Posted on: 14 June 2022

CNWL is investing in Open Dialogue and we will shortly be asking staff to apply for 130 staff training places. Dr Gareth Jarvis, Medical Director of Jameson Division, is the clinical lead on this project and blogs about it regularly.

Amanda Bueno is a Psychotherapist who is assisting developing the work and here she talks about what Open Dialogue is and why it is worthwhile. You can contact Amanda on

Amanda Bueno.jpg

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Wearing my professional hat, I am a UKCP Registered Systemic Family Psychotherapist and Clinical Supervisor with over three decades of experience of working with families.  I have worked on the wards, with a Home Treatment and was Practice Development Lead for a Community Transformation project embedding trauma informed practice.

However, wearing my personal hat, I am a passionate advocator for Mental Health changes who firmly believes that our clinical practices must now move from the medical model to one that includes a person’s family, social networks, and community. We need as a culture that rather than seeing mental health as primarily a bio-medical physical imbalance within a person, which instead first takes a trauma informed perspective that most people are experiencing an understandable response to their environment.

We all experience daily emotions, some are deeply distressing be that loneliness, despair, self-loathing (and so on) but they are not illnesses that need curing. Many of our clients have experienced significant trauma, which needs listening to, witnessing and compassionate collaborative understanding. A personality is not disordered for having a response to cruelty or poverty.

Our care notes are often kept private from patients.  The transparency and openness of Open Dialogue OD (the successful Finnish mental health system) is a timely, moral, and hopefully implementable framework that CNWL is ready to embed. A critical OD principle is “nothing about a client without a client” automatically removing the us and them.

CNWL have invested in the NHS Long Term vision outlined in the Community Mental Health Framework. However, there is invariably a gap between investment, intention, and implementation of change, as we all struggle with changes as individuals or within our systems.

There are numerous international best practice examples, but Open Dialogue ticks many boxes, and we are lucky at CNWL to have the opportunity and support to train teams in the method. (OD methodology and efficacy can easily be “googled”) I am excited that my role can bridge the gap between theory and practice. To work on the ground with the teams ensuring that this change can be fully adopted to run alongside treatment as usual. Not to replace current treatment protocols, but to add a trauma informed option to our tool belt.

My heartfelt goal is to move away from the diagnostic lens of labels in all our Mental Health teams. To connect us all to stories often emotionally challenging to hear. That the first thought we have as practitioners isn’t what’s wrong with you? But it is what’s happened to you?