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The open dialogue approach to acute psychosis: its poetics and micropolitics
Systems and Psychosocial Advances Research Center Publications and Presentations
  • Jaakko Seikkula, University of Jyvaskyla
  • Mary E. Olson, University of Massachusetts Medical School
UMMS Affiliation
Department of Psychiatry
Publication Date
Document Type
Acute Disease; Finland; Humans; *Language; Mental Health Services; *Patient Care Team; Psychotherapy; Psychotic Disorders

In 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.


Fam Process. 2003 Fall;42(3):403-18.


At the time of publication, Mary Olson was not yet affiliated with the University of Massachusetts Medical School.

Related Resources
Link to Article in PubMed
Citation Information
Jaakko 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)
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