Open Dialogue

“Open Dialogue” is an innovative approach to acute psychiatric crises developed by Jaakko Seikkula, Marku Suttela, and the multidisciplinary team at Keropudas Hospital in Tornio, Finland. It has its roots in systemic family therapy and its emergence in recent years has been an important counterpoint to the traditional biomedical model of mental illness. I’m adding Open Dialogue to my list of important practices because I’m aligning myself with an international movement for the transformation of the way we see “psychosis.”

At the heart of Open Dialogue is the understanding that we can see psychosis not as some biochemical symptom of disease but as taking place in the “in between spaces” between people. There are all kinds of lessons to learn from paying attention to what gets called “psychotic processes”. Open Dialogue is a group model that relies on a “tolerance of uncertainty” and the power of “polyphony” or, multiple perspectives. Here’s a fidelity paper that describes all of its aspects.

I had the good fortune to spend a year actively practicing this form of therapy in the public mental health system on a mobile treatment team as part of Parachute New York City. I also had a chance to study with the Institute for Dialogic Practice and received training in the Needs Adapted Treatment Model through my work. As someone who ended up in the psychiatric system and was diagnosed with a “psychotic disorder” as a teenager, it was an incredibly powerful experience for me to sit with families and individuals struggling with “psychosis” and create space for multiple perspectives. I’m grateful to be able to bring my experience working with Open Dialogue to my practice with individuals and families.

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