Posts | Will Hall, MA, DiplPW

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, 80% 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. Research is being conducted, 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. Jaakko Seikkula, Marku Suttela MA, Dr. Birgitta Alakare, Dr. Mary Olson, and others as part of my two year certificate in Open Dialogue. My training in Process Work, a Jungian therapy, also engages deeply with group and family dynamics from systems and communication perspectives, as Jung shares a dialogue based view of psychology and change.

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. My work with Open Dialogue includes adaption to my therapy practice where I work often with families and crisis, as well as using dialogue principles in my community development work, training, and research. I am grateful to Dr. Olson and our colleagues in Finland for their invitation to learn from and collaborate in the development of this work and for their support of my teaching offerings related to this learning. – Will Hall

—>>> Organizations Developing Open Dialogue:

Institute for Dialogic Practice, directed by Dr. Mary Olson, the North America training facility for Open Dialogue

Open-Dialogue.net

Network of Dialogical Practices, Europe’s Open Dialogue network founded by Jaakko Seikkula and colleagues (Facebook)

Open Dialogue Pacific

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

Mental Health Trialogue Network, Ireland

Open Dialogue UK

Peer Open Dialogue at the NHS in the UK

Jakko Seikkula’s website

Developing Open Dialogue website

—>>> What Is Open Dialogue?

Re-humanising Mental Health Systems: A Discussion with Jaakko Seikkula on the Open Dialogue Approach

Open Dialogue — Alternative Care for Psychosis In Finland |Will Hall (2013)

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

The Open Dialogue Approach to Psychosis: Its poetics and micropolitics

Open Dialogue An alternative Finnish Approach to Healing Psychosis: Documentary by Daniel Mackler

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

The Key Elements of Dialogic Practice in Open Dialogue: Fidelity Criteria

Audio: Madness Radio interview with Mary Olson on Open Dialogue

Outside Mental Health book excerpt: Mary Olson on Open Dialogue

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

—>>> Origins of Open Dialogue

Need-Adapted Treatment of Schizophrenia: Family Interventions | Klaus Lehtinen

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

Eva Kjellberg Child-And Adolescent Psychiatry in Northern Sweden

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

Family Therapy: An Intimate History, by Lynn Hoffman

Schizophrenia: Its Origins and Need-Adapted Treatment

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

Healing Homes Recovery from Psychosis Without Medication: Documentary by Daniel Mackler

Take These Broken Wings Healing from Schizophrenia, Cure without Medication: Documentary by Daniel Mackler

Michael Rymer’s film Face To Face on mediation resonates with Open Dialogue

The Story of the Weeping Camel must-see film about nomads evokes Open Dialogue

—>>> Research on Open Dialogue

Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies

The long-term use of psychiatric services within the Open Dialogue treatment system after first-episode psychosis | Tomi Bergström, Birgitta Alakare, Jukka Aaltonen, Pirjo Mäki, Päivi KöngäsSaviaro, Jyri J. Taskila & Jaakko Seikkula

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

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

Open dialogue approach: treatment principles and preliminary results of a two-year follow-up on first episode schizophrenia

From Research on Dialogical Practice to Dialogical Research: Open Dialogue Is Based on a Continuous Scientific Analysis

Open Dialogue: A Review of the Evidence

Open Dialogue: The Evidence and Further Research

Practitioners of open dialogue report their personal transformations as a result of conducting network meetings

“Always opening and never closing”: How dialogical therapists understand and create reflective conversations in network meetings

Open Dialogue as a Human Rights-Aligned Approach

The 10‐year treatment outcome of open dialogue‐based psychiatric services for adolescents: A nationwide longitudinal register‐based study

“Y, what do you think about what X just said?” Conversation analysis of stance-eliciting questions in open dialogue network meetings

The Finnish open dialogue approach to crisis intervention in psychosis: A review

—>>> Adaptation of Open Dialogue in New Contexts

The History of the Open Dialogue Approach in the United States

Adapting Open Dialogue for Early-Onset Psychosis Into the U.S. Health Care Environment: A Feasibility Study

Peer supported Open Dialogue in the National Health Service: implementing and evaluating a new approach to Mental Health Care

Open dialogues in the present and the future – new developments

Open Dialogue Shut Down In Ireland Despite Success

Finland in Boston? Applying Open Dialogue ideals on a psychotic disorders inpatient teaching unit

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

Open Dialogue Approach: Exploring and Describing Participants’ Experiences in an Open Dialogue Training Program

The introduction and implementation of open dialogue in a day center in Athens, Greece: experiences and reflections of mental health professionals

Introduction: Open Dialogue around the world – implementation, outcomes, experiences and perspectives

Open Dialogue compared to treatment as usual for adults experiencing a mental health crisis: Protocol for the ODDESSI multi-site cluster randomised controlled trial

WHO (2021). Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches

Urgently Awaiting Implementation: The Right to Be Free from Exploitation, Violence and Abuse in Article 16 of the Convention on the Rights of Persons with Disabilities (CRPD)

Open dialogue in the UK: qualitative study

An introduction to peer-supported open dialogue in mental healthcare

Exploring patients’ experience of peer-supported open dialogue and standard care following a mental health crisis: qualitative 3-month follow-up study

Peer support and shared decision making in Open Dialogue: Opportunities and recommendations

Open Dialogue: Development and Evaluation of a Social Network Intervention for Severe Mental Illness – large scale NHS trial

Adapting and Implementing Open Dialogue in the Scandinavian Countries: A Scoping Review

“Open Dialogue behind locked doors” – exploring the experiences of patients, family members, and professionals with network meetings in a locked psychiatric hospital unit: A qualitative study

Parachute Project New York City

Dialogue as a Response to the Psychiatrization of Society? Potentials of the Open Dialogue Approach

The Icarus Project and Freedom Center’s 52-page illustrated guide gathers the best information we’ve come across and the most valuable lessons we’ve learned about reducing and coming off psychiatric medication. Based in more than 10 years work in the peer support movement, this Guide is used internationally by individuals, families, professionals, and organizations, and is available in a growing number of translations. 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 where they are at to make their own decisions, balancing the risks and benefits involved. Written by Will Hall, with a 55-member health professional Advisory Board providing research assistance and more than 50 collaborators involved in developing and editing. The guide has photographs and art throughout, and a beautiful original cover painting by Jacks McNamara.

Now in a revised and expanded Second Edition.

Note: the guide is Creative Commons copyright and you have advance permission to link, copy, print, and distribute for non-commercial purposes, as long as you don’t
alter it and you credit the source.

Download and read the Guide in English.

Download a printer version, with scrambled pages ready to fold into a booklet (print double sided on legal paper, or send to a shop; booklet assembly instructions here). Download a powerpoint version here.

Download the Audiobook version mp3 here (rt/cntrl-click save as).

Download a European printer version in English, with scrambled pages ready to fold into a booklet (print double sided on A4 paper).

You can also order a bound, color cover edition through bookstores.

Read about the making of the first edition and second edition of the Guide.