was immediately struck by how well the 3 ‘higher order themes’ identified by the researchers fitted with the three stages of organisational change identified by pioneering social and organisational psychologist Kurt Lewin in his work on Force Field Analysis: these being the stages of unfreezing, movement and refreezing (Lewin K. (1951) ‘Field Theory in Social Science’, Harper & Row, New York).
These 3 higher-order themes were:
1. Personal Doubt, Discordance & Discomfort – so, some ‘unfreezing’ of the current working philosophies and practices evident here,
2. A Turning Point – the ‘movement’ i.e. changes to the working philosophies and practices starting to become evident here, and …
3. Needing Implementation at All Levels – identifying the need for ‘re-freezing‘ or embedding Intensive Interaction as a central aspect of the new organisational level working practices.
Using Lewin’s Force Field Analysis method to look analytically at working systems and organisations is something we have used over many years to help Intensive Interaction trainees more effectively lead sustainable change in their own working context. It is really nice to see the theory as visibly manifest in such real-life research.
Below is a summary of the Berridge & Hutchinson paper:
Method: A search was conducted across research databases to review the qualitative literature on staff experiences of the implementation of Intensive Interaction in their workplaces. Several inclusion/exclusion criteria were used, and a ‘Thematic synthesis’ was then used to develop a ‘meaningful synthesis of these data’ from the 9 included papers*. The ‘workplaces’ included schools, day services, an acute medical hospital and residential settings.
Results: the thematic synthesis of the 9 studies generated 3 higher-order themes: 1. Personal Doubt, Discordance & Discomfort, 2. A Turning Point and 3. Needing Implementation at All Levels.
Personal Doubt, Discordance & Discomfort: Some staff identified Intensive Interaction as not fitting with their former working methods, at times feeling uncertain in their own abilities or in the approach. Some staff were uncertain of how to “do” intensive interaction: “I don’t see the clear steps of what I should do…”. Intensive interaction was also seen to contrast with views on “age-appropriacy” and some worried about getting “too close” or losing previous levels of “control”. Interestingly, Intensive Interaction also appeared to make staff more aware of their own emotions and the emotions of those they worked with, changing the quality of their working relationships e.g., they started to feel more empathetic, or even “loving” towards the people they worked with.
A Turning Point: ‘A turning point’ was often identified during implementation when staff felt more positive about the approach, this generally being when they saw its vsisble benefits. Staff expressed feelings of “surprise”, or were “amazed” when they saw the outcomes for their clients/pupils. Subsequently, staff appeared to think more about clients/pupils and “treat them as an individual[s]”. Staff also gained more confidence and, therefore, more enjoyment from using the approach; this being directly related to the kinds of training and support they were given.
Needing Implementation at All Levels: Staff described ‘practical barriers’ in their workplace e.g., the need to work with many others, often with inadequate staffing levels. The number of staff ‘duties’ could also be overwhelming: “I’ve got quite a heavy workload anyway … and (it’s) getting bigger … so sometimes you just think ‘no, no I can’t do anymore’”. Some staff described feeling “self-conscious” in front of those unfamiliar with Intensive Interaction, although one felt the training ‘gave them permission’ to use the approach: “Now … everyone is doing the same thing. I just felt relieved”.
For successful implementation, “really good teamwork” was important, as were ‘consistency’ and ‘collaborative communication’. Ideally, there should be “a core team of consistent, enthusiastic staff who are trained in and committed to Intensive Interaction” to support systematic implementation. ‘Top-down support’ from managers was also seen as important, as was ‘making the approach official’ e.g., “… as a part of the pupil’s IEP”.
Discussion & Conclusions: In summary, the authors recommend that:
• Intensive Interaction training should provide opportunities for experiential learning, adapted to the trainees’ specific workplaces.
• Staff should be allowed time and a reflective space when implementing and using Intensive Interaction.
• An ongoing, whole-organizational approach should be taken during implementation.
[*Included papers = Clegg, et al. (2018); Jones & Howley (2010); Sri-Amnuay (2012); Zeedyk, et al. (2009); Bodicoat (2013); Firth, et al. (2008); Leaning (2006); Nagra et al. (2017); Rayner, et al. (2016)].
Connecting with Intensive Interaction 