Open Dialogue for Psychosis: Organising Mental Health Services to Prioritise Dialogue, Relationship and Meaning

Cover
Half Title
Series Information
Title Page
Copyright Page
Table of Contents
Contributors
Foreword
Prologue
Section 1 Introducing Open Dialogue
	1 What is Open Dialogue?
		The Structure of the Western Lapland Service
		Influences and Collaborations
		The Seven Principles
			Principle 1: Immediate Help
			Principle 2: Social Network Perspective
			Principle 3: Flexibility and Mobility
			Principle 4: Responsibility
			Principle 5: Psychological Continuity
			Principle 6: Tolerance of Uncertainty
			Principle 7: Dialogism
				Responsive Listening
				Agency
				‘Withness’ and ‘aboutness’
				Authenticity and Creativity
		Other Principles/Values
			Equality, Democracy and Respect
			Transparency (and Reflecting)
			Process-oriented Practice
		Conclusion
		Note
		References
	2 The Historical Development of Open Dialogue in Western Lapland
		Background
		Families in the Treatment
		Understandings of Psychosis
		Open Dialogue as a Form of Need-Adapted Treatment
		Training
			Family Therapy Training
		Research
		Teamwork
		Concluding Comments
		Notes
		References
	3 Psychosis is not an Illness but a Response to Extreme Stress – Dialogue is a Cure for it
		Introduction
		Psychosis, the Body, Trauma and Extreme Stress
		Generating Dialogue is the Response to Psychotic Experiences
		Some Simple Guidelines for Dialogues with People Having Psychotic Experiences
			Having a Relational Focus Throughout
			Respecting the Psychotic Experience Without Conditions
			Emphasising Feelings and the Affective Aspects of the Stories Told
			A Preference for Being Present in the Here and Now
		Long-term Psychotic Experiences
		Notes
		References
Section 2 Personal, Family and Professional Experiences of Open Dialogue
	Editors’ Introduction
		Relationships
		Early and Late Interventions
		Opportunity in a Time of Crisis
		Note
		References
	4 Our Son is ‘Coming Back’: A Dialogical-network Approach to a Young Adult Diagnosed with Schizoaffective Disorder
		Are You Coming Back?
		Conclusion
		Note
		References
	5 The Experience of a Family Open Dialogue Approach – a Sister and Practitioner Reflect One Year After Discharge from Services
		Background
		Conversation Between Kirsty (Sister and Network Member) and Yasmin (Open Dialogue Practitioner)
		Concluding Remarks
	6 Psychotic Behaviour: Symptom of a (Brain) Disease or an Attempt at Adjustment?
		Maria
		The Service
		Back to Maria
		Comments
		Note
	7 the Stress of Tolerating Uncertainty: Emails Can Help!
		Introduction
		Veronica (not My Real Name)
		Giuseppe Tibaldi
	8 Rooted in Love – A Journey Through a Dark Time with a Teenager and his Family
		Introduction
		Zelda
		Marc
		Sully
		Cathy
		Zelda
		Marc
	9 Open Dialogue as a Point of Entry to Reconnect to the Real World of Relationships
		Josh
		Debra – Josh’s Mum
		Annie Hodgkins (Care Coordinator/Open Dialogue Practitioner)
		Note
	10 Permission to Speak!
		Introduction
		Dan’s Story
		The Authors’ Reflections
		Note
Section 3 Open Dialogue Training, Including Reflections from Trainers and Participants and Adaptations in Different Settings
	Editors’ Introduction
	11 Introducing Open Dialogue Training
		Introduction
		Open Dialogue Training and Psychosis
		Foundation Training
		Full Training
			Theory Days
			Supervision Days
			Family of Origin Days
		Commonalities in Training Programmes
		In Conclusion
		Note
		References
	12 Reflections on the Dialogical Design of the Three/Four-Year Open Dialogue Training
		Commitment and Personal Challenges in the Process
		Dialogic Aspects Within the Training and the Skill of the Trainer
	13 Reflections on Participating in the Three-year Open Dialogue Training
		Supervision
		Unlearning and Healing
		Family of Origin
		Concluding Thoughts
	14 Thirteen Years of Running Open Dialogue Foundation Training Programmes
		Reference
	15 Reflections from Participants on an Open Dialogue Foundation Training
		Editors’ Introduction
		Practice/Role Plays
		Trainer’s Presence
		Safety, Equality and Being Valued
		Power/Responsibility
		Family of Origin
	16 Being ‘in Rhythm’ with Participants During Dialogical Training
		References
	17 Personal Reflections on the Italian Open Dialogue Training
		Notes
		References
	18 UK NHS Peer-supported Open Dialogue Training
Section 4 Introducing Open Dialogue in Different Contexts in Various Countries
	Editors’ Introduction
	The Challenges of Introducing Open Dialogue
	19 Open Dialogue in Germany – Opportunities and Challenges
		The German Healthcare System
		Open Dialogue Within a Hospital
		Dialogic Collaboration in a Community Mental Health Centre
		Open Dialogue in an Integrated Care Setting
		Discussion
		Notes
		Reference
	20 Open Dialogue in the Italian National Health Service: A View from the Borderland
		Changes to Our Practice
			Working as a Team in an Integrated Service
			Reflective Conversations and Democratic Process
			Peer Involvement
		The Seven Principles as Viewed by Trained and Untrained Professionals
		Note
		References
	21 the Challenges of Introducing Open Dialogue into a UK Early Intervention in Psychosis Service
		Context
		Rationale for Introducing Open Dialogue
		How we Went About Introducing Open Dialogue
		Challenges of Introducing Open Dialogue
		To Finish on a Positive Note
		References
	22 Two Open Dialogue Programmes at Advocates, Framingham, Massachusetts, USA
		The Collaborative Pathway
		Open Dialogue in Community Based Flexible Supports
		Challenges and Lessons Learned
		References
	23 Implementing Open Dialogue-informed Practices at the Counselling Service of Addison County in Vermont, Usa
		Antecedents
		How we Got Started
		Our Current Assessment of This Project
		The Impact on Staff
		Some Challenges
		Considerations Regarding Implementation
		Reference
	24 Migrant Families: Experiences Using the Open Dialogue Approach
		References
	25 Peer Workers in Open Dialogue
		Editors’ Introduction
		In What Way(s) Have You Been Able to Include Peer Workers in Your Open Dialogue Service?
			Edward Altwies
			Leslie Nelson
			Helene Brändli
		What Do You Think Peer Workers Add to Your Open Dialogue Service?
			Leslie Nelson
			Helene Brändli
			Edward Altwies
		What Challenges/obstacles Have You Encountered as the Peer Worker Role Has Been Developed in Your Service?
			Leslie Nelson
			Edward Altwies
			Helene Brändli
		What Advice Would You Give to People Who Would Like to Develop the Peer Worker Role in Their Open Dialogue Service?
			Leslie Nelson
			Edward Altwies
			Helene Brändli
		Reference
	26 The Challenge of Developing Open Dialogue in Hospital Settings
		Hospital 1
			What Did I Learn from These Developments?
		Hospital 2
			What Did I Learn from These Developments?
		Hospital 3
			What Did I Learn from This Observation?
		Summary
		References
	27 Open Dialogue Behind ‘closed Doors’ (a Locked Ward)
		References
Section 5 Opening the Dialogue with Other Approaches
	Editors’ Introduction
	28 Working with Open Dialogue Within the Neurobiological Model – Challenges and Opportunities
		Introduction
		Conceptualisation of Schizophrenia
		The Neurodevelopmental Model
		Role of Antipsychotic Drugs
		Conflicts Between Open Dialogue and the Biomedical Model
		References
	29 Systemic Therapy and Open Dialogue
		Introduction
		Systemic Therapy is a Broad Church
		Contemporary Systemic Therapy
		Are There Differences Between Systemic Therapy and Open Dialogue?
		References
	30 Open Dialogue and Cognitive Behavioural Therapy (CBT)
		General Principles of CBT
		CBT is a Broad Church
		CBT for Psychosis
		Outcomes and CBTp
		Extending the Dialogue Through CBTp and Other Approaches
		References
	31 Extending Need-adapted Interventions in a Contemporary Open Dialogue Service in Helsinki
		Introduction
		The Early Psychosis Centre
		Range of Therapeutic Approaches Offered Alongside Network Meetings
		Summary
		References
	32 Interfamily Therapy: Application of Dialogical Practices in the Multifamily Group
		Introduction
		Interfamily Therapy
		Theoretical and Methodological Background of IFT
		Contribution of IFT to Dialogical Practices
		Conclusion
		Note
		References
	33 Psychoanalysis and Open Dialogue
		Working with Families
		Free Association, Interpretations, Tolerance of Uncertainty and Authority
		Dynamic Unconscious Processes and Psychosis
		The Dark Side of us Humans
		References
	34 The Affinities Between Therapeutic Communities and Open Dialogue
		Democratisation
		Permissiveness
		Reality Confrontation
		Communalism
		Other Similarities and Differences
		Conclusion
		References
	35 Open Dialogue and Music Therapy
		Introduction
		Music Therapy
		Early Development and Dialogue
		Music Therapy and Psychosis
		Polyphony in Open Dialogue, Music and Music Therapy
		Concluding Remarks
		References
Section 6 Research into Open Dialogue
	Editors’ Introduction
	36 Research into the Need-adapted Treatment Approach to Psychosis
		Introduction
		Randomised Controlled Trials Versus Cohort Studies
		Nat Cohort Studies
		Are Neuroleptics Always Necessary?
		References
	37 Research from Western Lapland of Open Dialogue for Psychosis
		Hospital Stays and the Incidence of ‘Schizophrenia’ and ‘Psychoses’
		Long-term Stability of Outcomes in Acute Psychosis in Western Lapland
		Long-term Outcomes in Western Lapland
			A) Five-year Follow-up
			B) 19-year Follow-up
		References
	38 Open Dialogue Adherence and Fidelity Tools
		Introduction
		Psychotherapy Guide
		Fidelity Adherence Scale and Rating Manual
		Organisational Systems Guide
		Clinical Trial at Grady Hospital, Atlanta, Georgia, USA and ODDESSI, UK
		References
	39 The UK ODDESSI Trial
		Background
		Design of the Study
			Work Stream 1
			Work Stream 2
			Work Stream 3
			Work Stream 4
			Work Stream 5
		Training
		Challenges
		Note
		Reference
	40 Research into a Peer-supported Open Dialogue Service in the UK
		Introduction
		Study Design and Methods
		Results
		Discussion and Reflection
	41 Open Dialogue for Psychosis in Five Danish Municipalities – Results and Experiences
		Introduction
		Study Design and Participants
		Training of Staff
		Results
		Implementing Open Dialogue
		References
	42 Researching Whether Finnish Open Dialogue Transfers to the Italian Mental Health System
		Introduction
		Research Design
			Phase 1: Professionals’ View and System Antecedents
			Phase 2: Training Evaluation
			Phase 3: Pilot Study
		Preliminary Results
			Professionals’ Views and System Antecedents
			Training Evaluation
			Pilot Study
		Reflections
		Notes
		References
	43 A Feasibility Study of Adapting Open Dialogue to the US Health Context: The Collaborative Pathway at Advocates, Massachusetts, USA
		Context
		The Service
		Feasibility Study
		Outcomes of the Feasibility Study
		Lessons Learned
		References
	44 The Parachute Project NYC – The Project and Outcomes of the Brooklyn Mobile Team
		The Project
		Brian Martindale
		Outcomes of the Brooklyn Mobile Team
			Edward Altwies
		Selection Criteria
		Findings at Intake to Project
		Research Period and Data Collection
		Results/Outcomes
		Discussion
		Note
		References
	45 Open Dialogue Research in Ireland
		Introduction
		Research
		Research into Service Users and Families
		Research into Staff Attitudes and Experience
		Further Projects
		Questioning Research!
		References
	46 Anthropological Research into Open Dialogue in Berlin
	47 Openness and Authenticity in the Open Dialogue Approach
		References
	Epilogue
		References
Index