Intensive Interaction (as a psychological intervention)
Author: Dr Sophie Doswell
Continuing the Conversation
Part of the Estia Centre's Learning Together 2026 blog series, featuring articles from conference speakers and contributors.
This blog is based on the book ‘Integrating Intensive Interaction Principles into Psychological Practice’ (2026) edited by Sophie Doswell and Maggie Ellis.
What is Intensive Interaction?
Intensive Interaction is an approach to help children with severe and profound intellectual disability to develop their social and communication skills(Nind & Hewitt, 1994). In practice it involves ‘tuning in’ to the individual’s world to try to make a connection, using the sounds and actions that they are using.
Intensive Interaction has been used with children and adults with severe and profound intellectual disability, autistic individuals and people with dementia.
What does Intensive Interaction look like?
‘Tuning in’ involves spending time with someone, to understand how they engage with the world. This helps us to join them in their world, for example that might be through making eye contact and then mirroring the actions and noises that they make, watching carefully to see if they enjoy us joining in or not.
People use Intensive Interaction in different ways. Often it is used when we are ‘hanging out’ with people, as a way of spending time together. It is also used during activities, for example during time at the park or when having a bath. As a psychologist, it might also be used as a ‘session’, where the psychologist comes to see the person at the same time each week to try to build a relationship and help the person develop a sense of safety.
What are the benefits of using Intensive Interaction?
Intensive Interaction can help people to develop their communication skills and increase their engagement with others. It can make people happier.
Family members and staff report that Intensive Interaction improves their relationship with the person, and that they enjoy Intensive Interaction sessions too.
“It has been the only approach we’ve used, which has had a lasting benefit to our son and to our relationship with him. It has made him more sociable, connected and communicative…it has given us a relationship.”
“The whole family has benefitted from Intensive Interaction entering into our daily life: it’s created better emotional awareness for all of us”
If it is so great, why isn’t everyone using it?
There are barriers to using Intensive Interaction including:
- Staff and families not having training
- Staff feeling they don’t have the right support or enough time
- Not being sure about doing Intensive Interaction
- Some people feel embarrassed
- Research about Intensive Interaction isn’t as good as we would like
How to get started with Intensive Interaction
There are videos, books and papers written about Intensive Interaction that can help people to get a good understand of what the approach involves and how to do it well. There are also organisations that offer training in Intensive Interaction, including ‘Us in a Bus’ and the Intensive Interaction Institute.
However, many people tell us that they naturally use Intensive Interaction without having had lots of training, as the skills it involves are very human skills.
When you offer an Intensive Interaction session, it is helpful to spend some time afterwards to think about how it went. You could ask yourself–
- What did I do?
- What did they enjoy?
- What didn’t they enjoy?
- What was my experience of doing it?
- How would I do things differently next time?
- What do I want to share with others?
Final thoughts
Intensive Interaction is a valuable tool for meeting the needs of people with severe and profound learning disability, autistic individuals and those with dementia, when we are struggling to engage with them. Through Intensive Interaction, we can join them in their world, and this helps both them and us feel happier and more connected.
About the author
Sophie Doswell is a Consultant Clinical Psychologist at the South London and Maudsley NHS Trust. She has worked in the NHS with individuals with learning disability and/or autism for over 25 years and has been using Intensive Interaction all that time. She has written papers and book chapters about the approach and has presented at regional and national conferences. Sophie is an animal lover and has cats, tortoises and fish at home and enjoys scuba diving to see animals in the wild!
References
Nind, M. & Hewett, D. (1994). Access to communication: Developing the basics of communication with people with severe learning difficulties through intensive interaction. London: David Fulton.