fbpx
Wikipedia

Open Dialogue

January 01, 1970

Open Dialogue is an alternative approach[1] for treating psychosis as well as other mental health disorders developed in the 1980s in Finland by Yrjö Alanen and his collaborators.[2] Open dialogue interventions are currently being trialed in several other countries including Australia, Belgium, Denmark, Germany, Italy, Norway, Poland, the United Kingdom,[3] and the United States.[4] In Israel there is a non-governmental organization called Open Dialogue Israel.[5]

Open Dialogue (OD) developed from Need-Adapted Treatment as described by Alanen and colleagues in the early 1990s. This approach took shape within the mental health services of Finnish Western Lapland in the 1980s and 1990s. During its initial research and training in psychotherapy, seven key principles were identified:[6]

  1. providing immediate help
  2. considering clients' social network during the treatment
  3. being flexible and mobile during the treatment
  4. assigning the responsibility of organizing treatments to one professional
  5. ensuring psychological continuity
  6. accepting uncertainty
  7. engaging in dialogism

The first five principles focus on the organizational aspects of delivering mental health services; the last two principles are about the conversational methods mental health professionals use in network meetings with clients.[7] The participation of friends and family, responding to the client's utterances, trying to make meaning of what a client has to say, and "tolerating uncertainty".[8]

A recently published global survey on the worldwide implementation of Open Dialogue in mental health services gathered data from 142 Open Dialogue teams in 24 countries, mainly in Europe. Key factors enhancing Open Dialogue implementation included well-trained staff, regular supervisions, research capabilities, diverse professional teams, self-referrals, outpatient services, younger clients, and the involvement of experts by experience. The study underscores the importance of more Open Dialogue training, supervision, and research.[9]

Theoretical basis edit

In a paper illustrating the Open dialogue method Seikkula, Alakar and Aaltonen postulate that "from the social constructionist point of view, psychosis can be seen as one way of dealing with terrifying experience in one's life that do not have language other than the one of hallucinations and delusions" and that "psychotic reactions should be seen [as] attempts to make sense of one's experiences that are so heavy that they have made it impossible to construct a rational spoken narrative" arguing that people may talk about such experiences in metaphor.[10]

They offer a model that "psychotic reactions greatly resemble traumatic experiences" with experiences of victimization "not being stored in the part of the memory system that promotes sense-making". Postulating that "an open dialogue, without any preplanned themes or forms seems to be important in enabling the construction of a new language in which to express difficult events in one's life."[10]

This understanding differs radically from common psychiatric models of psychosis that view it as being caused by a biological process in the brain, such as the dopamine hypothesis of schizophrenia.[citation needed]

Effectiveness edit

Although pilot treatments since the 1980s show improved reintegration and a reduction in the need for medication,[11] a systematic review of academic publications on the topic in 2018 concluded that "further studies are needed in a real-world setting to explore how and why [open dialogue] works", remarking that "most studies were highly biased and of low quality".[4]

"Open Dialogue for Psychosis: Organising Mental Health Services to Prioritise Dialogue, Relationship and Meaning",[12] edited by Putman and Martindale was published in 2021. It includes chapters on long term randomised, controlled research projects currently underway in the UK, Italy and Denmark to establish an evidence base for Open Dialogue in those national health services, funded by grants from the NIH in the UK and the Ministry of Health in Italy. In the UK, five NHS trusts are involved with a common training regime for both clinic and peer worker participant staff and have enrolled participant service users. In Italy, eight regional mental health services are involved in that trial.

In Denmark, a trial was conducted across five municipalities, and in 2019, Buus et al. published a retrospective register study,[13] where they compared the level of contact with emergency and general practice services by young people who had been assisted by Open Dialogue services compared with those assisted by treatment-as-usual services in Denmark, and found that in the first year those in the Open dialogue cohort had more contacts but in the following years fewer, concluding that "Open Dialogue was significantly associated with some reduced risks of utilising health care services. These mixed results should be tested in a randomized design."

References edit

  1. ^ Larkin, Michael; Boden, Zoë; Newton, Elizabeth (30 May 2017). "If psychosis were cancer: a speculative comparison". Medical Humanities. 43 (2): 118–123. doi:10.1136/medhum-2016-011091. PMC 5520006. PMID 28559369.
  2. ^ Aaltonen, Jukka; Seikkula, Jaakko; Lehtinen, Klaus (2011). "The Comprehensive Open-Dialogue Approach in Western Lapland: I. The incidence of non-affective psychosis and prodromal states". Psychosis. 3 (3). Informa UK Limited: 179–191. doi:10.1080/17522439.2011.601750. ISSN 1752-2439. S2CID 143466250.
  3. ^ "Open Dialogue: The radical new treatment having life-changing effects on people's mental health". The Independent. 6 December 2015. Archived from the original on 2022-05-24. Retrieved May 29, 2020.
  4. ^ a b Freeman, Abigail M.; Tribe, Rachel H.; Stott, Joshua C. H.; Pilling, Stephen (2019). "Open Dialogue: A Review of the Evidence". Psychiatric Services. 70 (1). American Psychiatric Association Publishing: 46–59. doi:10.1176/appi.ps.201800236. ISSN 1075-2730. PMID 30332925.
  5. ^ "Open Dialogue Israel".
  6. ^ Seikkula, Birgitta Alakare, Jukka A, Jaakko (October 2001). "Open Dialogue in Psychosis I: An Introduction and Case Illustration". Journal of Constructivist Psychology. 14 (4): 247–265. doi:10.1080/10720530125965. ISSN 1072-0537. S2CID 216136239.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Seikkula, Jaakko (March 2003). "Open dialogue integrates individual and systemic approaches in serious psychiatric crises". Smith College Studies in Social Work. 73 (2): 227–245. doi:10.1080/00377310309517683. ISSN 0037-7317. S2CID 144131651.
  8. ^ Mary Olson; Jaakko Seikkula; Douglas Ziedonis. "The Key Elements of Dialogic Practice in Open Dialogue: Fidelity Criteria" (PDF).
  9. ^ Pocobello, Raffaella; Camilli, Francesca; Alvarez-Monjaras, Mauricio; Bergström, Tomi; von Peter, Sebastian; Hopfenberg, Mark; Aderhold, Volkmar; Pilling, Stephen; Seikkula, Jaakko; el Sehity, Tarek (2023). "Open Dialogue services around the world: a scoping survey exploring organizational characteristics in the implementation of the Open Dialogue approach in mental health services". Frontiers in Psychology. 14: 1–16. doi:10.3389/fpsyg.2023.1241936. PMC 10668593. PMID 38023059.
  10. ^ a b Jaakko Seikkula; Birgitta Alakare; Jukka Aaltonen (2001). "Open Dialogue in Psychosis I: An Introduction and Case Illustration". Journal of Constructivist Psychology. 14 (4). Informa UK Limited: 247–265. doi:10.1080/10720530125965. ISSN 1072-0537. S2CID 216136239.
  11. ^ . Archived from the original on 2023-10-03. Retrieved 2024-02-18.
  12. ^ Putman, Nick; Martindale, Brian (2021). Open Dialogue for Psychosis. doi:10.4324/9781351199599. ISBN 978-1-351-19959-9. S2CID 236298113.
  13. ^ Buus, Niels; Kragh Jacobsen, Elise; Bojesen, Anders Bo; Bikic, Aida; Müller-Nielsen, Klaus; Aagaard, Jørgen; Erlangsen, Annette (2019). "The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services: A retrospective register-based cohort study" (PDF). International Journal of Nursing Studies. 91: 119–127. doi:10.1016/j.ijnurstu.2018.12.015. PMID 30682632. S2CID 59274202.

External links edit

https://developingopendialogue.com/resources/ https://open-dialogue.net

January 01, 1970
open, dialogue, alternative, approach, treating, psychosis, well, other, mental, health, disorders, developed, 1980s, finland, yrjö, alanen, collaborators, open, dialogue, interventions, currently, being, trialed, several, other, countries, including, australi. Open Dialogue is an alternative approach 1 for treating psychosis as well as other mental health disorders developed in the 1980s in Finland by Yrjo Alanen and his collaborators 2 Open dialogue interventions are currently being trialed in several other countries including Australia Belgium Denmark Germany Italy Norway Poland the United Kingdom 3 and the United States 4 In Israel there is a non governmental organization called Open Dialogue Israel 5 Open Dialogue OD developed from Need Adapted Treatment as described by Alanen and colleagues in the early 1990s This approach took shape within the mental health services of Finnish Western Lapland in the 1980s and 1990s During its initial research and training in psychotherapy seven key principles were identified 6 providing immediate help considering clients social network during the treatment being flexible and mobile during the treatment assigning the responsibility of organizing treatments to one professional ensuring psychological continuity accepting uncertainty engaging in dialogism The first five principles focus on the organizational aspects of delivering mental health services the last two principles are about the conversational methods mental health professionals use in network meetings with clients 7 The participation of friends and family responding to the client s utterances trying to make meaning of what a client has to say and tolerating uncertainty 8 A recently published global survey on the worldwide implementation of Open Dialogue in mental health services gathered data from 142 Open Dialogue teams in 24 countries mainly in Europe Key factors enhancing Open Dialogue implementation included well trained staff regular supervisions research capabilities diverse professional teams self referrals outpatient services younger clients and the involvement of experts by experience The study underscores the importance of more Open Dialogue training supervision and research 9 Contents 1 Theoretical basis 2 Effectiveness 3 References 4 External linksTheoretical basis editIn a paper illustrating the Open dialogue method Seikkula Alakar and Aaltonen postulate that from the social constructionist point of view psychosis can be seen as one way of dealing with terrifying experience in one s life that do not have language other than the one of hallucinations and delusions and that psychotic reactions should be seen as attempts to make sense of one s experiences that are so heavy that they have made it impossible to construct a rational spoken narrative arguing that people may talk about such experiences in metaphor 10 They offer a model that psychotic reactions greatly resemble traumatic experiences with experiences of victimization not being stored in the part of the memory system that promotes sense making Postulating that an open dialogue without any preplanned themes or forms seems to be important in enabling the construction of a new language in which to express difficult events in one s life 10 This understanding differs radically from common psychiatric models of psychosis that view it as being caused by a biological process in the brain such as the dopamine hypothesis of schizophrenia citation needed Effectiveness editAlthough pilot treatments since the 1980s show improved reintegration and a reduction in the need for medication 11 a systematic review of academic publications on the topic in 2018 concluded that further studies are needed in a real world setting to explore how and why open dialogue works remarking that most studies were highly biased and of low quality 4 Open Dialogue for Psychosis Organising Mental Health Services to Prioritise Dialogue Relationship and Meaning 12 edited by Putman and Martindale was published in 2021 It includes chapters on long term randomised controlled research projects currently underway in the UK Italy and Denmark to establish an evidence base for Open Dialogue in those national health services funded by grants from the NIH in the UK and the Ministry of Health in Italy In the UK five NHS trusts are involved with a common training regime for both clinic and peer worker participant staff and have enrolled participant service users In Italy eight regional mental health services are involved in that trial In Denmark a trial was conducted across five municipalities and in 2019 Buus et al published a retrospective register study 13 where they compared the level of contact with emergency and general practice services by young people who had been assisted by Open Dialogue services compared with those assisted by treatment as usual services in Denmark and found that in the first year those in the Open dialogue cohort had more contacts but in the following years fewer concluding that Open Dialogue was significantly associated with some reduced risks of utilising health care services These mixed results should be tested in a randomized design References edit Larkin Michael Boden Zoe Newton Elizabeth 30 May 2017 If psychosis were cancer a speculative comparison Medical Humanities 43 2 118 123 doi 10 1136 medhum 2016 011091 PMC 5520006 PMID 28559369 Aaltonen Jukka Seikkula Jaakko Lehtinen Klaus 2011 The Comprehensive Open Dialogue Approach in Western Lapland I The incidence of non affective psychosis and prodromal states Psychosis 3 3 Informa UK Limited 179 191 doi 10 1080 17522439 2011 601750 ISSN 1752 2439 S2CID 143466250 Open Dialogue The radical new treatment having life changing effects on people s mental health The Independent 6 December 2015 Archived from the original on 2022 05 24 Retrieved May 29 2020 a b Freeman Abigail M Tribe Rachel H Stott Joshua C H Pilling Stephen 2019 Open Dialogue A Review of the Evidence Psychiatric Services 70 1 American Psychiatric Association Publishing 46 59 doi 10 1176 appi ps 201800236 ISSN 1075 2730 PMID 30332925 Open Dialogue Israel Seikkula Birgitta Alakare Jukka A Jaakko October 2001 Open Dialogue in Psychosis I An Introduction and Case Illustration Journal of Constructivist Psychology 14 4 247 265 doi 10 1080 10720530125965 ISSN 1072 0537 S2CID 216136239 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Seikkula Jaakko March 2003 Open dialogue integrates individual and systemic approaches in serious psychiatric crises Smith College Studies in Social Work 73 2 227 245 doi 10 1080 00377310309517683 ISSN 0037 7317 S2CID 144131651 Mary Olson Jaakko Seikkula Douglas Ziedonis The Key Elements of Dialogic Practice in Open Dialogue Fidelity Criteria PDF Pocobello Raffaella Camilli Francesca Alvarez Monjaras Mauricio Bergstrom Tomi von Peter Sebastian Hopfenberg Mark Aderhold Volkmar Pilling Stephen Seikkula Jaakko el Sehity Tarek 2023 Open Dialogue services around the world a scoping survey exploring organizational characteristics in the implementation of the Open Dialogue approach in mental health services Frontiers in Psychology 14 1 16 doi 10 3389 fpsyg 2023 1241936 PMC 10668593 PMID 38023059 a b Jaakko Seikkula Birgitta Alakare Jukka Aaltonen 2001 Open Dialogue in Psychosis I An Introduction and Case Illustration Journal of Constructivist Psychology 14 4 Informa UK Limited 247 265 doi 10 1080 10720530125965 ISSN 1072 0537 S2CID 216136239 Open Dialogue a family and social network approach to first episode psychosis care Archived from the original on 2023 10 03 Retrieved 2024 02 18 Putman Nick Martindale Brian 2021 Open Dialogue for Psychosis doi 10 4324 9781351199599 ISBN 978 1 351 19959 9 S2CID 236298113 Buus Niels Kragh Jacobsen Elise Bojesen Anders Bo Bikic Aida Muller Nielsen Klaus Aagaard Jorgen Erlangsen Annette 2019 The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services A retrospective register based cohort study PDF International Journal of Nursing Studies 91 119 127 doi 10 1016 j ijnurstu 2018 12 015 PMID 30682632 S2CID 59274202 External links edithttps developingopendialogue com resources https open dialogue net Retrieved from https en wikipedia org w index php title Open Dialogue amp oldid 1211221443, wikipedia, wiki, book, books, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.