Family experiences of open dialogue informed listening meetings (1)
Research type
Research Study
Full title
Family experiences of open dialogue informed listening meetings
IRAS ID
309658
Contact name
Amber Iszatt
Contact email
Sponsor organisation
Salomons institute Canterbury Christ Church University
Duration of Study in the UK
1 years, 7 months, 24 days
Research summary
Research Summary
There is an encouraging emerging evidence base for open dialogue (OD), which originated in Finland, as a treatment approach for individuals with experiences of psychosis (including a decrease in use of medication, hospital duration, disability allowance and return to employment/education). The approach involves the presence of the service user’s (SU) support system which is consistent with good practice guidelines about family and carer involvement(CQC 2017).
A pilot study of OD in the US reported themes of increasing understanding, aiding communication and finding ways to support the SU (Gidugu et al., 2021). Research has found positive responses to practitioner experiences of OD training in the UK (Wates et al., 2021). Attitudes amongst staff and SUs regarding a modified OD approach were also explored (Tribe et al., 2019). Further research to explore feasibility and add to the evidence base in the UK has been suggested.
Listening meetings use OD principles of engaging the network of a SU and working collaboratively from first contact. This study aims to use qualitative methodology to obtain in-depth information about the experience of family members who have attended listening meetings within early intervention services in the NHS. This will help gain an understanding of the experiences of the meetings and any relationship changes within the families. 8-10 interviews will take place at Lewisham early intervention service, at participant’s homes or online(based on the choice of the participant). The interview will take 45-90 minutes. Participants will be reimbursed for their time.
This study will contribute to understanding of how OD informed practice may contribute to change for SUs and families in the UK. Family perspectives are yet to be considered in OD research within UK services. Exploring family and carer experiences of listening meetings could inform family inclusive practice within services and highlight family and carer needs.
Summary of Results
Background: Open Dialogue (OD) provides an approach to work with a system in a network to help with managing crises for individuals experiencing severe distress. There is growing evidence for the effectiveness of OD as an intervention and it has been incorporated into services in varying ways. The present study aimed to explore family experiences of listening meetings which are an OD informed approach that has been adopted in an NHS Early Intervention for Psychosis Service in order to gain further understanding into experiences of the different ways OD is being practically implemented into already existing NHS services and ways to include a system as a network.
Aim: The study aimed to explore family experiences of OD informed listening meetings in an EIS. The following research questions were explored:
1. What are the family members’ experiences of listening meetings?
2. How (if at all) did participants feel the listening meetings contributed to any change in family relationships?
3. How (if at all) did listening meetings change how family members view their relationship to supporting the service user?Method: This used a qualitative approach called interpretative phenomenological analysis (IPA) to explore family member’s experiences of listening meetings. Seven family members were interviewed.
Outcomes: Four main themes were found across the data and 10 subthemes.
Main theme 1: “As a family as a whole”
Subthemes: Inclusion impacting role, improved relationships Main theme 2: Talking and listening that otherwise wouldn’t happen
Subthemes: New talking and listening, Meetings dampened the energy- emotions previously prevented talking and listening Main theme 3: Making sense together
Subthemes: Valuing voices to new perspectives, “In their presence”- kind of enlightening Main theme 4: Relationship to help
Subthemes: A place that creates safety to speak and listen, A bridge to accessing help, Empowered voices, Scratching the surfaceConclusions: A positive and useful experience of listening meetings were reported. Appreciation and usefulness of family and carer involvement was clear. Findings were consistent with existing key elements of open dialogue demonstrating an opportunity to incorporate adapted OD informed approaches in pre-existing NHS services. Experiences of systemic involvement and improvements in relationships, developing shared understandings, encouraging talking and listening, improved access to services and feelings of safety were reported. Participants felt like three sessions were not enough and were not frequent enough during this time of severe distress. One participant reported a positive experience in bringing the family together but expressed that they were unhappy overall with the service and mental health services in general. It could be hypothesised that three OD informed meetings felt helpful for those without prior experience of services but that three meetings may not be enough to rebuild trust or less beneficial to those who perhaps already lack trust in services.
Further exploration and understanding of the ways in which OD approaches are being incorporated into NHS services would be beneficial. Exploration of family experiences who have had previous involvement with mental health services will be useful.
REC name
West of Scotland REC 3
REC reference
22/WS/0019
Date of REC Opinion
30 Mar 2022
REC opinion
Further Information Favourable Opinion