3.

Open Dialogue Approach

What Is Open Dialogue?

Open Dialogue is a person-centered, community-based alternative to conventional mental health treatments—especially for individuals experiencing psychosis. Developed in Western Lapland over the past 30 years, it offers a radically human and relational approach that brings together the individual, their family or support network, and professionals in meaningful conversation and shared decision-making.

Rather than focusing on diagnosis or symptom reduction, Open Dialogue emphasizes presence, deep listening, and co-creating meaning in the healing process.

Key Features of the Open Dialogue Approach:

Collaborative & Inclusive

Involves the person in distress, their family, friends, and all professionals in shared, transparent conversations.

Community-Based Support

Services are provided in natural environments—like the home—where people feel safest and most at ease.

Immediate & Flexible Help

Response teams meet with individuals and families as soon as possible after a crisis, adapting to evolving needs.

Dialogic Practice

Creates space for open, respectful dialogue where all voices are heard. The goal is to understand and explore—not to control or "treat."

Integrative Treatment Web

Other therapeutic approaches (like systemic family therapy or narrative therapy) can be incorporated as long as they align with the core dialogic principles.

Seven Core Principles of Open Dialogue:

Immediate Help – Rapid access to support when a crisis emerges.
Social Network Perspective – Involving the person’s broader community in care.
Flexibility and Mobility – Services adapt to each person’s unique and changing needs.
Responsibility – The care team takes shared responsibility for planning and follow-through.
Psychological Continuity – The same team remains involved over time to ensure consistency and trust.
Tolerance of Uncertainty – Professionals stay present with distress without rushing to diagnose or intervene.
Dialogue – Creating space for authentic conversation and the emergence of new meaning.

Why It Matters:

Open Dialogue has shown promising outcomes, particularly when used early in the course of psychosis.
Involving family and community helps build trust and reduce isolation, often leading to lower relapse rates.
It offers a non-pathologizing and respectful alternative that centers healing around relationships, meaning, and human connection.

_____________________________________________________________________________________________Sources:

Olson, M., Seikkula, J., & Ziedonis, D. (2014). The key elements of dialogic practice in open dialogue: Fidelity criteria. The University of Massachusetts Medical School, 8, 2017. Pavlovic, R. Y., Pavlovic, A., & Donaldson, S. (2016). Open Dialogue for psychosis or severe mental illness. The Cochrane Database of Systematic Reviews, 2016(10), CD012384. https://doi.org/10.1002/14651858.CD012384