“It Makes us Realize that We Have Been Heard”: Experiences with Open Dialogue in Vermont

Florence, Ana Carolina; Jordan, Gerald; Yasuí, Silvio; Cabrini, Daniela Ravelli; Davidson, Larry

doi:10.1007/s11126-021-09948-1

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…It is possible that dialogic practitioners having a more regular audience with the department of mental health would improve communication and clarity about making systemic changes, and asking more directly for DMH’s support in creating funding mechanisms and other adaptations so that DMH’s substantial investment in training is more efficiently channeled into practice, and so that staff are not in the dissonant position of learning a new practice that can be experienced as being a square peg in a round role. This may be easier said than done, for as Florence et al (2021) point out, it may be “better to start somewhere and gradually take up other elements that can be harder to integrate in a system that operates in an antithetic way” to dialogic principles.…”

Section: Discussionmentioning

confidence: 99%

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Anticipation dialogs in Vermont’s system of mental healthcare: Sustaining the growth of a dialogic practice culture

Alpern¹,

Binshadler

Oakley³

2023

Front. Psychol.

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Open dialog is both a therapeutic approach and a way of organizing the system of mental healthcare that has been evolving in Finland since the 1980s. In Vermont, over the last decade, there has been an organic statewide effort to begin to integrate dialogic principles into the public system of mental healthcare. Because of the organic nature of these initiatives, there have not been coordinated systemic changes to support dialogic practices. To learn what visions participants in dialogically informed practice contexts have for the future as well as what structural innovations would support these visions anticipation dialogs were offered at three dialogically informed community mental health centers and one public psychiatric. The anticipation dialog was developed in Finland during the late 1980s to aid stuck professional and social networks in finding ways to move forward looking back from an imagined positive future. Twenty-seven multidisciplinary staff members and one service recipient participated in the dialogs. The authors conducted a multi-step process of thematic discourse analysis of all 4 anticipation dialogs. Findings underscore dilemmas entailed in growing a dialogic practice system, including the toll systemic uncertainty takes on workers in the system and the simultaneous pull to offer some amount of open-endedness to the system change process in the spirit of inclusiveness, mutual trust, democracy, and reducing hierarchy. Other key findings influencing sustainability of dialogic practices in community mental health include integrating dialogic work into roles rather than adding them to existing responsibilities. Our experiences indicate that anticipation dialogs may be a way of conducting systemic research that contributes to the forward momentum of system innovation. Offering a greater length of time for organizational anticipation dialogs would be valuable, as would centering the voices of clients and their networks.

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Section: Discussionmentioning

confidence: 99%

“…It could be argued that rather than being at an impasse, our system-and those of us working in it-was/were in a state of crisis at the time of this research, and that it is open dialogs rather than anticipation dialogs that are called for in moments of crisis (Eriksson and Arnkil, 2009).…”

Section: Limitationsmentioning

confidence: 99%

Anticipation dialogs in Vermont’s system of mental healthcare: Sustaining the growth of a dialogic practice culture

Alpern¹,

Binshadler

Oakley³

2023

Front. Psychol.

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“…In these studies most persons under OD-based treatment indicated that they were listened to and understood, although a minority had had mixed experiences regarding some aspects of the approach (e.g. Florence et al, 2021 ; Tribe et al, 2019 ; Wusinich et al, 2020 ). It nevertheless should be noted that, as already reported in earlier study (Bergström et al, 2019 ), in the majority of participants’ life stories treatment-related narratives were de-emphasized as compared to other themes; rather than focusing on mental health treatment, participants underlined the support from their close networks as well as their own actions in the gradual process of surviving from psychosis.…”

Section: Discussionmentioning

confidence: 99%

“…There have also been reports on how patients and their family members experienced OD at early phases of its implementation. According to these, service users felt that under OD they had been better listened to and understood (Florence et al, 2021 ; Gidugu et al, 2021 ; Hendy et al, 2020 ; Tribe et al, 2019 ; Twamley et al, 2020 ), notably in comparison with their earlier care experiences, even if a minority had also found the network treatment meetings to be emotionally overwhelming and strange (Tribe et al, 2019 ). In our earlier study (Bergström et al, 2019 ) it was found that among those service users who participated in the original OD projects in Western Lapland, the mental health treatment itself was not viewed as the most central element in their gradual recovery from psychosis.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Experiences of First-Episode Psychosis Treatment Under Open Dialogue-Based Services: A Qualitative Study

Bergström

Seikkula

Holma

et al. 2021

Community Ment Health J

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Open Dialogue (OD) is an integrated approach to mental health care, which has demonstrated promising outcomes in the treatment of first-episode psychosis (FEP) in Finnish Western Lapland region. However, little is known how treatment under OD is retrospectively experienced by the service users themselves. To address this, twenty participants from the original Western Lapland research cohort diagnosed with psychosis (F20–F29) were asked about their treatment of FEP, initiated under OD 10–23 years previously. Thematic analysis was used to explore how the treatment was experienced. Most participants viewed network treatment meetings as an important part of their treatment, as they enabled interactions with other people and the chance to go through difficult experiences. A minority of the participants had mixed experiences regarding family involvement and immediate home visits. OD may have the potential to promote therapeutic relationships, but replications from other catchment areas are needed.

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“…Despite variation in study design and contexts outside of Lapland, the OD approach is promising in that patients and their social network feel seen, heard and supported (Clement & McKenny, 2019; Florence et al, 2021; Jacobsen et al, 2018; Tribe et al, 2019; Twamley et al, 2021). In the United Kingdom, service users reported significant improvements in well‐being and functioning with OD (Kinane et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Clinicians and supervisors' experiences with developing practices of open dialogue in network meetings in public mental health services

Jacobsen

Karlsson

Grov

2022

Journal of Family Therapy

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Open Dialogue is a dialogical approach focusing on the perspectives of patients and their social networks on treatment and recovery processes. As part of a larger research project, this prospective cohort study explores what promotes and hinders the development of Open Dialogue in network meetings (ODNM) based on the experiences of thirty-seven clinicians and seven supervisors. Multistage focus group interviews were used to collect data and were analysed thematically. We generated two main themes: (1) togetherness and isolation and (2) challenging and evolving. The findings show that ODNM can be developed in public mental healthcare, but this leads to both challenges and opportunities at the organisational level, such as conflicting perspectives, the difficulty of maintaining interest in ODNM, the need for committed and involved leaders, and the growing change in the traditional view of treatment, which has made clinicians collaborate more with patients and their relatives.

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“It Makes us Realize that We Have Been Heard”: Experiences with Open Dialogue in Vermont

Cited by 8 publications

References 16 publications

Anticipation dialogs in Vermont’s system of mental healthcare: Sustaining the growth of a dialogic practice culture

Anticipation dialogs in Vermont’s system of mental healthcare: Sustaining the growth of a dialogic practice culture

Retrospective Experiences of First-Episode Psychosis Treatment Under Open Dialogue-Based Services: A Qualitative Study

Clinicians and supervisors' experiences with developing practices of open dialogue in network meetings in public mental health services

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