“This article discusses the importance and emphasis on the Open Dialogue Course and in Open Dialogue Supervision Model. Read this article.”
The original Open Dialogue training in the UK delivered by the NHS and NELFT discussed supervision and the importance of it. Although I do not feel that there was sufficient focus on the necessity of supportive clinical supervision to promote and sustain good practice. As a psychotherapist it was an essential aspect of my training to participate in monthly clinical supervision, to prepare for it and to use it effectively in fact obtaining the requisite amount of clinical supervision is essential to retain one's registrations and to enable ethical practice and in order to retain accreditation one must offer evidence of regular supervision.
There was much debate in Kent within my Trust KMPT in relation to how we would offer and design a supervision model that would fit our practitioners and our early Open Dialogue practice, prior to the setting up of the Open Dialogue service. Initially we met in patch supervision for 2 hours every 2 weeks rotating the meeting between the 3 geographical areas and meeting as a large group of practitioners every 2 months to discuss the more practical issues in relation to the implementation of Open Dialogue. We attempted to obtain video recordings of our work so that we could utilise these in supervision as a learning experience for the team and there were a few families that agreed to be videod. We also devised a model based on suggestions by Jaakko Sekkula and our idea of how the Finnish team operated in their Western Lapland Open Dialogue clinic supervisions. We developed patch supervisions which we videod consisting of the clinicians who comprised the workers in the Open Dialogue network meeting sitting in a central circle and discussing the events in particular the process that had occurred in the family meetings. The rest of the supervision group would form an external circle in which they would reflect on their own process in relation to their thoughts and feelings on hearing the central discussion and the central group would hear this in silence before reflecting on what they have heard.
We felt it was important in the Initial Open Dialogue supervisions to develop a parity between professionals and a non-hierarchical environment for mutual learning. This was always a challenge for Open Dialogue trainings and services within the NHS where the medical model and the role of consultant psychiatrist still dominates and where the structure of bandings and roles creates creates a hierarchical model so alien to the Finnish Open Dialogue concept and the culture we experience in our contact with the Finns.
The international Open Dialogue training in Helsinki focuses on teaching and supervision as the aim of the 2 year course is for the participants to deliver Open Dialogue to a range of individuals in different settings building on the work of the Finns. The supervision model we are utilising on the training involves bringing our clinical work either in the form of videos, recordings or transcripts and being supervised initially on a one to one basis by a peer who then opens the Open Dialogue supervision up to the larger group of colleagues. The purpose being to make use of the polyphony of voices in the room and the range of clinical experience available.
Author Bio: Jane Hetherington, Principal Psychotherapist at KMPT and an employee at Early Intervention Services in Kent, has completed Open Dialogue course and will be a part of the new Open Dialogue course. She is trained as an integrative psychotherapist and has experience working in primary care, substance misuse, and psychosis services. Here, she writes about a few psychotherapeutic theories.