Great Mates and Great Dates

1. 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

2. 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?

3. 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.

4. 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

5. 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

6. 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’

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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!

13. What did We Do?: Meeting People Planadapted 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

14. 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?

15. What Did We Do? Physical Intimacy • NB Not a sexual education group • Consider ‘bases’ • Consider power imbalances • Consider consent, especially after drinking

16. What Did We Do? Pitfalls in Relationships • Communication breakdown • Conflict resolution • Keeping a healthy balance • Coping with the ending

17. Grief/Loss Cycle(from Kübler-Ross, 1969)

18. 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)

19. Did it Work?: Self-developed Semi-structured Interview about Knowledge • 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) Q. How would you know if a relationship was over? Pre: ? 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? • Q. When is it Ok to have sex with someone? Pre: girlfriend Post: when you both feel ready

20. Did it Work?: Self-developed Likert scale re.Confidence

21. Did it Work?: Relationship Skills Assessment (Kelly, 2004, p90)

22. 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 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 How Did it Go?: Reflections

23. Any Questions? mwoodward@standrew.co.uk scooper-evans@standrew.co.uk