Peer Supported Open Dialogue Conference London 2018, the Morning Dialogues

Posted by Apopen Dialogue on April 26th, 2018

Unfortunately the weather which was appalling for this time of year and described as “the beast from the East” seriously impacted on the attendance at the conference. Not only limiting the number of attendees but additionally restricting the presentations because many from Kent and Essex were unable to travel. None the less the conference was well attended and started with the NELFT Chief Executive as is customary providing a ringing endorsement for Open Dialogue and NELFT’s lead in the POD field. I remember the first Open Dialogue London Conference and his initial involvement and support of Russell Razzaque the NELFT based psychiatrist who lies behind the current UK interest in the approach. Russell has promoted POD extensively in the UK and he and Steven HofenbecK an American academic who works in Norway and Val Jackson a UK based family therapist have been instrumental in the British development of the approach.

The conference started off with a group of psychiatrists who had completed anOpen Dialogue Trainingand were working in teams that were operating in an Open Dialogue manner, The psychiatrists discussed in a dialogical style how the training had impacted on them and their work within their various teams and organisational settings. They were quite candid about the power dynamics that exist within the NHS and Mental Health Teams. Where the psychiatrist sits at the top of the hierarchy because of the medical qualification which gives them the ability to diagnose and prescribe. This group of psychiatrists discussed how they found the greater parity of power with the POD approach liberating.

They found that discussing a service user with others and listening to their observations removed a level of pressure from their role and enabled them to be curious and to wonder about the client. It also liberates the psychiatrist from having to medicate at the point of the service user’s access to services. It is a generally held principle within Open Dialogue that medication is discussed with the family network and that no decision is made until the 3^rd meeting, unless a crisis indicates the necessity for a more immediate response. All the psychiatrists reflected on their level of comfort in being one of a team and in not having to hold the lead position. This may of course not be a comfortable stance for some psychiatrists and has certainly been an instrumental factor, I feel, in some of the original opposition to POD.

The next discussion should have occurred with 3 families from Kent but unfortunately due to the atrocious weather they were unable to attend. They did however want their voices to be heard at the conference and sent Yasmin Ishaq the service manager some messages that they wanted relayed to the attendees. Yasmin read some extremely emotional thoughts from a mother, sister and the service user. It was clear from the messages that the family had been in crisis and felt helpless to manage the situation, they had been confronted with through the service user’s psychosis. They had fet understood, supported and heard through the process of the network meetings and grateful for them as they were all too well aware that they were receiving a service that was not the “standard input”.

The network meetings had from the outset proved a huge relief and removed a weight from the mother’s shoulders, as she felt she had been overburdened with the responsibility of her child’s illness. The sister too conveyed the importance of the network meeting, of feeling heard and of not being rushed and confined to strict appointment times. After this moving testimony a film was showed with exerts from families discussing POD at the last conference.

About Author: I am Jane Hetherington Principal Psychotherapist with KMPT currently working in Early Intervention Services n Kent. I trained as an integrative psychotherapist and have worked in substance misuse, primary care and psychosis services. I have completed the Open Dialogue training and will be involved in the new Open Dialogue Service.