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A Review of Hugh Fox's Article on Narrative Therapy as an Intervention in Open Dialogue Training by Alice Campbell

A Review of Hugh Fox's Article on Narrative Therapy as an Intervention in Open Dialogue Training by
Article Posted: 02/21/2017
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A Review of Hugh Fox's Article on Narrative Therapy as an Intervention in Open Dialogue Training


“In  his  article “Combining  the  Use  of  Open  Dialogue  with  Narrative  Therapy”  Hugh  Fox  discusses  ideas  that  are  relevant  to  the  use  of  the  narrative therapy  approach  within  an  Open  Dialogue  training  and  an  Open  Dialogue  Service.”

I  decided  to  review  this  article  because  I  had  heard  a  great  deal  about  Hugh  Fox  as  a  supervisor  through  conversations  with  Val  Jackson,  (a  family  therapist  who  has  been  pivotal  to  the  development  of  Open  Dialogue training  within  the  UK)  and   I  have  attended  many  of  her  workshops.  I  therefore  felt  I  was  one  step  removed  from  knowing  him  and  was  interested  in  the  topic of  combining  the  Open  Dialogue  course  with  Narrative  Therapy.

As  Jaakko  Seikkula  has  discussed  in  various  presentations and  workshops I  have  attended,  Open  Dialogue training can  be  combined  with  a  number  of  therapeutic  approaches  and  is  needs  adapted,  the  therapist  working  with  the  client  would  however  attend  the  network  meeting.The  individual and  their  network  who are  working  with  the  Open  Dialogue Service are  not  precluded  from  further  interventions,  CBT, psychoeducation,  motivational  interviewing  etc.  In  his  article Hugh  Fox  discusses  how in Open  Dialogue  training  the  listening  is  not  to  assess ,  hypotheses  or  interpret  it  is  to  understand,  it  is  having  two  “I” ‘s  in  the  room,  not  another  object  but  two  subjects.  Fox  concentrates  on  the  commonality  of  the  approaches  he  does  not  discuss  the  first  principle  of  Open  Dialogue training  which is   the  immediate  response  to  a  crisis,  this is  more  practical  and  relates  to  the  formation  of  Open  Dialogue  Services.Foxalso doesn’tdwell  on the  bodily  response  to  the  individual, an  important  concept  within  Open  Dialogue  training. There  are    Fox  perceives  a  similarity  in  the  approaches  in  the  way  they  explore  the  development  of  language, the  acceptance  of  the  literal  expression  and  the  experience  without  judgement  or  interpretation, “the  being  with”.  The  importance  of  what  the  voices  represent,  their  polyphony   and  the  acknowledgement  of  the  experience  is  fundamental   to  both  approaches  and  they  both  eschew  the  medical  model  which  is  dismissive  of  the  meaning.  The  narrative  discourse  and  Open  Dialogue training  both  dispense  with  the  professional  as  being  the  sole  source  of  wisdom, in  Open  Dialogue Services  the  network  meeting    is  seen  as  a  resourcefor  the  individual’s recovery  and  their  expertise  is  recognised  and  valued.There  is  an   encouragement  to  treat  conversations  seriously  and   an  invitation  to  the  family to  participate and  they  are  encouraged  to  do  so  but  there    no  compulsion.

The  differences  are  that  narrative  therapy  has  little  interest  in  organisations  and  does  not  see  psychotic  experience  as  a direct  consequence  of  life  events  whereas  Open  Dialogue  training regards these  experiences  as formative.  Hugh  Fox  also  feels  that  narrative  therapy  is  more  proactive in  its  approach  to  change  and  making  new  meaning  than  a purist  Open  Dialogue training, although  both  approaches  emphasise  personal  agency.

The  discussion  in  relation  to  the  reflecting  teams  in  the  article  is  helpful   and  relates  tokeeping  to  the  network  meetings  own  words  and  using  the reflecting  period  to  introduce  and  experiment  with  new  ideas,  thus creating  a  space.  Jackson  discussed  using  the  reflecting  space    for  narrative  ideas  to  speed  up  the  process, because  there  are  more  frequent  meetings  in  Open  DialogueServices  than in  narrative  therapy(initially  an  Open  Dialogue Service may  be  meeting  daily  with  the  family  network). This  use  of  the  reflective  space  is  similar  to  the narrative  therapy  use  of  the  concept  of  outsider-witness.  Initially  the  therapeutic  encounter  requires  listening  but  later  with  the  development  of  the  relationship  increased  reflection is  deemed  necessary.

The  conclusion  being  that  Hugh  Fox  not  unsurprisingly  experiences  a  compatibility  and  a  fit  between  the  two  approaches.  He  feels  that  narrative  therapy  used  in  conjunction  with  Open  Dialogue  training  will  move  the  process  of  change  forward  faster.

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 service. 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.

Related Articles - Open Dialogue Service, Open Dialogue course,

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