Professionals’ experiences and perceptions of using DIALOG+ in inpatient mental health settings and factors influencing its use - A scoping review

Authors Katja Jung1, Dr Peter Sandy2, Dr Ulrike Gillon3 1. University of West London 2. University of West London 3. University of West London Abstract N/A Introduction Effective communication is central to recovery oriented, person centred mental healthcare, yet evidence remains limited on how best to structure interactions with people experiencing psychosis. To address this gap, Priebe et al. (2007; 2015) developed DIALOG - a structured communication and screening tool - and its enhanced therapeutic version, DIALOG+, which incorporates patient reported experience measures. Although the intervention is increasingly used in community mental health services internationally, its application within inpatient settings remains underexplored. The unique demands of inpatient care - higher acuity, complex relational dynamics and organisational constraints - may shape how DIALOG+ is used and experienced by health and care professionals. Preliminary searches were conducted using MEDLINE, the Cochrane Library, ProQuest Dissertations and Theses, Google Scholar and Microsoft Edge to scope available academic, clinical, and grey literature. No relevant systematic or scoping reviews were identified. During the preliminary search 10 studies were identified exploring professionals’ experiences of using DIALOG+ in community and primary care settings, but none focusing on inpatient services. Most studies were qualitative (n=7), using interviews and/or focus groups to explore professionals’ experiences and perceptions of using DIALOG+ (n=6) or the DIALOG scale alone (n=1). In addition, three studies employed mixed-methods approaches (n=3), combining an exploratory, pragmatic randomised control trial, surveys or process evaluations with qualitative components. A scoping review will be relevant here as it maps existing evidence and identifies what is known - and unknown - about professionals’ experiences of using DIALOG+ in recovery oriented mental healthcare. The review aims to highlight conceptual and evidence gaps to inform future research and practice. The approach demonstrates critical engagement with evidence based principles through the application of systematic enquiry. The final searches will be conducted via EBSCOhost using PsycArticles, ERIC, Academic Search Elite, OpenDissertations, and CINAHL Complete, supplemented by single database searches of CINAHL, OpenGrey, Prospero, and the British Library’s EThOS service. Review question The following question will guide the review: What is known about the experiences and perceptions of professionals using DIALOG+ in inpatient mental health settings, and the factors influencing its use? This scoping review aims to map and synthesise evidence on professionals’ experiences and perceptions of using DIALOG+ in inpatient mental health settings, including factors influencing its use. Objectives: - To highlight knowledge gaps to inform future guidelines and research - To identify factors influencing its use - To explore its potential to support recovery-oriented care - To explore experiences, perceptions and contextual challenges Inclusion criteria Participants: Professional role (health/social care); nurse; psychiatrist, psychologist; occupational therapist, social worker, doctor Concept: Experiences/perceptions (thoughts, views) of using (in professional practice) DIALOG+; barriers/challenges and facilitators Context: Inpatient; tertiary/secondary/community and primary health care and educational settings where finding are transferable or relevant to the review focus Types of sources Sources to be included if they meet the Population, Concept, and Context (PCC) criteria outlined in the Joanna Briggs Institute`s methodological framework (2020). Eligible studies are those, that a exploring health and care professionals’ experiences and perceptions of using DIALOG+ in healthcare or educational settings, as well as factors influencing its use. There are no restrictions on publication date and language. Methods This review will follow the Joanna Briggs Institute`s scoping review methodology outlined by Aromataris and Munn (2024) incorporating the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018). Search strategy Initial exploratory searches helped identify relevant studies and are informing refinement of the search approach - search terms to be systematically refined by reviewing keywords in titles, abstracts, and indexing terms, and by testing alternative strings in consultation with a university librarian. Insights from the exploratory phase guides the development of the final search strategy, which will be systematically applied across the selected academic databases. Titles and abstracts of retrieved records will be screened against the review’s inclusion criteria. For database searches, a number-based stopping rule to be used, ending screening when further records are unlikely to add new eligible studies (Boetje and van de Schoot, 2024, p. 2). Screening will stop after 200 records, as probably no new concepts, populations, or study types will be emerging. In contrast, search engine and web browser results can be screened until thematic saturation is reached, as these sources generate a high proportion of directly relevant (DIALOG+) materials (Saunders et al., 2018). Full-text sources will be assessed for eligibility, and the number of records identified, screened, and included in a PRISMA-ScR flow diagram, providing a transparent overview of the selection process. All identified citations to be collated and uploaded into a Systematic Literature Management tool, where duplicate records can be identified. Study/Source of evidence selection All sources meeting the inclusion criteria to be included, and those that do not meet them will be excluded. Screening will be conducted by the reviewers, who assess titles, abstracts, and full texts. Any discrepancies to be resolved through discussion and consensus, after which all reviewers verify the final decisions. Data extraction Data charting: A data charting form will be developed by reviewers, and data from eligible studies will be extracted into an Excel spreadsheet. The form will capture key study characteristics and information aligned with the PCC framework, inclusion/exclusion criteria, and the review question. Data Items: Data from all included studies will be extracted using a structured data extraction tool. Extracted information will cover the key elements of each study, including participant characteristics, the central concept, contextual details, methodological approach, and findings relevant to the review question. The extracted data will then be organised in a Word document to provide a clear, consolidated overview. Variables captured will include: author, year, study aim, context (setting and country), population characteristics, study design/methods, and the concept of interest (experiences, perceptions, and influencing factors) related to the use of DIALOG+. The draft data extraction tool will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Any disagreements that arise between the reviewers will be resolved through discussion. Data analysis and presentation Extracted data will be synthesised descriptively using the PCC framework and predefined data items. A basic deductive qualitative content analysis will then be applied (Pollock et al., 2023), using coding categories derived from the review question and key DIALOG+ concepts. This allows recurring features in how DIALOG+ was used, experienced, and perceived to be identified and compared across studies. Verbatim data will be coded against the predefined categories to ensure that all extracted content will be relevant to the review objectives. The screening and eligibility process will be summarised and illustrated, and the findings will present key study characteristics and professionals’ experiences with DIALOG+ across settings. The preliminary and final syntheses to be presented in tabular form, with the final synthesis also illustrated visually (Results section). Acknowledgements N/A Funding N/A Conflicts of interest N/A References Aromataris, E. and Munn, Z. (eds.) (2024) JBI Manual for Evidence Synthesis. JBI. Available at: https://jbi-global-wiki.refined.site/space/MANUAL (Accessed: 5 November 2025). Boetje, J. and van de Schoot, R. (2024) ‘The SAFE procedure: a practical stopping heuristic for active learning-based screening in systematic reviews and meta-analyses’, Systematic Reviews, 13(81). Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10908130/ (Accessed: 21 November 2025). Joanna Briggs Institute (JBI) (2020) JBI Manual for Evidence Synthesis: Chapter 10.3.6 Inclusion Criteria. Available at: https://jbi-global-wiki.refined.site/space/MANUAL/355862985/10.3.6+Inclusion+Criteria (Accessed: 5 November 2025). Pollock, D., Peters, M.D.J., Khalil, H., McInerney, P., Alexander, L., Tricco, A.C., Evans, C., Brandao de Moraes, E., Godfrey, C.M., Pieper, D., Saran, A., Stern, C. and Munn, Z. (2023) ‘Recommendations for the extraction, analysis, and presentation of results in scoping reviews’, JBI Evidence Synthesis, 21(3), p.528. doi: 10.11124/JBIES-22-00123 Priebe, S., Kelley, L., Omer, S., Golden, E., Walsh, S., Khanom, H., Kingdon, D., Rutterford, C., McCrone, P. and 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(5), pp.304-313. doi: 10.1159/000430991 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. and Wr