Open Dialogue

We are currently taking part in a national pilot project involving the Open Dialogue (OD) approach. 

OD is an approach to working with individuals with mental distress in which a multidisciplinary team of professionals respond to acute crises by holding meetings which bring together the person in distress and any members of their family and social networks as chosen by the service user.

Currently, we are leading the way in developing and evaluating this model as an alternative to standard mental health care in the NHS.

The approach we are piloting promotes the involvement of peer support workers who are seen as experts in their own right through lived experience of mental distress.

KMPT’s Peer Supported Open Dialogue is supported by the Health Foundation’s Innovation for Improvement programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.

The OD approach is supported by 7 key principles:

  1. Immediate help: Support is offered within 24 hours of the first call to services.
  2. Social network perspective: Key members of the social network are invited to meetings to mobilise support for the service user and family.
  3. Flexibility and mobility: Staff are able to work flexibly to suit the needs of the service user and family.
  4. Responsibility: The OD team is responsible for the entire treatment process.
  5. Psychological continuity: Staff remain constant through a individual’s contact with services.
  6. Tolerance of uncertainty: Premature decisions about treatment are avoided. Families are encouraged to explore options together.
  7. Dialogue and polyphony: Every voice is heard, respected, and responded to.

For more information contact research@kmpt.nhs.uk or 01622 723100.

Our journey so far

Our pilot team includes 17 practitioners predominantly working in Early Intervention in Psychosis (EIP) but also from other services that manage severe presentations within Kent. The initial stage of the pilot requires the team to undertake a foundation course, a year of intensive part time training in Peer Supported Open Dialogue (POD). The course promotes recognition of the necessity of the therapeutic relationship and the importance of dialogue to foster personal recovery and humanising psychiatry and mental health care. 

Our pilot

The approach we are piloting is similar to that which has been pioneered in New York. The project promotes the involvement of peer support workers in the training and process. They are seen as experts in their own right through lived experience and will be encouraged to share the training throughout their professional network.

The POD approach

The Peer Supported Open Dialogue (POD) approach involves psychologically consistent, family and social network meetings where members of the service user’s family or peer group will meet with a team of professionals in their own home and engage in dialogue including the service user. Members of the professional team will remain consistently involved in the treatment. POD assists those in a crisis situation to work with the emotions of the crisis and to tolerate the uncertainty.

POD results

Over the course of time, working in a dialogic manner results in understanding of the meaning of the crisis and in healing and reparation. The meeting places the individual, their families and peer group at the heart of the provision of care, with the ability to make decisions pertaining to treatment. Fostering this involvement provides the individual and their network with a better experience of the system and will ultimately lead to a future reduction in chronicity and less long term dependence on mental health services.

Open dialogue

Want to read more?

The Independent interviewed a family in the UK who has already benefited from Open Dialogue.

Check out the article on Open Dialogue on the Community Care website featuring the Trust's Yasmin Ishaq.

Read more about Open Dialogue from a carer's perspective. Annie Jeffrey talks to Jane Hetherington about being involved in Open Dialogue training.

Useful documents