Combining Intensive Interaction and Video Feedback

I completed my training in Video Interaction Guidance (VIG) in 2006 and since then have successfully combined the approach with Intensive Interaction. I am finding that the combination works extremely well, because VIG enhances the reflective component that is so integral to Intensive Interaction (apart from Intensive Interaction being enjoyable and fun!).

How VIG is done

VIG is a non-advice based technique to improve communication and relationships using video. As a VIGer (Video Interaction Guider), I film 5-10 minutes of interaction between an adult with learning disabilities and their support worker or carer; I then micro-analyse and edit the footage in the office. I return later with several short video clips which show the support worker’s best examples of communication. These clips are selected using the ‘Contact Principles’ (see diagram). The video clips of successful interaction then form the basis for reflection during a video feedback session with the support worker.

The ‘Contact Principles’ include being attentive to the other person, letting the other person lead, taking turns, using an interesting facial expression and tone of voice etc, which are also the building blocks for the interactive style that is used in Intensive Interaction. VIG is based on the principle of self-modelling: it allows people to see themselves on video displaying only positive, adaptive behaviours (even if they display these behaviours very infrequently). Through this process and through the ensuing discussion, support workers gain a raised awareness of their own interaction skills (e.g. responding to and ‘celebrating’ what the other person does and exaggerating their own non-verbal responses) and they feel motivated to use these behaviours more often.

Another characteristic of VIG is that the VIGer strives to display the same set of Contact Principles towards the person receiving the feedback (in fact, VIG trainees regularly take videos of themselves giving feedback and reflect with their supervisor on their own communication style). Hence a very therapeutic and collaborative relationship develops between the VIGer and the person receiving the feedback.

How I used to deliver an Intensive Interaction intervention

I used to do an introductory training session on Intensive Interaction , then went into a work setting and pretty much aimed to work with each member of the staff team. I relied heavily on ‘other modelling’ (as opposed to ‘self-modelling’) i.e I started out by doing the Intensive Interaction sessions myself and letting staff observe, and then asked them to join in and do sessions. Afterwards, the staff and I would have a discussion about what happened during the session and we would complete a session recording from.

Usually, staff needed some guidance with completing the recording form, or they did not have the confidence to complete the form and asked me to do it. After I had completed the intervention, staff would phone me to ask if I could show a new staff member how to do Intensive Interaction (it was like a runaway train!). If lucky, staff would sometimes continue with the Intensive Interaction (sometimes not), but they would typically soon stop recording the sessions.

How I do it now

I still do the introductory training, then usually work with only a small core group of staff. I now invite staff members to join in as soon as they are ready (for those who are ‘video shy’), or to take sessions from the start. I usually do one or two Intensive Interaction sessions with each worker, which are immediately followed by corresponding feedback sessions. Often to finish off, I sit with the whole team and let staff share some of the video footage (at this stage I might ‘edit’ some video clips in preparation) so that everyone can see what the other staff members are doing during the sessions.

Because staff have experienced positive feedback themselves and also see the positive reactions of the learner in the video, they are very upbeat about what everyone is doing, praising each other!

At the end of a video feedback session...

• Staff often comment how useful they found the video feedback, and that they did not realise what they were doing and how effective they were
• Staff are able to complete the session recording forms independently (once they have observed themselves doing things on video and they have been assisted to reflect on this, they do not usually forget what happened and find it easy to record)
• Usually staff display more of the adaptive behaviours in subsequent sessions

I also now get more positive outcomes:

• I have seen staff adopting a very positive attitude towards Intensive Interaction, often from very early on. For example, staff commenting how Intensive Interaction is helping them to have better relationship with service users
• Staff are highly motivated to continue with sessions. Staff have taken me completely by surprise, by reporting that they have created a timetable for Intensive Interaction sessions and that they have started doing sessions independently (it’s almost as if by not giving staff advice, they start putting things in place! It’s wonderful)
• Core staff who I have worked with feel confident enough to cascade down their skills and to show other/new members of staff how to do Intensive Interaction (they might still approach me for occasional trouble shooting advice, but I have not had a single request to train up other staff!)
• Staff are generally more open to reflection. Some staff groups report that they sit and discuss Intensive Interaction strategies and successes during their staff meetings
• I usually hand out an ‘Intensive Interaction Evaluation Questionnaire’ at the end of my intervention. On a five point scale (‘How confident do you feel doing Intensive Interaction with _____ (name of service user)?‘, staff members’ confidence ratings have increased. Also when asked ‘Do you feel you need further guidance and support for doing Intensive Interaction from the Speech and language Therapist?’, a lot of staff tick ‘no further guidance and support needed ‘

And finally…..

Because I can see staff growing in confidence and feeling more empowered to use Intensive Interaction, I, myself, am enjoying even more what I am doing!

To find out more about VIG and/or training as a VIG Practitioner, visit the VERoC website, www.cpdeducation.co.uk/veroc

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  Andrea providing video feedback to a member of staff