ABSTRACT
This In Practice article describes the implementation of Open Dialogue, a dialogic, network-based approach to mental health, within Youth and Family Services at the Counseling Service of Addison County, a community mental health agency in rural Vermont, USA. It outlines how Open Dialogue network meetings were integrated into everyday clinical practice and reports service activity between 2022 and 2025, during which the team facilitated 880 meetings with 232 families. The article explores the relevance of Open Dialogue for youth and families, including its attention to complex family dynamics and the voices of children and adolescents, and reflects on practical challenges such as staffing, documentation and regulatory pressures within community-based mental health services. Drawing on this experience, the paper offers practice-based reflections on how Open Dialogue may be implemented and sustained in youth mental health settings.