Open Dialogue

Open Dialogue is an alternative approach for treating psychosis as well as other mental health disorders developed in the 1980s in Finland by Yrjö Alanen and his collaborators. Open Dialogue interventions are currently being trialed in several other countries including Australia, Belgium, Denmark, Germany, Italy, Norway, Poland, the United Kingdom, and the United States. In Israel there is a non-governmental organization called Open Dialogue Israel.

Open Dialogue (OD) developed from Need-Adapted Treatment as described by Alanen and colleagues in the early 1990s. This approach took shape within the mental health services of Finnish Western Lapland in the 1980s and 1990s. During its initial research and training in psychotherapy, seven key principles were identified:

1. providing immediate help
2. considering clients' social network during the treatment
3. being flexible and mobile during the treatment
4. assigning the responsibility of organizing treatments to one professional
5. ensuring psychological continuity
6. accepting uncertainty
7. engaging in dialogism

The first five principles focus on the organizational aspects of delivering mental health services; the last two principles are about the conversational methods mental health professionals use in network meetings with clients. The participation of friends and family, responding to the client's utterances, trying to make meaning of what a client has to say, and "tolerating uncertainty".

A recently published global survey on the worldwide implementation of Open Dialogue in mental health services gathered data from 142 Open Dialogue teams in 24 countries, mainly in Europe. Key factors enhancing Open Dialogue implementation included well-trained staff, regular supervisions, research capabilities, diverse professional teams, self-referrals, outpatient services, younger clients, and the involvement of experts by experience. The study underscores the importance of more Open Dialogue training, supervision, and research.