The family-oriented open dialogue approach in the treatment of first-episode psychosis: Nineteen–year outcomes

Bergström, Tomi; Seikkula, Jaakko; Alakare, Birgitta; Mäki, Pirjo; Köngäs-Saviaro, Päivi; Taskila, Jyri J.; Tolvanen, Asko; Aaltonen, Jukka

doi:10.1016/j.psychres.2018.09.039

Cited by 133 publications

(77 citation statements)

References 37 publications

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“…In this sense, we argue that OD can be understood as a human rights-aligned approach. Yet there is a major limitation to this argument, as the mentioned studies on OD did not investigate its impact on any forms of coercion, such as rates of forced or non-consensual treatment, detainment, isolation, and other forms of restraints, with exception to one study that demonstrated a reduction of involuntary admissions in the regions that practiced OD and compared with Finland (26). Currently, there is an extensive and controversial debate on coercion and psychiatric practices, particularly on how to understand Art.…”

Section: Discussionmentioning

confidence: 99%

Open Dialogue as a Human Rights-Aligned Approach

et al. 2019

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Throughout the last 20 years, the human rights perspective has increasingly developed into a paradigm against which to appraise and evaluate mental health care. This article investigates to what extent the Finnish open dialogue (OD) approach both aligns with human rights and may be qualified to strengthen compliance with human rights perspectives in global mental health care. Being a conceptual paper, the structural and therapeutic principles of OD are theoretically discussed against the background of human rights, as framed by the Universal Declaration of Human Rights, the UN Convention on the Rights of People with Disabilities, and the two recent annual reports of the Human Rights Council. It is shown that OD aligns well with discourses on human rights, being a largely non-institutional and non-medicalizing approach that both depends on and fosters local and context-bound forms of knowledge and practice. Its fundamental network perspective facilitates a contextual and relational understanding of mental well-being, as postulated by contemporary human rights approaches. OD opens the space for anyone to speak (out), for mutual respect and equality, for autonomy, and to address power differentials, making it well suited to preventing coercion and other forms of human rights violation. It is concluded that OD can be understood as a human rights-aligned approach.

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Section: Discussionmentioning

confidence: 99%

Open Dialogue as a Human Rights-Aligned Approach

et al. 2019

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“…Collaboration with families and other network members in the region has been crucial for the development of the model. Research that has been focusing particularly on the treatment of acute psychosis is currently undergoing a 20‐year follow‐up study (Bergström et al., ; Bergström et al., ). Over the entire follow‐up, the figures for durations of hospital treatment, disability allowances, and the need for neuroleptics remained significantly lower with the Open Dialogue group.…”

Section: The Open Dialogue Approach In Psychiatrymentioning

confidence: 99%

The Psychiatrist's Role in Implementing an Open Dialogue Model of Care

Valtanen

2019

ANZ J of Family Therapy

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The Open Dialogue approach is a family‐oriented early intervention model for mental health problems developed in the health district of Western Lapland, Finland. Since the 1990s the psychiatric service system in Western Lapland Health Care District has been organised according to Open Dialogue principles and applied to the treatment of any mental health concerns. The Open Dialogue approach considers the client and their family as active participants rather than as objects of treatment in its planning and implementation with a psychotherapeutic focus. In daily work, the responsibility for the treatment process is shared with the case‐specific team. The model of care requires a dialogical orientation from all staff members, psychiatrists included, to interact with the team and the client's network. In this article I describe the role of the psychiatrist in implementing an Open Dialogue model of care in psychiatric services leaning on my experiences of clinical work in the adolescent psychiatric team in Western Lapland.

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“…The approach might be linked to fewer days of hospitalisation, reduced psychotic symptoms, and improved social function and employment status for people experiencing a first-episode of psychosis (Aaltonen et al, 2011, Gromer, 2012, Seikkula et al, 2003. Resent publications describe 19-year follow-up analyses of the some of the patients included in these studies (Bergström et al, 2017, Bergström et al, 2018. However, the body of evidence on Open Dialogue is limited to small-scale, descriptive studies of adult samples, using historical comparison groups, and not adjusting for important confounders (Buus et al, 2017, Gromer, 2012.…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%