Open Dialogue
What is 'Open Dialogue'?
Open Dialogue (OD) is a social network model of mental healthcare. Open Dialogue teams are trained to work systemically. They focus on enabling people's families and networks to take more control and use their own resources in their own recovery. People often describe Open Dialogue as a less hierarchical and more collaborative approach to care.
An OD team works with service users from their initial crisis and beyond. OD care includes the social network of service users throughout: families, friends and any other people who are important in that person's life might be invited to join 'network meetings'.
OD is underpinned by seven key principles: (1) Immediate response, (2) A family and social network approach, (3) Flexibility and mobility, (4) Responsibility, (5) Psychological continuity, (6) Tolerance of uncertainty, and (7) Dialogism (Seikkula et al., 2003). See the below video from Kent and Medway NHS Partnership and Social Care Trust (KMPT) talking about each principle.
Open Dialogue's development
OD was originally developed in Finland, and has been offered to people in crisis over the last 40 years. Studies have suggested that people are less likely to be admitted to hospital and are more likely to have a meaningful recovery than with the pervious model of care provided in the country (Seikkula et al., 2011). For more information, see the below video of Jaakko Seikkula talking about OD.
The delivery of OD is becoming more wide-spread across England and the rest of the UK. Alongside the NHS Trust's delivering OD as part of the ODDESSI trial, OD is also being delivered by services such as Dialogue First.
Open Dialogue UK was established in 2012 to support the implementation of OD in the UK. Based in London, Open Dialogue UK offers a full three year Open Dialogue practitioner training, the first to offer this training outside of Finland.
The Academy of Peer-Supported Open Dialogue (APOD) is a professional body for peer-supported OD who provide training, register qualified practitioners, and promote the use of peer-supported OD across mental health services.
What happens during a network meeting?
Service users and their social network meet, either in person or via phone or video call, to talk about whatever is important for them. They decide together about any treatments (pharmaceutical, psychological, social). There are two or more Open Dialogue Practitioners in every network meeting.
See a video below from Kent and Medway NHS Partnership and Social Care Trust (KMPT) highlighting the importance of family involvement in OD.
You can read more about OD on the NELFT NHS and Developing Open Dialogue websites.
This study is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research (Grant Reference Number RP-PG-0615-20021). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.