Open dialogue in the UK: qualitative study

Abstract

BackgroundOpen 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.MethodIn total 19 participants were interviewed (8 service users and 11 clinicians) and an inductive thematic analysis of the data was conducted.ResultsFour 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.ConclusionsThe 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.

Keywords

• Open dialogue
• qualitative research
• thematic analysis
• psychosis
• schizophrenia