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Title: Nurses' experiences on using Open Dialogue Approach in a local mental health service : an interpretative phenomenological analysis
Author: Jones, Thomas Mark
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2019
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Background: Open Dialogue Approach (ODA) is a collaborative intervention and framework for using with service users with complex mental health such as psychosis. Aims: To explore nurses’ experiences when using ODA and in particular how ODA culture compares to other mental health cultures within a local health board. Method: Through the qualitative approach of Interpretative Phenomenological Analysis five members of staff were purposively sampled and participated in the research. Findings: The participants discussed ideas and concepts that developed into the following themes: the first theme was based on learning ODA skills and concluded that experiential learning and more formalised teaching is beneficial for ODA roll out, however, having a more experienced clinician partnered with a novice is crucial. The second theme focussed on participants perception of impact: all participants/clinicians agreed that ODA was an effective approach for the service users they worked with, due to the therapeutic relationship, service user empowerment and openness and transparency. The third theme identified ‘barriers’: the ODA principle of tolerance of uncertainty was a barrier that was encountered by the participants. Participants felt they must take positive risks and use minimal recording and not communicate about the service user without their presence, which is not in keeping with current legislation (UK and Wales). Also of significance is the fact that the service user is empowered within ODA to lead and direct the conversation which could be perceived as a barrier by some staff and professional groups who may feel threatened by this. This was evident in managing staff emotions within initial network meetings, managing risk and maintaining professional boundaries. In order to overcome this, the principle of tolerance of uncertainty was relaxed by participants in order to manage risk and for them to comply with current legislation. The empowered relationship in ODA is critical (through clinicians being open and truthful), as it appears to be the central and core intervention mechanism within ODA. Conclusion: ODA is reported as being effective by the participants within this study, but it will require further research to demonstrate this effectiveness within the UK to the wider clinical body and policy developers. The study also indicates a mechanism for ODA effectiveness: control and empowerment of the service user and openness/transparentness from clinicians. If this is employed then it appears that the principle of tolerance of uncertainty can be ameliorated to fit with UK legislation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.A.H.P.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available