Peer supported open dialogue in a UK NHS trust – a qualitative exploration of clients’ and network members’ experiences

Date02 January 2020
Publication Date02 January 2020
AuthorCorrine Hendy,Mark Pearson
SubjectHealth & social care,Mental health,Mental health education
Peer supported open dialogue in a
UK NHS trust a qualitative
exploration of clientsand network
Corrine Hendy and Mark Pearson
Purpose As the evidence base in relationto open dialogue continues to grow and develop, this paper
contributes to the growing evidence base within the UK. The purpose of this paper is to focus on the
experiences of those who have received the service and reports a qualitative evaluation of an open
dialogueservice operating within the National HealthService of the UK.
Design/methodology/approach The opportunity to participate was offered to all those who had
received open dialogue within this particular National Health Service (NHS) trust. In total, seven
participants, from four different social networks, participated in the research and attended semi-
structured focus groups. The audio recordings of all focus groups were transcribed and the data as
subjectedto inductive thematic analysis.
Findings The results provide an insight intothe lived experience of the individualswho received open
dialogue. The analysis ofthe data gathered in the focus groups revealed three major themes:relational
mutuality,dichotomy with other mental healthservices and dialogical freedom.
Practical implications The results suggest that individuals and networks positively experienced
receiving open dialogue,particularly in relation to the way in which they were able torelate to, and work
with practitioners. However, the results did also raise some issues in relation to the complications of
introducingthe open dialogue model into existingNHS structures.
Originality/value This research contributes to the emerging evidence base in relation to open
dialogue,especially considering the currentlack of existing research undertakenwithin the UK.
Keywords Dialogue, Shared decision making, Mutuality, Open dialogue
Paper type Research paper
Open dialogue is a term first used in 1995, in Western Lapland, to describe a social network
approach to working with, and supporting those who are experiencing mental health difficulties
(Aaltonen et al., 2011). Open dialogue is a way of organising a whole mental health system and
describes a distinct form of therapeutic dialogue created in social network meetings (Olson et al.,
2014). In open dialogue, network meetings are arranged according to the needs of the client, in a
location of their choice, usually their own home and facilitated by two open dialogue practitioners
(Seikkula, 2011). Whilst sharing some of its origins with family therapy, it is distinct in its structure
and delivery (Stockmann et al., 2019). Open dialogue draws on the work of Mikhail Bakhtin
(1984) where dialogue is seen to extend in both directions between practitioners, clients and
family members, and it is through this process of dialogue, within the network, that problems are
explored and therapy is undertaken (Schriver et al., 2019). The approach draws on social
constructionist theory, suggesting that meaning is social constructed (Anderson and Goolishian,
Corrine Hendy is based at
Healthcare NHS Trust,
Nottingham, UK.
Mark Pearson is based at
the School of Health
Sciences, University of
Nottingham, Nottingham,
Received 9 October 2019
Revised 19 November 2019
3 December 2019
Accepted 3 December 2019
DOI10.1108/JMHTEP-10-2019-0052 VOL. 15 NO. 2 2020,pp. 95-103, ©Emerald Publishing Limited, ISSN 1755-6228 jTHE JOURNAL OF MENTAL HEAL TH TRAINING, EDUCATION AND PRACTICE jPAGE 95

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