Peer work in Open Dialogue: A discussion paper

Abstract

Open Dialogue is a resource-oriented approach to mental health care that originated in Finland. As Open Dialogue has been adopted across diverse international healthcare settings, it has been adapted according to contextual factors. One important development in Open Dialogue has been the incorporation of paid, formal peer work. Peer work draws on the knowledge and wisdom gained through lived experience of distress and hardship to establish mutual, reciprocal, and supportive relationships with service users. As Open Dialogue is now being implemented across mental health services in Australia, stakeholders are beginning to consider the role that peer workers might have in this model of care. Open Dialogue was not, initially, conceived to include a specific role for peers, and there is little available literature, and even less empirical research, in this area. This discussion paper aims to surface some of the current debates and ideas about peer work in Open Dialogue. Examples and models of peer work in Open Dialogue are examined, and the potential benefits and challenges of adopting this approach in health services are discussed. Peer work in Open Dialogue could potentially foster democracy and disrupt clinical hierarchies, but could also move peer work from reciprocal to a less symmetrical relationship of 'giver' and 'receiver' of care. Other models of care, such as lived experience practitioners in Open Dialogue, can be conceived. However, it remains uncertain whether the hierarchical structures in healthcare and current models of funding would support any such models.

Open Dialogue, need‐adapted mental health care, and implementation fidelity: A discussion paper

“…(2017, Ong et al, 2019), or to Bellingham et al . (2018), published in this journal. However, for context, Open Dialogue is founded upon seven need‐adapted principles described by Seikkula et al .…”

“…It is not the intention of this paper to describe Open Dialogue in detail; readers interested in a mental health nursing perspective on Open Dialogue are referred to Buus et al (2017, Ong et al, 2019, or to Bellingham et al (2018), published in this journal. However, for context, Open Dialogue is founded upon seven need-adapted principles described by Seikkula et al (2001aSeikkula et al ( , 2001b):…”

Beyond polyphony: Open Dialogue in a Women’s Shelter in Australia as a possibility for supporting violence‐informed practice

“…The shelter offers safe refuge and crisis intervention for women experiencing compromises to their safety, such as homelessness and violence. We anticipated that Open Dialogue network meetings, which attend to relations of power and privilege, include networks of support, acknowledge all voices in a polyphony (Bellingham et al, 2018), and incorporate a dialogical style might be especially therapeutic for these women. The aims of the network meetings were to improve the network’s understandings of how women see the challenges they face and to support the network to identify possible resources and ways forward.…”

Clinician experiences of “Let’s Talk about Children” training and implementation to support families affected by parental mental illness

“…Most studies evaluating LTC have been conducted in Finland, meaning its suitability for other contexts is largely unknown (Solantaus et al, 2010;Solantaus and Toikka, 2006). Specific contextual factors which may influence uptake, adherence to the model and family outcomes include clinician training, allocated resourcing, organisational models and structures (Bellingham et al, 2018). This body of literature is further limited by its focus on nursing staff working in acute hospital settings where opportunities for FFP can be limited, and the use of focus group methods in which peer pressure within the group may influence the data gathered (Maybery et al, 2015;Reupert et al, 2015;Tchernegovski et al, 2015).…”