The open dialogue approach to acute psychosis: its poetics and micropoliticsSystems and Psychosocial Advances Research Center Publications and Presentations
UMMS AffiliationDepartment of Psychiatry
Medical Subject HeadingsAcute Disease; Finland; Humans; *Language; Mental Health Services; *Patient Care Team; Psychotherapy; Psychotic Disorders
AbstractIn Finland, a network-based, language approach to psychiatric care has emerged, called "Open Dialogue." It draws on Bakhtin's dialogical principles (Bakhtin, 1984) and is rooted in a Batesonian tradition. Two levels of analysis, the poetics and the micropolitics, are presented. The poetics include three principles: "tolerance of uncertainty," "dialogism," and "polyphony in social networks." A treatment meeting shows how these poetics operate to generate a therapeutic dialogue. The micropolitics are the larger institutional practices that support this way of working and are part of Finnish Need-Adapted Treatment. Recent research suggests that Open Dialogue has improved outcomes for young people in a variety of acute, severe psychiatric crises, such as psychosis, as compared to treatment-as-usual settings. In a nonrandomized, 2-year follow up of first-episode schizophrenia, hospitalization decreased to approximately 19 days; neuroleptic medication was needed in 35% of cases; 82% had no, or only mild, psychotic symptoms remaining; and only 23% were on disability allowance.
Related ResourcesLink to Article in PubMed
Citation InformationJaakko Seikkula and Mary E. Olson. "The open dialogue approach to acute psychosis: its poetics and micropolitics" Vol. 42 Iss. 3 (2003) ISSN: 0014-7370 (Linking)
Available at: http://works.bepress.com/mary_olson/1/