Conversation Analysis of Open Dialogue Network Meetings

Open Dialogue is a collaborative approach to working with people and their support networks during times of mental health crisis. A central principle of the approach is the promotion of dialogue between all the participants. Open Dialogue therapists are advised to create opportunities for all voices to be expressed and to view all voices as equal. This includes the voice of therapists having no greater or lesser “value” or authority than other participants. Therapists thus have potentially conflictual roles of managing the session while also downgrading or mitigating the authority of their positions. With these issues in mind, we wanted to analyse and understand what conversational practices characterise Open Dialogue conversations. We video recorded 14 hours of Open Dialogue sessions in a child and youth mental health service in Western Sydney. Therapists had experience in the Open Dialogue approach and were also undertaking advanced training in the approach. We have used Conversation Analysis to investigate these conversations. Conversation Analysis focuses on the conversational practices utilised by the participants and how these practices achieve social actions, rather than references to internal motivations or broader social discourses. In our analyses we identified some ways that therapists work to mitigate both their epistemic authority (their claims to knowledge about the family), and their deontic authority (their ability to determine the actions of others) when directing a session. These results have implications for other psychotherapeutic approaches that seek to promote collaboration with clients and families.