Open Dialogue

The Open Dialogue approach is both a philosophical/theoretical approach to people experiencing a mental health crisis and their families/networks, and a system of care, developed in Western Lapland in Finland over the last 30 years or so. In the 1980s psychiatric services in Western Lapland were in a poor state, in fact they had one of the worst incidences of ‘schizophrenia’ in Europe. Now they have the best documented outcomes in the Western World. For example, around 75% of those experiencing psychosis have returned to work or study within 2 years and only around 20% are still taking antipsychotic medication at 2 year follow-up.

Remarkably, Open Dialogue is not an alternative to standard psychiatric services, it is the psychiatric service in Western Lapland. This has afforded a unique opportunity to develop a comprehensive approach with well-integrated inpatient and outpatient services. Working with families and social networks, as much as possible in their own homes, Open Dialogue teams help those involved in a crisis situation to be together and to engage in dialogue. It has been their experience that if the family/team can bear the extreme emotion in a crisis situation, and tolerate the uncertainty, in time shared meaning usually emerges and healing is possible. Open Dialogue has drawn on a number of theoretical models, including systemic family therapy, dialogical theory and social constructionism.

Videography

Bibliography

Websites

the international website for the Open Dialogue approach

Books

Articles

Open Dialogue

Open dialogues in the present and the future – new developments

Jaakko Seikkula August 20, 2016 [1]

Ο Ανοιχτός Διάλογος στο παρόν και το μέλλον – νέες εξελίξεις

Jaakko Seikkula, 20 Αυγούστου 2016 [2]

Dialoghi aperti nel presente e nel futuro: nuovi sviluppi

Jaakko Seikkula November 21, 2016 [3]

Otevřené dialogy v současnosti a do budoucna – aktuální vývoj

Jaakko Seikkula August 20, 2016 [4]

Hallucinations

Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes

Neuroleptics vs Social Approach

Whitaker, R., (2004). The case against antipsychotic drugs: a 50-year record of doing more harm than good
The Treatment of Acute Schizophrenia Without Drugs: An Investigation of Some Current Assumptions WILLIAM T. CARPENTER, JR., M.D., THOMAS H. MCGLASHAN. M.1)., AND JOHN S. STRAUSS, M.D. 14 Am J Psychiatry /34:1, January 1977
Bola, John R. (2006). Medication-Free Research in Early Episode Schizophrenia: Evidence of Long-Term Harm? Schizophrenia Bulletin vol. 32 no. 2 pp. 288–296, 2006 doi:10.1093/schbul/sbj019
Harrow, M., Jobe, T. H. Factors Involved in Outcome and Recovery in Schizophrenia Patients Not on Antipsychotic Medications: A 15-Year Multifollow-Up Study
Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study M. Harrow*, T.H. Jobe and R. N. Faull
The limitations of antipsychotic medication on schizophrenia relapse and adjustment and the contributions of psychosocial treatment Gerard E[ Hogarty\ Richard F[ Ulrich
Two-year outcome in first-episode psychosis treated according to an integrated model. Is immediate neuroleptisation always needed? V. Lehtinen 1* , J. Aaltonen 2 , T. Koffert 1 , V. Räkköläinen 3 , E. Syvälahti
A Non-Neuroleptic Treatment for Schizophrenia: Analysis of the Two-Year Postdischarge Risk of Relapse
GUY CHOtJINARD, M.D., M.SC. (PHARMACOL), BARRY D. JONES, M.D., AND LAWRENCE ANNABLE, DIP. STAT. Neuroleptic-Induced Supersensitivity Psychosis
Wunderink, Lex MD, PhD; Roeline M. Nieboer, MA; DurkWiersma, PhD; SjoerdSytema, PhD; FokkoJ.Nienhuis, MA Recovery in Remitted First-Episode Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy Long-term Follow-up of a 2-Year Randomized Clinical Trial

Withdrawal

Clinical Risk Following Abrupt and Gradual Withdrawal of Maintenance Neuroleptic Treatment
Guided discontinuation versus maintenance treatment in remitted First Episode Psychosis: relapse Rates and Functional Outcome
Neuroleptic Withdrawal in Schizophrenic Patients

Study in favor of neuroleptics

Schizophrenia A Follow-up Study of Results of Treatment Philip R. A. May, MD; A. Hussain Tuma, PhD; Coralee Yale, MS; Penelope Potepan; Wilfrid J. Dixon, PhD
11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study
Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patients With Schizophrenia: An Observational Follow-Up Study