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Open dialogue in the UK: qualitative study

Tribe, RH; Freeman, AM; Livingstone, S; Stott, JCH; Pilling, S; (2019) Open dialogue in the UK: qualitative study. BJPsych Open , 5 (4) , Article e49. 10.1192/bjo.2019.38. Green open access

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Abstract

BACKGROUND: Open dialogue is an integrative approach to the organisation of specialist mental health services and therapeutic meetings.AimsThis qualitative study sought to explore service users' and clinicians' experiences of network meetings during the implementation of open dialogue in a modified version, for a UK-based mental health service. METHOD: In total 19 participants were interviewed (8 service users and 11 clinicians) and an inductive thematic analysis of the data was conducted. RESULTS: Four dominant themes were identified: (1) open dialogue delivery, (2) the impact of open dialogue principles; (3) intense interactions and enhanced communication, and (4) organisational challenges. Clinicians considered open dialogue as a preferred, but challenging way of working, while being therapeutic. The data indicated that service users' experiences of network meetings were mixed. There was a wide variety of service user views as to what the purpose of a network meeting was and for some witnessing reflective conversations felt strange. However, the majority described feeling listened to and understood, excluding one service user who described their experience as distressing. Clinicians expressed an authentic self in their interactions with service users and both service users and clinicians described network meetings as emotionally expressive, although this was described as overwhelming at times. CONCLUSIONS: The results of this thematic analysis indicate that service users' and clinicians' experiences of open dialogue warrant further investigation. The intensity of interactions in network meetings should be carefully considered with service users before gaining consent to commence treatment. Implementation of open dialogue should be monitored to assess clinician- and service-level adherence to the principles of the approach.Declaration of interestNone.

Type: Article
Title: Open dialogue in the UK: qualitative study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjo.2019.38
Publisher version: https://doi.org/10.1192/bjo.2019.38
Language: English
Additional information: © The Royal College of Psychiatrists 2019. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Open dialogue, psychosis, qualitative research, schizophrenia, thematic analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10076577
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