What is Open Dialogue?
1. Dag van Wetter, Dienke Boertien en Dirk Corstens: Open Dialogue for people in crisis – from stranger to connection
Two times the same half-day workshop.
Open Dialogue is a system of mental health care, developed in Finland by Jaakko Seikkula and his colleagues, with strong follow-up in other countries and regions.
This specific approach is focused on actively seeking connection and dialogue with all parties involved, starting from within the crisis situation itself, without hesitation or delay. Listening openly to all the various voices, experiences and perspectives makes it possible to find some new understanding together, with different goals, strengths and resources to carry on together – this way there’s a future to be won. The particular Open Dialogue approach follows a number of crucial principles, which we’re learning to develop together as professionals and peer-workers, translated into our own regional context and partnerships.
Based on our current practice and our further challenges, together with the participants of the workshop we will explain and exchange about the core of these Open Dialogue key principles and the impact of this approach on connecting people in real life.
In a roleplay with the participants of the workshop we will also experience how Open Dialogue challenges ourselves in our authenticity and self-reflective work – how to tolerate uncertainty, how to postpone making our own opinions and avoid premature decisions, how to listen carefully to all the different voices and themes, … “Learn to listen so others are invited to speak, learn to speak so that others are invited to listen.”
This preconference workshop is also a first taste aperitif for the program of the ISPS conference, with a lecture on Open Dialogue by Nick Putman (Open Dialogue UK and international) on Thursday and his participation in the final debate on Sunday.
About the presenters:
Dag Van Wetter is staff officer patient care and Open Dialogue facilitator in Psychiatric Center Sint-Amandus Beernem (Belgium), where he and many other colleagues and compagnons work together on the shift to recovery-oriented network care. Along other projects, Care Circuit Psychosis North-West-Flanders (www.verbindendsprekenmetpsychose.com) is a regional collaboration of various facilities, services and other partners in the broader Bruges region, who work with and for people with a psychotic vulnerability. Seeking connection with and between people is the common purpose, with the further development of the Open Dialogue approach in the region as an important commitment.
Dirk Corstens is working as a social-psychiatrist and psychotherapist at METggz Roermond and vice chair of Intervoice, the charity that supports the International Hearing Voices Network.
Dienke Boertien is staff member on the topics Recovery and Experiential based Expertise at Phrenos Center of Expertise for severe mental illness . She followed education for Peer Supported Open Dialogue and the mentor training POD at the NHS and fulfils a coordinating task in the partnership POD Netherlands.
Make yourself familiar with ACT in a few minutes, watch Demons on the boat:
2. Dr Joe Oliver, Acceptance and Commitment Therapy for Psychosis
Two times the same half-day workshop.
Do you work with clients who experience distressing psychosis? Are you wondering how acceptance and commitment therapy (ACT)—and mindfulness in general—can help? Do you want to help your clients more effectively manage distressing symptoms so they can lead full, rich and meaningful lives? Acceptance and Commitment Therapy for Psychosis (ACTp) is a powerful behavioral approach that incorporates acceptance and mindfulness techniques to help people to disentangle from difficult thoughts, feelings, or distressing experiences, to engage in behaviors that are guided by personal values.
Experiential avoidance, cognitive fusion, and a reduced capacity for perspective taking, all play major roles in the distress and disability associated with psychosis. ACT offers a pathway to better psychological health and wellbeing through the cultivation of experiential openness, self-awareness, engagement in life, defusion from hallucinations, delusions and other unhelpful cognitions, self-compassion, acceptance of pain, and actions based on personal values. Due to the emphasis on values-directed action and personal meaning ACTp is consistent with recovery principles, and is highly acceptable by clients.
In this workshop, Dr Joe Oliver will introduce the core skills and knowledge to help clients recover from psychosis, using ACTp.
Learning Objectives for the workshop:
- Define how the challenges surrounding psychosis can be conceptualized using the ACT model
- Identify at least 3 main tenets of the ACT therapeutic stance and describe their relationship to working with people with psychosis.
- Define how ACTp can be a pragmatic treatment for people with early and established psychosis as well as carers of people with psychosis
- Describe how to adapt ACT metaphors and exercises for people with psychosis
- Learn the central acceptance and defusion skills in working with voices, paranoia and delusions.
- Describe how to safely and usefully use mindfulness and present moment exercises.
- Summarize the main issues in doing values work in psychosis
- Demonstrate key skills in facilitating ACTp in individual and group-based settings
About Your Presenter
Dr Joe Oliver is a Consultant Clinical Psychologist and course director for the post graduate diploma in CBT for Psychosis at University College London. He also works as a clinician within the UK National Health Service (NHS) and is Director for Contextual Consulting, offering ACT-focused training, supervision, and therapy.
Joe regularly delivers teaching and training on both ACT and cognitive behavioural therapies, in the UK and internationally and is an Association of Contextual Behavioural Science (ACBS) peer reviewed trainer.
Joe is co-editor of the textbook, “Acceptance and Commitment Therapy and Mindfulness for Psychosis” co-author the popular ACT self-help book, “ACTivate Your Life” and “ACT for Psychosis Recovery” (www.actforpsychosis.com).
More of Will Hall on handling medication
More of Will Hall and suicidal feelings:
3. Will Hall,
- how to handle suicidal ideation.
One time half- day
Suicidal feelings are more common than we realize. Not a symptom of disease, the urge to die is often a desperate need for change conflicting with an overwhelming sense of powerlessness. How can we support others – and respond to these feelings in ourselves?
Discover latest research, hear about innovative practices, and learn useful tools. Clinicians, students, people who have struggled with suicidal feelings, and family/friends are welcome.
- Psychiatric Medication Withdrawal: A Harm Reduction Perspective
One time half-day
Psychiatric medication such as antipsychotics, antidepressants, lithium, and other have become standard of care treatments, but little support or information is available on medication withdrawal. Author of the Harm Reduction Guide to Coming Off Psychiatric Drugs (in 14 languages), Will Hall works from a perspective that is not pro-medication or anti-medication, bu tpro informed choice. This workshop will address:
- Going off and reducing medications and developing medication alternatives
- Utilizing a Harm Reduction perspective to coming off psychiatric drugs.
- Recovery and Person-centered education frameworks for understanding medications as well as their risks and benefits.
- Building skills around medication empowerment and optimization in peer support and clinical settings.
- Supporting individuals to reduce and come off of their medications responsibly and safely.
Dr. Victor Kouratovsky
4. Samrad Ghane, PhD (1, 2) / Victor Kouratovsky, PhD (1, 3, 4, 5.): Building bridges using the Cultural Formulation: towards a person-centered and context sensitive treatment of psychosis.
Two times the same, half-day workshop
(1) Parnassia Psychiatric Institute- Cultural Psychiatry domain
(2) Arq Psychotrauma Expert Group
(4) Dutch Institute for Psychologists (NIP) Committee on Cultural Diversity
(5) Board member ISPS Lowlands and member Organizing Committee Stranger in the City
Connecting to patients’ sociocultural context as well as to their unique experience and view on illness and health is an important pre-condition for any effective treatment. This may even be more so in case of psychosis where patients’ experiences are traditionally pathologized and their sociocultural context is often overlooked. Thus, methods and instruments that may assist patients and clinicians to explore personal and contextual dimensions of the illness can be of particular value.
The Cultural Formulation Interview (CFI) is part of the DSM-5 and entails a way to systematically assess and take notice of four relevant cultural dimensions: (1) cultural definition of the problem, (2) cultural perceptions of cause, context, and support, (3) cultural factors affecting self-coping and past help seeking, and (4) cultural factors affecting current help seeking.
In this the CFI makes it for instance possible to explore different ways of understanding, strengths and resources, and ways to deal with problems. Using the cultural formulation may prevent misdiagnoses and lead to a more personalized approach, a better working alliance, and a more positive outcome.
In this workshop we will introduce the Cultural Formulation Interview (CFI) as a way to come into contact and to start a dialogue. In an interactive presentation the history and structure of the CFI will be discussed while the participants will become familiar with the use of the CFI through role plays. Finally, the therapeutic potential of the cultural formulation will be explored by using different case descriptions.
- Participants are familiar with the backgrounds and the structure of the CFI and can use it to start a dialogue;
- Participants are able to use the cultural formulation to adapt their treatment approach according to the particular backgrounds, needs and views of individual patients.
5. Amy Hardy: Breaking the silence: Talking about trauma in psychosis
Two times the same, half-day workshop
We now know that childhood adversities are associated with psychosis, and empirical evidence investigating the causal mechanisms underlying this association is accruing (Bentall et al, 2014; Gibson et al, 2016; Hardy, 2017; Varese et al, 2012). People with psychosis are also at an increased risk of revictimisation and are more likely to experience a range of post-traumatic stress difficulties. In line with these findings, it is recommended that trauma and post-traumatic stress reactions are routinely assessed in people with psychosis, and therapy offered when indicated (NICE, 2014). Unfortunately, it is rare for traumatic experiences and post-traumatic stress to be recognised in psychosis services, preventing access to psychological treatments (de Bont et al, 2015). The challenge is to effectively disseminate trauma-informed care within frontline services and ensure people’s needs are met. This workshop will start by exploring the principles of trauma-informed care, and opportunities and challenges of implementation in psychosis services. A framework for talking about trauma and responding to disclosures will be outlined. Preliminary findings from a pilot project using this framework in early intervention and promoting recovery services in inner city London will be shared.
Amy is a Research Clinical Psychologist based in the Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London and the Psychology Lead for Posttraumatic Stress in the Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust. Her research investigates the role of psychological processes in post-traumatic stress in psychosis and she is interested in the development, testing and implementation of trauma-informed practice and trauma-focused CBT for psychosis. She set-up the first specialist NHS clinic offering psychological assessment and treatment for post-traumatic stress in psychosis, and provides supervision, consultation and training in trauma-informed care to therapists and clinicians working in inpatient and community services across the psychosis spectrum. She also collaborates with inclusive designers and technologists on digital projects to enhance the usability and outcomes of psychological ways of managing distress and improving quality of life.
6. Peter Dierinck en Stijn Vanheule
Effectuating recovery: two perspectives
This workshop consists of 2 parts of half a day
During the first part Stijn Vanheule will focuses on how Lacanian psychoanalytic therapy might engender a process of existential recovery. In the second part Peter Dierinck discusses how the practice of quarter-making (“kwartiermaken”) contributes to processes of recovery.
Starting from a theoretical perspective on psychiatric symptoms Stijn Vanheule will address how psychopathology implies existential challenges that might be addressed in psychoanalytic therapy. Focusing on psychosis he will discuss how the Lacanian approach aims at finding stabilizing solutions for maddening issues people are confronted with in their lives. Published examples as well as cases from his own practice will be discussed, and brought into dialogue with the audience.
As Peter Dierinck will discuss, quarter-making consists of finding and creating hospitable places for people that are being excluded because of intellectual disability, race, sexual orientation or mental vulnerability. Professionals engaged in quarter-making aim at effectuating recovery, starting from an attitude of equality between professional and patient. The entire process starts with the question as to what a patient values in life. Psychiatric hospitalization frequently entails social isolation, which might be countered by actively connecting with relevant social networks. With multiple specific examples from his own practice Peter Dierink will address quarter-making, thus indicating how professionals can implement it.
Peter Dierinck is a clinical psychologist in Belgium, and works in a psychiatric clinic (Gent-Sleidinge). For 25 years he worked at a ward for homeless people with mental vulnerability, and for 3 years in an ACT-team. In 2017 he published a book about these experiences (“Hoop verlenen”, 2017, Witsand). Currently he runs a pilot project on quarter-making (“kwartiermaken”).
Stijn Vanheule is a clinical psychologist, psychoanalyst (New Lacanian School), and professor of clinical psychology at Ghent University. He published widely on psychosis, assessment, and clinical practice, mostly starting from a Lacanian psychoanalytic and critical perspective (e.g. “The Subject of Psychosis: A Lacanian Perspective”, 2011, Palgrave Macmillan; “Psychiatric Diagnosis Revisited: from DSM to Clinical Case Formulation”, 2017, Palgrave Macmillan)
7. Devi Hisgen information on handling weed wisely
Tour, two times half-day
Rotterdam is a big city with a lot of drugs related problems. 2 peers take you on a city tour on the bike to see how they lived in the city and what the role of drugs was in their live. Now they use this knowledge to support their (F)ACT teams. They are experts in recovery and they know that abstinence better for the patients but not always the attainable solution.
The use of drugs and psychiatric problems are more the rule than the exception. Drugs have a major impact on recovery. To much pressure on abstinence is often a reason for drop out. In order to come into contact as a healthcare worker, knowledge of drugs can be an ice breaker. How can we assist and advise our patients?
By increasing the knowledge of the assistance on the how and why of the use, the care provider gets more insight and tools to guide the client and to work on recovery.
This training provides tools for the healthcare worker to successfully deal with the problem. Through a combination of recent science about drugs and the experiences of the course leaders (both with recovery and with the use of drugs) the participant gets practical tools to achieve success with this target group.
So come with us, see the city, learn about heath care, drugs and have a lot of fun together