Peer-supported Open Dialogue: a thematic analysis of trainee perspectives on the approach and training.

BACKGROUND: Open Dialogue (OD) is a Finnish social network based model of care, with practice and organisational aspects. Peer-supported Open Dialogue (POD) is a UK version involving peer workers, whose contributions include building on fragmented social networks. Fifty-four NHS staff undertook the first training in POD between 2014 and 2015. The training course was organised as four separate residential weeks, together with reflective sharing on an online platform. AIMS: This study aimed to explore the perspectives of the POD trainees on the training and the POD approach. METHODS: At the end of the training year, four focus groups were conducted using a semi-structured interview measure examining trainees' perspectives on the training and POD approach. A thematic analysis was performed on the transcripts to analyse data. RESULTS: Four superordinate themes emerged: personal experience, practice development, principles of POD, and pedagogical issues, each with a variety of subordinate themes. CONCLUSIONS: The course was widely reported as a positive experience, with substantial changes in attitudes and approaches to clinical work arising thus. Across the four superordinate themes, participant responses described a highly experiential course, experienced as an emotional journey which enabled them to embody the principles of POD, as well as use them at work.

Examining cognitive functioning of adult acute psychiatric inpatients through a brief screening assessment.

OBJECTIVE: Psychiatric inpatients present with multiple difficulties, including comorbid diagnoses, social problems, trauma, and high levels of psychiatric medication use. All of these factors have been associated with poorer cognitive functioning, which is rarely assessed. The aim of this study was to examine the acceptability of a brief cognitive screening assessment, and identify the cognitive and psychological profile of current psychiatric inpatients. METHOD: A cross-sectional design was adopted. Participants (N = 75) were administered brief measures of cognitive functioning, the Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005), and psychological global distress, Clinical Outcomes of Routine Evaluation-Outcome Measure, (CORE-OM; Evans et al., 2002) within the first 4 weeks of their hospital admissions. RESULTS: The MoCA was identified as acceptable for the inpatient environment. Most of the participants (79%) met the cut-off for mild cognitive impairment. No significant differences were found across diagnoses in regard to cognitive functioning, but participants with diagnoses of personality disorder experienced the most psychological global distress. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Acute psychiatric inpatient wards should consider mild cognitive impairments when assessing and treating people with serious mental illness and make appropriate adaptations to their care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).