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Handbook of Community-Based Clinical Practice$
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Anita Lightburn and Phebe Sessions

Print publication date: 2005

Print ISBN-13: 9780195159226

Published to Oxford Scholarship Online: April 2010

DOI: 10.1093/acprof:oso/9780195159226.001.0001

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Open Dialogue Integrates Individual and Systemic Approaches in Serious Psychiatric Crises

Open Dialogue Integrates Individual and Systemic Approaches in Serious Psychiatric Crises

(p.502) 31 Open Dialogue Integrates Individual and Systemic Approaches in Serious Psychiatric Crises
Handbook of Community-Based Clinical Practice

Jaakko Seikkula

Oxford University Press

This chapter presents the work of the Open Dialogue (OD) approach to mental health intervention in psychiatric crises developed by a team of clinicians and researchers in Finland. In Open Dialogue, the first treatment meeting occurs within 24 hours after contact and includes as many significant people as possible from the patient's social network. The aim is to generate dialogue and put words to the experiences embodied in the patient's psychotic symptoms. Psychosis is a way of responding to stressful life situations, and in therapy, generating dialogue becomes the primary aim. All issues are analyzed and addressed with everyone present. Treatment is adapted to the specific and varying needs of patients and takes place at home, if possible. Psychological continuity and trust are emphasized by constructing integrated teams that include both inpatient and outpatient staff, all of whom focus on generating dialogue with the family and patients instead of trying to rapidly remove psychotic symptoms. Treatment is based on generating dialogue; a case is analyzed to illustrate this principle.

Keywords:   Open Dialogue, mental health intervention, community-based clinical practice, Finland, psychiatric patients

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