Table_1_Becoming an Open Dialogue practitioner: a qualitative study of practitioners’ training experiences and transitioning to practice.DOCX

IntroductionIn the context of transforming mental healthcare towards more personalised and recovery-oriented models, Open Dialogue has attracted significant international interest. Open Dialogue proposes a way of organising services and delivering care that supports an immediate response to crisis, relational continuity of care, a social network approach and the empowerment of networks through shared decision-making and a flattened hierarchy. The ODDESSI trial currently being conducted in the UK is assessing the model’s clinical and cost-effectiveness. Practitioners who delivered the approach within the trial undertook a one-year Open Dialogue foundation training programme, however little is known about their training experiences. This study aimed to explore practitioners’ experiences of receiving the training and transitioning to dialogic practice. MethodsIndividual, joint and focus group interviews with 32 Open Dialogue practitioners were conducted. Thematic analysis was used to analyse the transcripts and transformational learning theory informed the interpretation of the findings. ResultsTwo themes further divided in subthemes were generated from the data: (1) experiences and impact of formal training and (2) becoming an Open Dialogue practitioner as an ongoing learning process beyond formal training: barriers and facilitators. DiscussionThe one-year Open Dialogue foundation training was a transformative experience for participants due to its emphasis on self-work and its impact on a personal level. Practitioners felt adequately prepared by their training for dialogic practice, yet becoming an OD practitioner was seen as a continual process extending beyond formal training, necessitating ongoing engagement with the approach and organisational support. However, the commitment of participants to deliver optimal dialogic care was occasionally impeded by organisational constraints, resource limitations, and often having to concurrently deliver conventional care alongside Open Dialogue.引言：在精神卫生保健向更具个性化、以康复为导向的模式转型的背景下，公开对话疗法（Open Dialogue）已引发国际社会的广泛关注。该疗法提出了一套服务组织与照护提供的模式，能够支持对危机的即时响应、照护关系的连续性、社会网络方法，并通过共同决策与扁平化层级结构赋能网络建设。目前在英国开展的ODDESSI试验，正对该模式的临床有效性与成本效益进行评估。参与该试验中该疗法实施的从业者，均接受了为期一年的公开对话疗法基础培训项目，但目前学界对其培训经历仍知之甚少。本研究旨在探索从业者接受该培训并向对话式实践转型的相关经历。 方法：研究对32名公开对话疗法从业者开展了个体访谈、联合访谈与焦点小组访谈。本研究采用主题分析法对访谈转录文本进行分析，并以转化学习理论（transformational learning theory）为框架解读研究结果。 结果：研究从数据中提炼出两大主题，且各主题均下设子主题：（1）正规培训的经历与影响；（2）成为公开对话疗法（OD）从业者：超越正规培训的持续性学习过程——阻碍因素与促进因素。 讨论：为期一年的公开对话疗法基础培训，因强调自我探索与对个人层面的影响，为参与者带来了极具转化意义的体验。从业者认为该培训使其充分具备了开展对话式实践的能力，但成为公开对话疗法（OD）从业者被视为一项持续性过程，远超正规培训范畴，需要持续投入该疗法实践并获得组织支持。然而，参与者为提供优质对话式照护所付出的努力，偶尔会受到组织限制、资源匮乏的阻碍，且从业者往往需要同时开展常规照护与公开对话疗法服务。