Exploring service users, families, and professionals’ experiences with Open Dialogue in a Portuguese psychosocial rehabilitation unit

Abstract

Open Dialogue is a collaborative approach that emphasizes the involvement of the person at the center of concern (PCC), their family, and professionals in network meetings to foster mutual understanding and joint decision-making. This study explores the experiences of these three groups during the implementation of Open Dialogue in a Portuguese Psychosocial Rehabilitation Unit. A descriptive qualitative study was conducted with thirteen interviews with four service users, four family members, and five professionals. The participants were selected by purposive non-probabilistic sampling. Data was collected through semi-structured interviews and analyzed through reflexive thematic analysis, using WebQDA software. Four dominant themes emerged: rethinking mental health care, implementation challenges, adherence to principles and impact on PCC, families, and professionals. Challenges included resistance to change, time constraints, and cultural adaptation. Key principles such as flexibility, immediate help, and acceptance of uncertainty were highly valued. Open Dialogue meetings enhanced communication, creating a more humanized therapeutic environment and fostering family involvement and professional collaboration. However, successful implementation requires ongoing training and organizational support.