Open Dialogue Approach

Open Dialogue (OD) is an innovative, language-based, network approach to acute psychiatric crises. A multi-disciplinary team at the University of New Mexico (UNM) led by Dr. Douglas Ziedonis and collaborating with many clinical/research groups around the world, including China, Denmark, Finland, Italy, Japan, Latvia, are studying and developing tools for training and research on the Finnish “Open Dialogue” approach in the United States.

What is open-dialogue?

Open Dialogue (OD) is an innovative, network-based approach to acute psychiatric care that was first developed in the 1980s by Jaakko Seikkula, Birgitta Alakare, Jukka Aaltonen and their multi-disciplinary team at Keropudas Hospital in Tornio, Finland. This psychosocial intervention has two components:

a community-based, integrated treatment system that engages families and social networks, and
a distinct and unique form of dialogues within open psychiatric meetings.

The approach has been effective in reducing symptoms of psychosis, leading to fewer and shorter hospitalizations, reduced neuroleptic medication dosage, greater improvements in functioning and improved likelihood of employment (Seikkula et al. 2006).

Related Resources and Research

Open Dialogue is a heavily researched subject with a library of resources.

Discover more about Open Dialogue

Learn more

Key Principles of Open Dialogue Practices

Immediate helpthat begins with a treatment meeting within 24 hours
A social perspectivethat includes the gathering of clinicians, family members, friends, co-workers and other relevant persons for a joint discussion
Embracing uncertaintyby encouraging open conversation and avoiding premature conclusions and treatment plans
Creating a dialogue, or a sense of “with-ness” rather than “about-ness” with meeting participants by dropping the clinical gaze and listening to what people say – rather than what we think they mean

Open-Dialogue and Recovery-oriented practice

There is a strong convergence between Open Dialogue and recovery-oriented principles and practices. Both embrace recovery as a genuine process of revival and resiliency, which is grounded in hope, empowerment, and a supportive network. Open Dialogue creates democratic partnerships between professionals and the people they serve to restore productive and meaningful lives. Both the recovery perspective and Open Dialogue are reinforced by the knowledge that people with mental health and addiction problems can and do persevere and play meaningful roles in society.

The World Health Organization (WHO) recently identified Open Dialogue as an approach to community mental health services and to crisis intervention services that are consistent with a human rights based approach.

Guidance on community mental health services: promoting person-centred and rights-based approaches. Geneva: World Health Organization; 2021 (Guidance and technical packages on community mental health services: promoting person-centred and rights-based approaches). Licence: CC BY-NC-SA 3.0 IGO.
https://www.who.int/publications/i/item/9789240025721
Mental health crisis services: promoting person-centred and rights-based approaches. Geneva: World Health Organization; 2021 (Guidance and technical packages on community mental health services: promoting person-centred and rights-based approaches). Licence: CC BY-NC-SA 3.0 IGO.
https://www.who.int/publications/i/item/9789240025721

Research Infrastructure Development Project

Launched in September 2012 and funded by the the UMMS/Finland OD initiative will develop practical tools for clinicians, program leaders, and researchers in the United States – and throughout the world – who hope to further investigate the OD approach.

The collaboration will produce several products to help with adaptation of the Open Dialogue model, including:

A psychotherapy-focused manual and fidelity tool for clinical interactions with individuals and families
A system-focused manual and fidelity tool for assessing program/organizational implementation.