Open Dialogue

A collection of resources on Open Dialogue and Open Dialogue practices

“Open Dialogue” is an innovative approach to acute psychiatric crises developed by Jaakko Seikkula, Marku Suttela, and the 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 description at the Institute for Dialogic Practice

The principles and values of Open Dialogue as practiced out of Keropudas hospital in Finland draw from multiple rich traditions, including but not limited to Milan family therapy, the work of Dr. Tom Andersen, the Need Adapted Treatment model, and the psychology of Mikhail Bakhtin. Many people in the US and internationally are now studying and rediscovering this tradition, in methods such as the treatment meeting dialogue, limiting use of psychiatric medications, working in teams, reflecting process, and seeing psychosis as taking place in the “in between spaces” between people. Pilot projects are underway internationally to spread this approach and a growing number of practitioners are receiving training to bring Open Dialogue learning into their own work.

Interest in Open Dialogue has spread around the world, and now there are many expressions and interpretations that identify as Open Dialogue in a wide variety of clinical and training contexts. I am not a a Finnish clinician and am not part of the hospital team in Finland, but I have studied Open Dialogue with Dr. Seikkula, Marku Suttela MA, Dr. Mary Olson, Dr. Nazlim Haggman MD, and others as part of my two year certificate. I teach and practice “Learning From Open Dialogue” to advance inquiry into the Finnish approach and its rich origins, and to discover how we can reshape the social response to psychosis and emotional crisis. I am grateful to Dr. Olson and colleagues in Finland for their invitation to learn from and collaborate in the development of this work.

The Institute for Dialogic Practice, directed by Dr. Mary Olson, is the North America training facility for Finnish Open Dialogue and dialogical therapy

Preparing Open Dialogue Approach for Adaptation in the US – UMass Medical School research project

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

Need Adapted Treatment Model, developed by Alanen, Räkköläinen, Lehtinen, Aaltonen, and Rasimus

Madness Radio interview with Mary Olson on Open Dialogue

Open Dialogue — Alternative Care for Psychosis In Finland

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

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

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

Need Adapted Treatment of New Schizophrenic Patients: Experiences and Results of the Turku Project

Kjellberg Chapter on Scandinavia / Finland Approach to Psychosis

Mental Health Trialogue Network, Ireland

Open Dialogue UK

Peer Open Dialogue at the NHS in the UK

Parachute NYC – Need Adapted Treatment model through the New York Department of Health and Mental Hygiene, with shared roots with Open Dialogue

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

The Reflecting Team: Dialogue and Meta-Dialogue in Clinical Work by Tom Andersen

Lynn Hoffman essay Beyond Power and Control

Developing Open Dialogue website has useful links and resources

Michael Rymer’s film Face To Face dramatizes a workplace restorative justice mediation that has interesting resonance with Open Dialogue

Story of the Weeping Camel about healing in a traditional nomadic tribe in Mongolia was studied at the IDP as evocative of Open Dialogue principles