DIALOG+ is an intervention delivered by a mental health professional and other practitioners or the public using an app on a smartphone or tablet (e.g. an iPad or android device) within routine clinical meetings.

The DIALOG+ app is available to be downloaded for Android devices and Apple iPads (The app is currently not available on iPhones).

For more information on the app please visit the DIALOG website.

For PIECEs, DIALOG+ will initially be implemented as a pilot (3 months intervention), which to ensure it is culturally appropriate before it is tested in a cluster randomised controlled trial (RCT), for a period of 6 months.

How Dialog+ is used

Each session begins with the patient using the tablet to rate their satisfaction with eight life domains (mental health, physical health, job situation, accommodation, leisure activities, friendships, relationship with family/partner, personal safety) and three treatment aspects (medication, practical help, meetings with professionals).

The ratings are summarised on-screen, allowing for comparisons with ratings from previous meetings. Clinicians are instructed to offer positive feedback on any improving or high-scoring domains

The tablet allows patients to be more actively involved in the meeting, with the tablet easily passed between the clinician and patient. Each satisfaction item is rated on a scale from 1 (“totally dissatisfied”) to 7 (“totally satisfied”), and followed by a question on whether the patient wants additional help with that domain.

The ratings are followed by a four-step solution-focused approach to identify the patient’s existing resources that can be used to address the concerns raised. The four steps are: Understanding (Why is the patient dissatisfied? What went nevertheless well?); Looking Forward (What is the best case scenario? What is the smallest step forward?); Exploring Options (What can the patient, the clinician or others do?); and finally Agreeing on Actions (What can the patient/the clinician/others do?).

How Dialog+ is used

Each session begins with the patient using the tablet to rate their satisfaction with eight life domains (mental health, physical health, job situation, accommodation, leisure activities, friendships, relationship with family/partner, personal safety) and three treatment aspects (medication, practical help, meetings with professionals).

The ratings are summarised on-screen, allowing for comparisons with ratings from previous meetings. Clinicians are instructed to offer positive feedback on any improving or high-scoring domains

The tablet allows patients to be more actively involved in the meeting, with the tablet easily passed between the clinician and patient. Each satisfaction item is rated on a scale from 1 (“totally dissatisfied”) to 7 (“totally satisfied”), and followed by a question on whether the patient wants additional help with that domain.

The ratings are followed by a four-step solution-focused approach to identify the patient’s existing resources that can be used to address the concerns raised. The four steps are: Understanding (Why is the patient dissatisfied? What went nevertheless well?); Looking Forward (What is the best case scenario? What is the smallest step forward?); Exploring Options (What can the patient, the clinician or others do?); and finally Agreeing on Actions (What can the patient/the clinician/others do?).

Relevant literature

Priebe S, McCabe R, Bullenkamp J, Hansson L, Lauber C, Martinez-Leal R, Roessler W, Salize H, Svensson B, Torres-Gonzales F, van den Brink R, Wiersma D, Wright D (2007) Structured patient-clinician communication and 1-year outcome in community mental healthcare. Cluster randomised controlled trial (DIALOG). British Journal of Psychiatry, 191:420-426. DOI:10.1192/bjp.bp.107.036939 

Priebe S, Kelley L, Omer S, Golden E, Walsh S, Khanom H, Kingdon D, Rutterford C, McCrone P, McCabe R (2015) The effectiveness of a patient-centred assessment with a solution-focused approach (DIALOG+) for patients with psychosis: A pragmatic cluster-randomised controlled trial in community care.  Psychotherapy and Psychosomatics, 84:304-303. DOI:10.1159/000430991

Omer S, Golden E, Priebe S (2016) Exploring the mechanisms of a patient-centred assessment with a solution-focused approach (Dialog+) in the community treatment of patients with psychosis: a process-evaluation within a cluster-randomised controlled trial. PLoS ONE; 11(2).