The following guest blog is contributed by Jane Hetherington, Senior Highly Specialist Psychological Practitioner from Canterbury EIP.
I along with a team of eighteen others from Kent and Medway Partnership Trust an assorted bunch of clinicians, managers and at one point our Medical Director embarked with some apprehension last week for Birmingham to start the first week of the Foundation Diploma in Peer –Supported Open Dialogue, Social Network and Relationship Skills. The course will be accredited at foundation level from the Association of Family Therapists and is designed by the North East London NHS Foundation Trust in partnership with Gjovik University College, Norway. The trainers who have compiled the programme are Val Jackson, Mark Hopfenbeck and Russell Razzaque, without Russell’s energetic championing of Open Dialogue and the Spring Conference he organised, the thinking and resulting pilot would not have progressed and evolved with such dynamism.
KMPT is one of the four NHS Trusts, the others being Nottingham, North Essex and North East London involved in an exciting, pilot project commencing next year to implement Peer Supported Open Dialogue within the NHS, initially we will be working with those experiencing first episode psychosis. The team from KMPT comprised practitioners from the Early Intervention in Psychosis Services and Medway Psychological Services , peer support workers and carers . We were required to read a number of articles prior to starting the course to inform us on the philosophy, history and practice of Open Dialogue, so we had some familiarity with the material. The timetable we received indicated a series of long days with 7pm starts and 9 pm finishes and this is what happened we started the day with either yoga or mindfulness exercises and finished exhausted……
Open Dialogue is an approach which was originally developed in Finland in the 1980’s and which has been adopted in a number of other countries including the majority of Scandinavia, Germany , some US states and excitingly the Parachute project in New York recently visited by our Medical Director and our Chief Executive. During the course of the week’s training we linked up with New York to discuss their development of peer worker inclusion within their teams as experts in their own right. Peer workers receive additional training in crisis care and holistic models of support and are incorporated within the Open Dialogue team with practitioners. Open Dialogue involves a family and social network approach incorporating the patient in decisions that are made within the system network meeting resulting in the patient’s increased autonomy and improved outcomes for long term recovery. The statistics relating to the work originating at a much visited hospital in Tornio in Western Lapland reveal improved recovery rates after an acute episode with 50% relapsing after standard care as contrasted to 20% when Open Dialogue is the approach
We aspire on completing this course to support the recovery journey for patients and their families in a more effective manner and we will be carrying out a project as the initial stage of implementing POD within our Trusts. We will be establishing peer support groups and providing them with the relevant training. These groups will develop a locally based model of peer support within their localities and services. The course emphasises the importance of the psychologically consistent family and network approach and the predominance of relationships in the recovery process. The ethos is on a philosophy and value system that is person centred in a Rogerian sense and these principles incorporate peer support and are client orientated.
Fundamental to the ethos of the POD approach is an increased use of the self in the therapeutic work with families and thus a need for a better level of self-awareness and understanding of our own complexities as practitioners and individuals so that we can work at a more congruent, liberated level. During this intense week our introduction to yoga and mindfulness was seen by many of us as a fundamental component of increased self awareness, many of us intend to continue this practice between modules. The majority of us left the first week of training with an almost evangelical desire to change things within our services and a hope that this could in the longer term be a catalyst for change within the NHS.
Another extremely exciting aspect of the training and pilot is that a television production company will be following us for the next 3 years to film the training and the resultant working pilot within the Trusts. The company have had interest displayed in the documentary, (which will currently comprise 3 episodes) by the major channels. It was initially a little uncomfortable being filmed but within a day we were not noticing the intrusion and the crew mingled with us at meal times and breaks increasing our confidence in their professionalism and sensitivity, they have already made a number of acclaimed documentaries in this field.
Jane Hetherington, Senior Highly Specialist Psychological Practitioner EIP