Welcome to the Open Dialogue UK Website. On this page you can find information on why Open Dialogue was formed, our current work, the development of Open Dialogue UK and a basic introduction to the Open Dialogue approach. You will find links on this page to further intormation about the approach, introductory seminars, supervision, and the current training programmes that we have planned. To keep up to date on our work and developments in the approach, you can sign up to our newsletter.

Why was Open Dialogue UK formed?

Open Dialogue UK was formed in 2012 in order to support the development of the Open Dialogue approach in the NHS in the UK.

Nick Putman, a psychotherapist based in the UK, had a long standing interest in working with people diagnosed with ‘psychosis’, experiencing extreme states, or hearing voices. Having worked and lived in various therapeutic communities and trained as a psychotherapist with The Philadephia Association in London, who have a long history working therapeutically with people having such experiences, he became interested in the possibility of developing a more therapeutic, psychosocial, and family-based approach to ‘psychosis’ within the NHS. In his experience there was not enough of such work taking place in the NHS, where the treatment for people diagnosed with ‘psychosis’ was primarily based on medication and often hospitalisation, with any family work typically focused on psycho-education.

Research conducted by John Read and others has highlighted the prevalance of trauma in the histories of people who have ‘psychotic’ experiences later in life, and Nick became convinced that the approach taken by the NHS and most public mental health services internationally needed to be developed in order to offer more therapeutic work that could include family/social network members. He travelled the world, meeting many inspiring people working in a variety of community projects, largely outside the public mental health care system, and became further convinced of the need for change.

Given that most people diagnosed with ‘psychosis’ are in need of public mental health care at the time of crisis, Nick continued to look for a model that could be taken up by the NHS, and on travelling twice to Western Lapland in 2012, spending a month in total studying the Open Dialogue model developed there and participating in network meetings, it became very clear that this was the model he had been looking for – he felt very much at home and was energised by what he found.  And so he formed Open Dialogue UK and began working hard to create opportunities to develop the approach both in the UK and internationally.

What is the Open Dialogue approach?

The Open Dialogue approach is both a philosophical/theoretical approach to people experiencing a mental health crisis and their families/networks, and a system of care, developed in Western Lapland in Finland over the last 40 years. In the 1980s psychiatric services in Western Lapland were in a poor state, in fact they had one of the worst incidences of the diagnosis of schizophrenia’ in Europe. Now they have the best documented outcomes in the Western World. For example, around 75% of those experiencing psychosis have returned to work or study within 2 years and only around 20% are still taking antipsychotic medication at 2 year follow-up.

Remarkably, Open Dialogue is not an alternative to standard psychiatric services, it is the psychiatric service in Western Lapland. This has afforded a unique opportunity to develop a comprehensive approach with well-integrated inpatient and outpatient services. Working with families and social networks, as much as possible in their own homes, Open Dialogue teams work to help those involved in a crisis situation to be together and to engage in dialogue. It has been their experience that if the family/team can bear the extreme emotion in a crisis situation, and tolerate the uncertainty, in time shared meaning usually emerges and healing/recovery is possible. Open Dialogue has drawn on a number of theoretical models, including systemic family therapy, dialogical theory and social constructionism.

Our current work

Our current focus is on running Open Dialogue training programmes for individuals and teams working in the NHS and international public mental health services, as well as teams from related mental health and social services and independent practitioners. We have always worked with a wide variety of professionals, including psychologists, peer workers, psychiatrists, social workers, care coordinators and support workers. We are currently running an online (20 day) foundation training programme and a trainers training programme in London, which takes place over two years (40 days). As well as running our foundation training programme online, we are able to travel as a trainer team to run the programme within the UK. Typically this programme is run over 8-12 months in blocks of varying length (2-5 days). For further information, please see this page. A new online foundation training programme is planned for 2027 and applications are now open. For further information and to apply to the programme, please see this page.

In addition to this we will shortly be resuming our one and two day online introductions to the Open Dialogue approach. You can find information on the next seminars we have planned to the right of of this page, and here.

We also offer one day and half-day supervision sessions to teams, which can either be organised online or in person. For further information, please see this page.

For information about the work we have done previously, please see the section below.

The development of Open Dialogue UK

For the first few years our work was focused on raising awareness of the Open Dialogue approach across the UK. Following seminars in Brighton, London and Nottingham in 2012 and 2013, we organised a series of two day seminars in Hackney, London in 2014, which were led by Jaakko Seikkula, one of the founders of the Open Dialogue approach, Nick Putman, and key members of the staff team from the mental health service in Western Lapland where Open Dialogue was developed – Markku Sutela, Kari Valtanen and Mia Kurtti. Around 300 participants attended at least one seminar, and more than 25 NHS trusts were represented. Inspired by this experience Mia Kurtti and Nick Putman travelled across the UK in 2015 to run seminars in London, Bristol, Birmingham, Mancester and Edinburgh.

Given our aim of developing the Open Dialogue approach in the NHS, it was clear that we needed to establish training programmes for staff. Work on this aim began in 2013, and by 2015 we had established the first full three year Open Dialogue training progamme to be run outside of Finland.

 

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