Open Dialogue is a form of integrated therapy where the service user and their family or close friends interact with two professionals and decide together on how to solve a crisis.
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The Open Dialogue method aims to commence meetings at the start of a mental health crisis
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The same professionals are involved throughout all the sessions.
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Regular meetings will be offered with the service user and their social network i.e. family or close friends. These are chosen by the service user.
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The meetings can be offered in person and online.
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No clinical discussions will be taking place behind the backs of the service user and their loved ones.
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All decisions about how to move forward or organise extra help will be taken by the service user and their loved ones, in conjunction with the professionals, and will not be imposed upon them.
CNWL will be gradually moving towards an Open Dialogue philosophy of care, which will eventually be offered across all mental health teams. The Trust will also be building a peer support team, in adaptation of the original Finnish model of Open Dialogue.
CNWL aims to create a mutually agreed approach where staff work alongside people and those close to them, rather than a top-down approach. Open Dialogue is about working “with people”, not “to people”.
Mental Health teams will be closely supported with learning and techniques of applying Open Dialogue within the treatment they offer. As this added service grows in different boroughs, it can be flexible to the needs of the service users and staff in that area.
Open Dialogue is a compassionate, person-centred approach to mental health care that emphasises equality, listening and collaboration. It’s about holding meaningful conversations, not just with the person experiencing distress, but with their entire support network. Instead of making decisions in isolation, the approach brings together families, carers, and professionals to work as a team, building a shared understanding of what’s happened and what’s happening, and empowering everyone involved to contribute to what’s helpful.
By focusing on relationships and creating space for everyone’s voice to be heard, Open Dialogue builds trust and opportunities to work together, and can help people be part of the treatment process, reducing the sense of isolation often felt in times of crisis. Evidence shows it not only helps people recover from challenges, but can promote sustainable outcomes by strengthening their support systems and broad understanding of factors that contribute to maintaining individual and network wellbeing.
For us as professionals, it’s an opportunity to deepen our practice and work in a way that aligns with core values of empathy, transparency, partnership and respect.
Peer-Supported Open Dialogue is a way of working that puts you first. It is a way of bringing all of our team’s listening skills and expertise together in one place. Usually, we ask “who is important to you?" This is so that you can invite the people who help and love you the most to regular meetings. This might be family, it might be friends, social workers or others.
We hope this may eventually reduce the number of appointments you have, the number of times you need to tell your story and join up your care. In these meetings, a pair of practitioners listen to you for a long while. We then turn to each other and talk about what we have heard you say so that you can hear us. We hope that through this reflective and honest way of working, a true understanding will build: enabling you and the people closest to you to communicate more clearly and cope better.
Open Dialogue is flexible: we can come to you. It is focused on the present, not the past: guided by what is happening in the here and now. In practice this is quite different from how services currently look and there may be an adjustment period. What is hoped is that Network meetings facilitate clearer and more timely communication, validating feelings and activating support with you at the centre. By using Open Dialogue as the framework through which we all listen to each other, we hope to deliver you a more effective service.
Further Reading
The POD team at CNWL
Nina Dawson – Strategic Programme Manager for Peer-informed Open Dialogue – nina.dawson1@nhs.net
Darren Baker – Open Dialogue Practice Development and Training Lead – Darren.baker@nhs.net
Ali Wragg – Operation Lead in the Implementation of Open Dialogue in Westminster – alison.wragg@nhs.net
Open PODpod: The Open Dialogue Podcast
Listen to the latest episodes below
