Open Dialogue and Families

I have been thinking over the last week in relation to the network meetings and Open Dialogue and how we could best adapt the ideas in non Open Dialogue services. Recently I have encountered a number of families whom have been bereaved by a suicide of a family member and I think family work would be a way of meeting their needs and addressing issues that are difficult to raise and impact on the family. We have locally had a spate of suicides, all but one young men who have chosen to take their lives by hanging or jumping from our cliffs onto the rocks / concrete below.

My understanding is that these families have received little in the way of support from local services. This certainly appears to be what they are stating in interviews with the local press. There are no real bereavement support services locally and Cruse the specialist counselling service for those who have experienced a loss have long waiting lists. I have also had conversations with residents who knew some of these young men and with residents who discovered their bodies, these experiences are causing trauma to locals and there is no forum to explore it.

Myself and some colleagues working in the NHS locally have been minded to consider setting up some voluntary sector therapeutic support. Also some basic training for cafe owners who have offered to provide a listening ear for those who have been feeling isolated, alone and unable to manage. Other local businesses want to take part in this project but I am mindful that we cannot take on the role of statutory sector services and the project will need good Open Dialogue foundations.

The Final week of the Helsinki training an emotional journey

The last module of the first International Trainers Training in Helsinki was held directly after the Open Dialogue Trainers Network  Conference, it was the end of 2 years of this groundbreaking trainers training for the 18 attendees who were a truly international group. The quality of the experience was exceptional and this was supported  by the expertise within the group and the willingness to explore issues in an open and curious manner. 

It was not an easy 2 years as there were days of family of origin and self exploration work which is of itself requiring the trainee to explore issues that can verge from discomfort to extreme distress. There was also a requirement for one’s family of origin to become involved in the process. This was not always en easy requirement and required a level of self awareness from our relatives and an understanding of their own sensitivities  plus a level of honesty that does not always enter into normal family discourse. In addition there were taught modules on adolescent difficulties, psychosis, severe mental health issues, difference and power dynamics. There was a high level of regular supervision of client work and supervision of the supervision with recorded work in the form of videos being supervised by one’s colleagues. There were different models adopted by the different supervisors which gave us a wide and varied experience and confidence in challenging a supervisee supportively.

The intensity of the weeks of training and the levels of exposure assisted in creating a bond between the trainees and a level of trust enabling us to discuss difficult material and emotions in an honest and reflective manner. English is fortunately my first language but for many of the trainees the course necessitated working with emotional issues  and complex concepts in a language which was not their first and this applied to the tutors too whose first language was Finnish.

For me this was one of the highlights of my career as a psychotherapist, the course, the emotional intensity and the bonds it created left me wishing we could continue as a group. I think and hope we will maintain contact through various connections we have created and through, conferences, websites and the network we are attempting to set up. I for one would not wish to loose these valuable and enriching connections.

Mental Health Difficulties in Students and Open Dialogue

I now supervise a University counselling and well-being service and I have been shocked by the level of referral and obvious psychological distress within the student population. Nationally within the U.K. the number of students declaring problems on arriving at university has surged. There is additionally an expectation that the students will be well supported because they are now paying considerably more for their courses. Unfortunately some universities are dispensing with their student counselling support services and providing wellbeing support and mentors instead. This is because staff you are fully qualified psychological practitioners cost more to employ. The welfare services should be in addition to counselling not instead of and is an abrogation of the university’s duty of care.

The whole student issue is a complex one in that students are now under considerably more pressure because of the debt implications of studying. The lucky few have parents that are able to fund the tuition fees for courses which average £10,000 per year, added to which there is the cost of accomadation and living expenses. The additional anxieties and pressures of the debt that most students leave university saddled with and cost of courses is something my generation did not have to consider because tuition was free. 

The university has a considerable body of overseas students where much of the income is derived and many of the issues that arise within the overseas student body are cultural. There are specific difficulties relating to particular ethnic groups which require considerable diversity awareness. There are also issues relating to the Family of Origin underlying many of the student presentations and this is why I am encouraging thinking in relation to some family training on an Open Dialogue framework occurring. The family training will of necessity incorporate a high level of cultural awareness and I will be involving practitioners from diverse backgrounds with different religious and cultural perspectives. There are other issues that also need to be incorporated in the training and that is the large number of students identifying as LGBTQ. In particular the huge increase in those students who identify as transgender or non binary, these issues are a comparatively recent development and many staff have had insufficient training to manage these presentations.