“Open Dialogue” is an innovative approach to acute psychiatric crises developed by Jaakko Seikkula, Markku Sutela, and their multidisciplinary team at Keropudas Hospital in Tornio, Finland. Starting in the eighties, there have been a variety of research studies of Open Dialogue and its outcomes with early psychosis. Garnering widespread international attention, the results consistently show that this approach reduces hospitalization, the use of medication, and recidivism when compared with treatment as usual. For example, in a five-year study, 83% of patients had returned to their jobs or studies or were looking for a job (Seikkula et al. 2006), In the same study, 77% did not have any residual symptoms. Such outcomes led the Finnish National Research and Development Center for Welfare and Health to award a prize recognizing the Keropudas group for “the ongoing development of psychiatric care over a period of ten years.” — From the Institute for Dialogic Practice

The principles and values of Open Dialogue are also applied to a variety of contexts beyond the Keropudas hospital response to psychosis, such as individual and family therapy and domestic violence. Many people in the US and internationally are now studying these methods such as the group dialogue, reflecting teams, and relational view of psychosis.

The Institute for Dialogic Practice, directed by Dr. Mary Olson, is the U.S.-based training facility for Finnish Open Dialogue and dialogical therapy.

The Network of Dialogical Practices, Europe’s Open Dialogue network founded by Jaakko Seikkula and colleagues.

The International Network for the Treatment of Psychoses, founded by Tom Andersen

Madness Radio interview with Mary Olson on Open Dialogue

Open Dialogue — Alternative Care for Psychosis In Finland Developed By Jaakko Seikkula

Open Dialogue: A Documentary by Daniel Mackler

Open Dialogue: a documentary on a Finnish alternative approach to healing psychosis

Finnish Open Dialogue: High recovery rates leave many psychiatric beds empty

The Open Dialogue Approach to Psychosis: Its poetics and micropolitics

Inner and outer voices in the present moment of family and network therapy

Family and Network Therapy Training for a System of Care: “A Pedagogy of Hope”

Book Chapter on Scandinavia / Finland Approach to Psychosis

Mental Health Trialogue Network, Ireland

Mikhail Bakhtin: Creation of a Prosaics, by G. Morson & C. Emerson

Family Therapy: An Intimate History, by Lynn Hoffman

Steam of Life film – Finnish men and saunas

Reflecting Teams, introduction to Tom Andersen’s book, by Lynn Hoffman

Reflecting Teams article by Tom Andersen

This video provides some basic guidance for anyone considering reducing or coming off psychiatric medications and their supporters, which is discussed in greater detail in the Harm Reduction Guide. This video and Guide are in the spirit of peer support and mutual aid for educational purposes, and not medical advice. (While everyone is different, coming off medications, especially abruptly, can sometimes be dangerous. Seek support when possible and use caution.)

You can contact me at http://www.willhall.net Please share this video; it’s Creative Commons copyright 2011 BY-NC-ND and the url is here: http://youtu.be/O4bdG601k4k

The Icarus Project and Freedom Center’s 52-page guide gathers the best information we’ve come across and the most valuable lessons we’ve learned about reducing and coming off psychiatric medication. Includes info on mood stabilizers, anti-psychotics, anti-depressants, anti-anxiety drugs, risks, benefits, wellness tools, psychiatric drug withdrawal, information for people staying on their medications, detailed Resource section, and much more. A ‘harm reduction’ approach means not being pro- or anti-medication, but supporting people to make their own decisions balancing the risks and benefits involved. Written by Will Hall, with a 40-member health professional Advisory Board providing research assistance and 50 other collaborators involved in developing and editing. The guide has photographs and art throughout, and a beautiful original cover painting by Ashley McNamara.

The Guide is now available in a revised and expanded Second Edition.

Download a .pdf to read below. It is also easy to use the printer version to print and fold into a booklet (instructions below) for yourself.

You can also print multiple copies to distribute, or send the pdf file to a print shop for color copies and stapling.

Download and read the Guide.

Download a printer version, with scrambled pages ready to fold.

Download simple assembly instructions for the printer version.

Available in Spanish here… Disponible en Castellano/ Espanol. Spanish printer version here

Available in German.

Available in Greek.

Available in Bosnian-Croatian-Serbian

Note that the guide is Creative Commons copyright and you are free to copy and distribute for non-commercial purposes, as long as you credit the source and don’t alter it.

Read about the making of the Guide.

Read about the making of the Second Edition.

Video on Coming Off Medications with Will Hall on YouTube

Audio talk on Coming Off Medications from 2009 Hearing Voices Congress

Article by on “Addressing Non-adherence to Antipsychotic Medication: a Harm-Reduction Approach” in the Journal of Psychiatric and Mental Health Nursing

If you are looking for more information and support on psychiatric medication options including coming off / withdrawal, please see the Icarus Project coming off forums, the website Beyond Meds, the UK website ComingOff.com, and this audio on “Coming Off Medications”.

Also check out this video by Will Hall discussing coming off medications: