Transcript Great Mates and Great Dates
Great Mates and Great Dates
A Healthy Relationship Skills Group for High Functioning ASD
Mary Woodward, Highly Specialist Speech and Language Therapist Sam Cooper-Evans, Consultant Clinical Psychologist A charity leading innovation in mental health
Aims of Presentation
• • • • • • Why did we bother?
Who did we do it for?
What were the main aims?
What did we do?
Did it work?
How did it go?
Why bother?
• • • • Lack of published programmes for development of adult relationships (both platonic and intimate) Recognising that many individuals with ASD have a normal desire for friendships/relationships but struggle to initiate or maintain them Lack of supportive relationships or social knowledge is contributing factor to offending Need to address relationship skills, as part of a wider treatment programme: – address ASD specific need – maximise the likelihood of individuals having successful social lives in the future – minimise future risk.
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Who Did we Do it For?: Group Attendees
6 males, aged 20 -28 All detained under Mental Health Act (1983) for having committed offences (mainly sexual offences, but also aggression and/or arson) Social communication and relationship difficulties were considered to be a contributing factor High functioning ASD/AS, though some literacy difficulties All had experience of group work Some had completed some foundation work on relationships in 1:1 sessions
What Were the Main Aims?
• • • • • • to provide an overview of positive relationship skills, which may be considered as part of offence-related treatment to consider different types of relationships (personal/professional etc), the differences between them, and the intrinsic boundaries to consider ways in which they may make friends (where/how to meet, how to communicate etc) to consider how to transition from friendship to dating to explore legal issues, e.g. consent to consider the possible pitfalls in relationships and how to deal with them
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What Did we Do?: Practicalities
Sessions planned and facilitated by a multi disciplinary team: – led by SLT and Psychology – supported by OT, Education & Nursing staff 10x75mins sessions, with ‘personal practice’
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What Did We Do?: Session Content
FRIENDSHIPS: – What is a friend?
– How do you make a friend?
– How do you keep a friend?
– Trust – The changing boundaries of friendships (close v. acquaintances) RELATIONSHIPS: – Acting on attraction: when is it appropriate? How do you go about it?
– Coping with unrequited attraction – Forming and maintaining a relationship – Intimacy: emotional and physical – Legal issues: consent, power – Managing differences and conflict – Coping with the end of a relationship
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What Did We Use?: Resources
Kelly, A (2004) Talkabout Relationships: Building Self-esteem and Relationship Skills. Milton Keynes: Speechmark • Ramey, E.M. & Ramey, J.J. (2008) The Autistic’s Guide to Dating. London: Jessica Kingsley Publishers • Marc Segar (1997) Survival Guide for People with
Asperger’s Syndrome
http://www.asperger marriage.info/survguide/contents.html
• Media clips (DVDs, youtube, newspapers etc) • Devised own activities
What Did We Do?: Format of Sessions
• • • • • Recap what was discussed in the last session Watch a funny bit of DVD to introduce the topic Have a bit of a chat about it Some activities to think more about the topic Do some activities on your own between sessions
What Did We Do? Some Example of Activities
Friendship Circles – Emotionally close/distant – Professional/personal – What can you talk about?
– What activities would you do?
– Physical contact
Inner circle
is for intimate relationships
Second circle
is for close friends and close family
Third circle
is for friends etc
Fourth circle
is for some closer professional relationships
Outer circle
is for acquaintances, less close professional relationships etc
Outside
the circles is for strangers
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What Did we Do?: Social Profile
They were asked to: Describe themselves (physically) Describe their personality Describe their interests Describe what they’re looking for in a friend/partner Think about the impression they’re creating for target audience (i.e. want to stand out but not put people off). Honesty – being yourself.
Produce own example.
Example of Social Profile
Maria Hi, I’m 5’6, slim, with short brown hair. I’m a bubbly, chatty person, and like to have a laugh. I have quite a stressful job, so like to relax by watching TV or movies, doing yoga or dance, singing, or spending time with friends. I like cooking, especially Thai food, and since buying a new house recently, I’ve become a bit of a domestic and gardening goddess, though have to admit I prefer lying in my hammock to weeding!
I’ve just moved to a new town, and so would love to meet more people to share my spare time with. I get on best with reliable people who can be serious, but now how to have a laugh, who enjoy going out for a meal or to the cinema, and maybe even joining me for a bit of yoga or dancing sometime!
What did We Do?: Meeting People Plan
• • • • • adapted from The Autistics’ Guide to Dating (Ramey and Ramey) Consider how their interests can provide opportunities to meet people How/where to go about meeting people What stages to go through Also considering security issues, dos and don’ts of communication, internet dating etc Develop their own plan
• • • • • • • • • • • What Did we Do? Conversation Starters/Chat-up Lines You look really nice.
Get your coat, you’ve pulled… Do you believe in love at first sight, or should I walk by again?
Hi, my name is….
I just wanted to show this rose how incredibly beautiful you are!
There must be something wrong with my eyes, I can't take them off you Can I buy you a drink?
Is your name Gillette? ...because you're the best a man can get.
Is there a rainbow, because you're the treasure I've been searching for.
I’ve been wanting to read that book. Is it any good?
Did it hurt when you fell out of heaven?
What Did We Do? Physical Intimacy
• • • • NB Not a sexual education group Consider ‘bases’ Consider power imbalances Consider consent, especially after drinking
What Did We Do? Pitfalls in Relationships
• • • • Communication breakdown Conflict resolution Keeping a healthy balance Coping with the ending
Grief/Loss Cycle (from Kübler-Ross, 1969)
Did it Work? Pre/Post measures
• • • Self-developed semi-structured interview about knowledge Self-developed Likert scale re.confidence Relationship Skills Assessment (Kelly, 2004, p90)
Did it Work?: Self-developed Semi-structured Interview about Knowledge
1) Q. How can you know if someone you ‘fancied’ was also attracted to
you?
Pre: enjoys hanging around with you. Post: You don’t know for sure. 2) Pre: ?
Q. How would you know if a relationship was over?
Post: when you can’t resolve your differences 3)
Q. What would be a good thing to say to someone that you would like to get to know better as a friend?
Pre: Don’t know Post: Do you have any hobbies? 4) Q. When is it Ok to have sex with someone? Pre: girlfriend Post: when you both feel ready
Did it Work?: Self-developed Likert scale re.Confidence
Item # # # starting a conversation with someone 5 1 being a good friend 5 1 making a new friend recognising your feelings of attraction for someone recognise someone else’s feelings of attraction towards you asking someone out on a date 6 4 3 making interesting conversation whilst on a date keeping a relationship going beyond the first date dealing with disagreements in a relationship coping with a relationship ending 4 4 5 5 3 TOTAL 44 1 2 2 1 1 1 2 12 1 4 1 1 1
Did it Work?: Relationship Skills Assessment (Kelly, 2004, p90)
Service User Pre (%) Post (%) Change?
1 2 40 67 44 84 3 4 70 77 84 87 5 6 67 67 67 70
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How Did it Go?: Reflections
CONs Anxiety re.attending group rather than 1:1 Lack of commitment to ‘personal practice’ Too much to cover in 10 sessions Difficulty generalising in this setting Lack of robust pre/post measures • • • • • PROs Enabled therapists to assess further needs Covered important foundation skills as precursor for other work Developed confidence and knowledge, also seen in other ward situations Good attendance and enthusiasm MDT collaboration – became part of ward ethos