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“It Makes us Realize that We Have Been Heard”: Experiences with Open Dialogue in Vermont

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Abstract

The Open Dialogue approach was developed in Finland as a form of psychotherapy and a way to organize mental health systems. Open Dialogue has drawn global interest leading to adaptations worldwide, including in Vermont-US where it is called Collaborative Network Approach. Our study aimed to investigate the experiences of families who received Collaborative Network Approach in two agencies in Vermont. Qualitative interviews were conducted with 17 persons receiving services. Seven themes emerged: 1) network focus, 2) decision-making, 3) structure of care, 4) use of reflections, 5) medications, 6) hospitalizations, 7) challenges. Our study provides evidence that CNA is well-received, appreciated, and for many people an empowering form of mental health care. The findings suggest that elements of Open Dialogue are highly consistent with the vision for recovery-oriented care, in that they are flexible, person-centered, encourage processes of negotiation, and highlight the importance of family and social supports in care.

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References

  1. Seikkula J, Arnkil TE. Open Dialogues and Anticipations: Respecting Otherness in the Present Moment. Tampere: Finnish University Print. 2014.

    Google Scholar 

  2. Alanen YO, Lehtinen K, Rakkolainen V, Aaltonen J. Need-adapted treatment of new schizophrenic patients: experiences and results of the Turku Project. Acta Psychiatr Scand. 1991;83(5):363–72. https://doi.org/10.1111/j.1600-0447.1991.tb05557.x.

  3. Seikkula J, Alakare B, Aaltonen J. Open dialogue in psychosis I: An introduction and case illustration. J Constr Psychol. 2001;4(4). https://doi.org/10.1080/107205301750433397.

  4. Bergstrom T, Alakare B, Aaltonen J, Maki P, Kongas-Saviaro P, Taskila JJ, et al. The long-term use of psychiatric services within the Open Dialogue treatment system after first-episode psychosis. Psychosis Psychol Soc Integr Approach. 2017;9(4). https://doi.org/10.1080/17522439.2017.1344295.

  5. von Peter S, Aderhold V, Cubellis L, Bergstrom T, Stastny P, Seikkula J, et al. Open Dialogue as a Human Rights-Aligned Approach. Front Psychiatry. 2019;10:387. https://doi.org/10.3389/fpsyt.2019.00387.

  6. World Health Organization. Guidance on community mental health services: promoting person-centred and rights-based approaches. Geneva World Health Organ. 2021.

    Google Scholar 

  7. Gordon C, Gidugu V, Rogers ES, DeRonck J, Ziedonis D. Adapting open dialogue for early-onset psychosis into the U.S. health care environment: A feasibility study. Psychiatric Serv. 2016;67(11). https://doi.org/10.1176/appi.ps.201600271.

  8. Gidugu V, Rogers ES, Gordon C, Elwy AR, Drainoni M-L, Id, et al. Client, family, and clinician experiences of Open Dialogue-based services. Psychol Serv. 2021;18(2). https://doi.org/10.1037/ser0000404.

  9. Rosen K, Stoklosa J. Finland in Boston? Applying open dialogue ideals on a psychotic disorders inpatient teaching unit. Psychiatric Serv. 2016;67(12). https://doi.org/10.1176/appi.ps.201600340.

  10. Hopper K, Van Tiem J, Cubellis L, Pope L. Merging intentional peer support and dialogic practice: Implementation lessons from Parachute NYC. Psychiatric Serv. 2020;71(2). https://doi.org/10.1176/appi.ps.201900174.

  11. Florence A, Jordan G, Yasui S, Davidson L. Implanting Rhizomes in Vermont: a Qualitative Study of How the Open Dialogue Approach was Adapted and Implemented. Psychiatric Quarterly. 2020;91(3):681-93.

  12. Buus N, Bikic A, Jacobsen EK, Muller-Nielsen K, Aagaard J, Rossen CB. Adapting and implementing open dialogue in the Scandinavian countries: A scoping review. Issues Ment Health Nurs. 2017;38(5). https://doi.org/10.1080/01612840.2016.1269377.

  13. Freeman AM, Tribe RH, Stott JCH, Pilling S. Open Dialogue: A review of the evidence. Psychiatric Serv. 2019;70(1). https://doi.org/10.1176/appi.ps.201800236.

  14. Sells D, Topor A, Davidson L. Generating coherence out of chaos: examples of the utility of empathic bridges in phenomenological research. J Phenomenol Psychol. 2004;35(2):253–71.

  15. United States Census Bureau. Quick Facts: Vermont. 2019. Available from: https://www.census.gov/quickfacts/fact/table/VT/PST045219.

  16. Slade M. Personal recovery and mental illness: A guide for mental health professionals. Cambridge University Press. 2009.

  17. Harrow M, Jobe TH. Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: A 15-year multifollow-up study. J Nerv Mental Dis. 2007;195(5).

  18. Olfson M, Gerhard T, Huang C, Crystal S, Stroup TS, Id, et al. Premature mortality among adults with schizophrenia in the United States. JAMA Psychiatry. 2015;72(12). https://doi.org/10.1001/jamapsychiatry.2015.1737.

  19. Gerhard T, Huybrechts K, Olfson M, Schneeweiss S, Bobo WV, Doraiswamy PM, et al. Comparative mortality risks of antipsychotic medications in community-dwelling older adults. Br J Psychiatry. 2014;205(1). https://doi.org/10.1192/bjp.bp.112.122499.

  20. Stastny P, Lovell AM, Hannah J, Goulart D, Vasquez A, O’Callaghan S, et al. Crisis Response as a Human Rights Flashpoint: Critical Elements of Community Support for Individuals Experiencing Significant Emotional Distress. Health Hum Rights. 2020;22(1):105–19.

    PubMed  PubMed Central  Google Scholar 

  21. Olson M, Seikkula J, Ziedonis D. The key elements of dialogic practice in open dialogue: Fidelity criteria. Worcester: The University of Massachusetts Medical School. 2014.

    Google Scholar 

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Acknowledgements

The authors would like to thank all participants who gave up their time to share their experiences.

Funding

This study was funded in part by Coordenacao de Aperfeicoamento de Nivel Superior - Brasil (CAPES) and the Department of Mental Health of the State of Vermont.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University, New Haven, CT), USA

    Ana Carolina Florence, Gerald Jordan & Larry Davidson

  2. São Paulo State University, Assis, SP, Brazil

    Silvio Yasui & Daniela Ravelli Cabrini

Authors
  1. Ana Carolina Florence
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  2. Gerald Jordan
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  3. Silvio Yasui
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  4. Daniela Ravelli Cabrini
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  5. Larry Davidson
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Contributions

Ana Carolina Florence, Gerald Jordan, Silvio Yasui, Daniela Ravelli Cabrini and Larry Davidson contributed to the study conception and design. Material preparation and data collection were performed by Ana Carolina Florence. All authors contributed to data analysis. The first draft of the manuscript was written by Ana Carolina Florence and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ana Carolina Florence.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Yale University School of Medicine Institutional Review Board (HIC/HSC # 2000024372).

Consent to Participate

Informed consent was obtained in writing from all participants of the study.

Consent for Publication

Not applicable

Conflicts of Interest

Ana Carolina Florence has received a Doctoral award from the Coordenacao de Aperfeicoamento de Nivel Superior - Brasil (CAPES); Postdoctoral funding from the Connecticut Department of Mental Health, and Addiction Services, and Yale Franke Program in Science and the Humanities; consulting fees and travel reimbursements from the Vermont Department of Mental Health. Gerald Jordan has received Doctoral and Postdoctoral training awards from the Canadian Institutes of Health Research Doctoral, Fellowship, and Strategies for Patient Oriented Research programmes; the Fonds de Recherche Santé – Québec Doctoral and Postdoctoral programmes; the Department of Psychiatry at McGill University; and the Yale Franke Program in Science and Humanities. Larry Davidson has received funding from the Connecticut Department of Mental Health and Addiction Services and the Vermont Department of Mental Health. Silvio Yasui and Daniela Cabrini report no conflicts of interest.

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Florence, A.C., Jordan, G., Yasui, S. et al. “It Makes us Realize that We Have Been Heard”: Experiences with Open Dialogue in Vermont. Psychiatr Q 92, 1771–1783 (2021). https://doi.org/10.1007/s11126-021-09948-1

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  • DOI: https://doi.org/10.1007/s11126-021-09948-1

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