Dominant themes and subthemes

Dominant theme	Subthemes	Clinicians and service-users variation on subthemes
		Clinicians	Service users
1. Open dialogue delivery	1.1 Open dialogue as a positive change	Open dialogue as a preferred way of working	Previous experiences of treatment unhelpful
	1.2 Impact of reflections	Reflections as therapeutic	Reflections as strange
2. Impact of open dialogue principles	2.1 Impact of uncertainty	Uncertainty as challenging	Uncertainty as unsettling
	2.2 Impact of dialogism	Eliciting multiple perspectives	Feeling listened to and understood
3. Intense interactions and enhanced communication	3.1 Authenticity	Authenticity of self	Authenticity of self and perceived authenticity of clinician
	3.2 Emotional expression	Heightened self-disclosure	Heightened emotional expression
4. Organisational challenges (clinicians only)	4.1 Lack of resources and processes
	4.2 Challenging hierarchical structures
	4.3 Lack of wider implementation