Open Dialogue Therapy: A New Way Of Dealing With Crises
For a long time, mental health care in the face of crises has been based on actions that are certainly controversial. Thus, when faced with a psychotic episode, involuntary admission or prescription of drugs without the consent of the affected person is not uncommon. On the contrary, open dialogue therapy proposes a new intervention approach that guarantees respect for the human rights of the patient.
This model moves away from the patient’s vision as a mere passive object and recipient of care. On the contrary, it involves him and his family environment in the intervention, considering them active agents in the face of the crisis.
Faced with a situation of such magnitude, it is common for anguish and confusion to seize all those involved. For this reason, it is intended to create a space for dialogue in which the affected person and their relatives can express themselves and be heard and responded to.
With the supervision of the professional team, those involved are helped to make sense of the experience they are living and to make communication more flexible.
What is open dialogue therapy?
Open dialogue therapy is based on seven fundamental principles for successful crisis intervention. They are as follows:
Inmediate attention
The care team conducts the first interview with the patient within 24 hours after the crisis.
In addition, immediate attention is guaranteed in the most severe cases, with the patient participating from the first minute. This is done in order to avoid as many internments as possible.
Involvement of the social network in open dialogue therapy
From the beginning, family, friends and other important people from the patient’s social network are invited to participate in the intervention. Thus, neighbors, co-workers or even representatives of employment agencies can attend.
All this in order to mobilize all the support and understanding that the patient and the family require at this time. That is, they are provided with social support.
Responsibility
From the beginning , a specific team of professionals is established who will be responsible for the treatment. They will make the decisions together with the family and will be accessible and available for any consultation. This will help the patient and those close to him to regain a sense of security.
Flexibility
The intervention is tailored to the specific needs of each patient and family. For this, the therapeutic methods and modalities that best suit the demand are selected in each case.
In addition, as long as the family agrees, treatment meetings are held at the patient’s home.
Psychological continuity
The process of recovering from a psychosis picture can take several years, so the team is responsible for the treatment for as long as it is necessary. They act and accompany both during hospitalization and in the outpatient phase.
And, likewise, members of the patient’s social network participate in meetings throughout the process. Priority is given to caring for the therapeutic bond between the professional team and the family.
Tolerance for uncertainty
In critical situations it is possible to make the mistake of rushing. Something that can lead to hasty measures that violate the rights of the subject.
Therefore, from this approach it is sought to generate a feeling of security that allows to tolerate uncertainty. The steps to follow are evaluated at each meeting and the convenience of each one is carefully weighed.
Dialogue
In joint meetings, the generation of a dialogue is prioritized. A space that allows families to take center stage in their own lives. That allows them to analyze, understand and integrate past experiences through a new approach achieved by a change in language.
Open dialogue therapy: a look to the future
This new model of approach to crises has been proving its effectiveness since it was implemented in Finland more than three decades ago. The data are clear: about 80% of patients treated under this approach make a full recovery.
After two years, they do not present any symptoms and are free of antipsychotic drugs. In light of these data, Open Dialogue Therapy is positioned as an excellent alternative to the current model of intervention.
