Anestis Eleftherios, Weaver Timothy, Melia Claire, Clarke Katherine, Pilling Steve
Department of Mental Health and Social Work, Faculty of Health, Social Care & Education, Middlesex University London, London, United Kingdom.
Government Social Research, UK Civil Service, London, United Kingdom.
Front Psychol. 2024 Aug 12;15:1432327. doi: 10.3389/fpsyg.2024.1432327. eCollection 2024.
In the context of transforming mental healthcare towards more personalised and recovery-oriented models, Open Dialogue has attracted significant international interest. Open Dialogue proposes a way of organising services and delivering care that supports an immediate response to crisis, relational continuity of care, a social network approach and the empowerment of networks through shared decision-making and a flattened hierarchy. The ODDESSI trial currently being conducted in the UK is assessing the model's clinical and cost-effectiveness. Practitioners who delivered the approach within the trial undertook a one-year Open Dialogue foundation training programme, however little is known about their training experiences. This study aimed to explore practitioners' experiences of receiving the training and transitioning to dialogic practice.
Individual, joint and focus group interviews with 32 Open Dialogue practitioners were conducted. Thematic analysis was used to analyse the transcripts and transformational learning theory informed the interpretation of the findings.
Two themes further divided in subthemes were generated from the data: (1) experiences and impact of formal training and (2) becoming an Open Dialogue practitioner as an ongoing learning process beyond formal training: barriers and facilitators.
The one-year Open Dialogue foundation training was a transformative experience for participants due to its emphasis on self-work and its impact on a personal level. Practitioners felt adequately prepared by their training for dialogic practice, yet becoming an OD practitioner was seen as a continual process extending beyond formal training, necessitating ongoing engagement with the approach and organisational support. However, the commitment of participants to deliver optimal dialogic care was occasionally impeded by organisational constraints, resource limitations, and often having to concurrently deliver conventional care alongside Open Dialogue.
在将精神卫生保健转向更个性化和以康复为导向的模式的背景下，开放对话引起了国际社会的广泛关注。开放对话提出了一种组织服务和提供护理的方式，支持对危机的即时响应、护理的关系连续性、社会网络方法以及通过共同决策和扁平化层级赋予网络权力。目前在英国进行的ODDESSI试验正在评估该模式的临床和成本效益。在试验中采用这种方法的从业者参加了为期一年的开放对话基础培训课程，然而，对于他们的培训经历却知之甚少。本研究旨在探讨从业者接受培训以及向对话实践过渡的经历。
对32名开放对话从业者进行了个人访谈、联合访谈和焦点小组访谈。采用主题分析法对访谈记录进行分析，并运用转化学习理论对研究结果进行解读。
从数据中生成了两个主题，并进一步细分为子主题：（1）正式培训的经历和影响；（2）成为开放对话从业者是正式培训之外的持续学习过程：障碍和促进因素。
为期一年的开放对话基础培训对参与者来说是一次变革性的经历，因为它强调自我工作及其对个人层面的影响。从业者认为他们的培训为对话实践做好了充分准备，但成为开放对话从业者被视为一个超越正式培训的持续过程，需要持续采用这种方法并获得组织支持。然而，参与者提供最佳对话护理的承诺偶尔会受到组织限制、资源限制的阻碍，而且通常还必须在开展开放对话的同时提供传统护理。
