Posted on: 5 April 2022
Hello,
I’m Gareth and I’ll be writing to you every couple of weeks about ‘dialogical practice’ and my learning over the years about the Open Dialogue approach to mental healthcare; something I hope we’ll be able to adopt here in CNWL. (See the bottom of this page to catch up on my six previous blogs)
I have a big announcement this week. The eagle eyed among you will have noticed we missed a week in the rhythm of my blogs. I wanted firm confirmation of some exciting developments that I have been dying to tell you all about…
So, for my big announcement! We have been working hard across the Senior Management Team of CNWL over the last couple of months to pull together a significant investment in developing Open Dialogue. We have been successful in securing a partnership with the training provided by London South Bank University (LSBU), the Association of Peer Supported Open Dialogue (APOD) and North East London Foundation Trust (NELFT).
We’ll be able to put 120 CNWL staff through this intensive training course this year! I could not be more pleased, and I must say a big thank you to everyone who helped make it happen.
This is the training which I undertook six years ago. I thought you might like to hear about what it involved and my experience with it. I am hoping there are many of you out there who are champing at the bit to be involved and have the opportunity. I would like to make the training available to everyone, but in this first year of us investing in the course we will need to make some strategic decisions that may limit who ultimately gets to go. I will lay out some of our thinking on this towards the end of this week’s blog.
The Training
There are not many providers of training in Open Dialogue in the UK (only three that I am aware of to date). The very first training here was put together eight years ago. The people who undertook that first training have been coming together ever since to provide training to new cohorts each year, with people travelling from across Europe to attend. They have worked closely with some of the original Finnish Team to develop that training, including key figures such as Jaako Seikkula, who usually returns each year to provide some of the training. They also brought in Mary Olson, an American Social Worker who spent a number of months working alongside the Finnish team in Tornio studying how they do what they do. She has been key in translating and communicating some of the practice for the Western world and is now the Director of the Dialogical Institute in Massachusetts, US.
The course involves four week long residential training blocks. As you might expect, these training weeks run through a lot of the practicalities of what is involved in delivering an Open Dialogue approach. They explain each of the key elements and principles in detail, giving time for you to debate and explore these. They also do a lot of immersive role-play to help you experience the differences and subtleties of how this way of working and develop some of the specific skills you will need.
They also spend a lot of time getting you to work on yourself. This is a big part of what makes the difference, and something we do not put enough emphasis on within our own mental health trainings here in the UK. There is a lot of examining your own history, reflecting on this by yourself and with colleagues. You are invited to explore the idea for yourself of “what is personal, and what is private”. The difference between the two can be subtle and will ultimately be very individual. You need to play with it and calibrate it for yourself. We spoke in a previous blog about the need to be human within this way of working. This can present some challenges for professionals trying to reassess where their own boundaries may now lie.
One technique the course leaders have adopted to help people gain insight in to their inner workings is to build in a regular mindfulness practice. Russel Razzaque, visiting Professor at LSBU, Consultant Psychiatrist at NELFT, and Lead Clinician for the ODDESSI Study at UCL, has written an article about the overlaps he has found between Mindfulness and Open Dialogue (2015). I have attached it here for you to read more. He is one of the course leaders and delivers a daily guided practice during the training to help people with self-reflection.
I must admit the first week I attended of the course I personally felt a little overwhelmed and disorientated. It was quite different from any training I had been on before and it questioned a lot of things about mental health care which I took for granted. Having time to sit with these thoughts and to reflect on myself felt at times quite challenging. However, by the end of the week I felt like pieces had begun to fall in to place. By weeks, two, three and four I was really looking forward to this precious time to reflect and grow.
Between each residential training week, participants are encouraged to put the techniques in to practice with colleagues and with the service users they are working with. You are invited to write short reflective diary entries on how you and your practice is changing.
There is an opportunity to gain a formal qualification (PGCert) through LSBU. If you take this up you have to write four short essays pulling together your learning about Open Dialogue from the literature and the course. I personally found this very rewarding, it helped me see how ‘academically deep’ the development of this approach was. However, if the academic component is not for you there is not an expectation that everyone completes this.
If you would like to read more about the course you can find details here:
http://apopendialogue.org/open-dialogue-course/
CNWL’s Approach
We have already sent our first six people on the 2021/22 training course. They include a Peer Working Lead in Brent/Harrow, a Consultant Psychiatrist for the Early Intervention service in Kensington & Chelsea and Westminster, the One Community Project Lead at St Charles, the Lead Psychologist for Trauma Informed Care, a Consultant Psychiatrist for Crisis Resolution and Home Treatment in Harrow, and the Lead Inpatient Psychologist for Milton Keynes. These pioneers are helping us think through how we might approach developing and spreading Open Dialogue ideas through the Trust.
The course for 2022/23 will be starting in September and run for eight months. Exact dates will be able to be shared with you in the next few weeks once details have been firmed up.
There are a number of principles we will be following in deciding who will get access to the training this year.
- There must be representation from Adult Mental Health Services across the Trust, meaning people from each of our five London Boroughs and Milton Keynes. No service is excluded, so it could be inpatient or community.
- There must be representation of all our key professional groups on the training, including, but not limited to: Peer Workers, Nurses, Social Workers, Psychologists, Therapies Staff, Psychiatrists, Support Workers, Community Champions and Occupational Therapists.
- With such a significant investment we must ensure there is sustainability to what is delivered. Ultimately, we want a thriving Community of Practice which one day would be able to deliver its own internal training to the Trust. Thus, the people who go on this training must be in a position to put it in to practice when they return to their workplace and commit to spreading the ideas with their colleagues. We will be looking to concentrate the training in to groups of linked colleagues who can commit to working in this new way with each other.
- The people who are put forward to go on the course need to be able to commit to attending each of the four residential training weeks in full. It will need support amongst your team members to cross cover your work whilst you are away. As such, you will need the support of your team leadership and a commitment to spread the learning with your team when you return to your team.
We will be meeting soon to make some decisions about who will be offered the opportunity to go on this training and then start approaching some of you about this, providing details of how you can apply.
If you want to be considered as an individual, or have your team / service considered, a good start would be to ensure you have given your details to our Project Manager Nina Dawson for the Register of Interest. The details are at the end of the blog below.
Even though 120 training places seems like a big number, and it is a fantastic investment, CNWL is still a very big place. This will sadly mean some of you may be disappointed this time round. I do not want any of you to lose enthusiasm. We will find ways to include you in other training and information sharing events we have planned, and then hopefully get you access to the full training in coming years.
I could not be more excited that we are taking such a bold step towards growing our understanding of dialogical practice here at CNWL and I hope you are too.
I love hearing your responses to my blogs. Please send them to me at: Gareth.jarvis@nhs.net
References
Razzaque, R., 2015. Mindfulness and open dialogue: A common foundation and a common practice. Context, 137, p.45.
Finding out more
I am getting more and more of you contacting me to say you want to find out more about how to access training and learn more. We have a ‘Register of Interest’, through which we can be targeted in communicating opportunities to people in the future. If you are interested in being added to the Register of Interest please email:
This year’s National Peer Supported Open Dialogue Conference will be taking place Wednesday 4 May, on Oxford Street – See Flyer Here
Tickets are on a donation basis – so pay as much or as little as you like – and it all goes to the cause of promoting Peer-supported Open Dialogue in the NHS.
Please register here:
We have a regular Special Interest Group, which is open for anyone interested to attend, on a monthly basis.
Our next meeting will be Thursday 7th April 15:30: