Open Dialogue (OD) has emerged in the last 25 years as a potent psychosocial treatment for emerging psychosis, and in 2011 data were published in an historical control design report from the whole of the Western Lapland district of Finland (population 72,000). The data show that over the first 20 years of the application of this approach, at a two year follow up, for non-affective psychoses treated, 81% of patients did not have any residual psychotic symptoms, and 84% had returned to fulltime employment or studies. Only 33% had required neuroleptic medication.
OD combines features of the Need Adapted Approach (Alanen, 2011) with Dialogical Practices, developed within family therapy systems (and derived from the work of Mikhail Bakhtin, who wrote that, “For a human being there is nothing more terrible than a lack of response”), to create a family centred early intervention system, where a series of family meetings, usually in the home, focus on creating an opportunity for all effected family members and other important community members (open meetings) to jointly contribute to an understanding of the psychosocial factors which underpin the emergence of the psychosis. According to dialogical conceptions of man, a human being is born into dialogical relationships.
These relations become a part of our selfhood. Human wellbeing and mental health are always connected to the relationships in which we are living. The question then becomes, are we able to utilise the resources present and emerging in social networks and collaboration in our clinical work? This presentation will describe the preparations of staff for the implementation of the Finnish programme, the structures and processes of the OD approach as they have matured, and the ongoing opportunities for those interested to explore this approach in more detail.
