Preparing the Open Dialogue Approach for Implementation in the U.S.

Open Dialogue Pic

Check out our newly released first version of The Psychotherapy-Focused Fidelity Chapter entitled "The Key Elements of Dialogic Practice in Open Dialogue: Fidelity Criteria". The intent of this document is to help support the development of an Open Dialogue practice and way of relating in teams that can be used for “self-reflection” by an individual practitioner or whole team participating in Open Dialogue meetings, for supervision and training purposes, and for helping in systematic research.  Please send your comments and feedback to

The paper "An Auto-ethnographic Study of Open Dialogue: The Illumination of Snow" by Dr. Mary Olson has been published on-line in Family Process (Olson, M. (2015), An Auto-Ethnographic Study of "Open Dialogue": The Illumination of Snow. Family Process. doi: 10.1111/famp.12160). This paper represents an introductory lecture used in training and includes a description of the forces leading to the growing interest in Open Dialogue in the United States. A video abstract of the paper is available at

A multi-disciplinary team at the University of Massachusetts Medical School (UMMS), led by Drs. Douglas Ziedonis (PI) and Mary Olson (Co-I) of the UMMS Department of Psychiatry, is collaborating with Dr. Jaakko Seikkula and his colleagues at the University of Jyväskylä, Finland, to prepare the Finnish “Open Dialogue” for adaptation and implementation in the U.S.

Open Dialogue (OD) is an innovative, language-based, network approach to acute psychiatric crises developed by Jaakko Seikkula, Birgitta Alakare, Jukka Aaltonen and their multi-disciplinary team at Keropudas Hospital in Tornio, Finland. This psychosocial intervention has two components: (1) a community-based, integrated treatment system that engages families and social networks, and (2) 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).

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.

Research Infrastructure Development Project:

Open DialogueLaunched in September 2012 and funded by the Foundation For Excellence in Mental Health Care, 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:

1.  A psychotherapy-focused manual and fidelity tool for clinical interactions with individuals and families

2.  A system-focused manual and fidelity tool for assessing program/organizational implementation.

Related links 
Video – Dr. Jaakko Seikkula speaks about Open Dialogue 
Madness Radio: Open Dialogue for Psychosis w/ Mary Olson 
Institute for Dialogic Practice, Haydenville, MA 
Open Dialogical Practices 
National Empowerment Center - Dialogical Recovery from Monological Medicine

Related references 
Aaltonen, J., Seikkula, J., & Lehtinen, K. (2011). Comprehensive open-dialogue approach I: Developing a comprehensive culture of need-adapted approach in a psychiatric public health catchment area the Western Lapland Project. Psychosis, 3, 179 – 191.

Olson, M, Seikkula, J. & Ziedonis, D. (2014). The key elements of dialogic practice in Open Dialogue. The University of Massachusetts Medical School. Worcester, MA.

Seikkula, J., Aaltonen, J., Alakare, B., & Haarakangas, K. (2006). Five-year experience of first-episode nonaffective psychosis in open-dialogue model. Psychotherapy Research, 16(2), 214-228.

Seikkula, J., Alakare, B., & Aaltonen, J. (2011). The comprehensive open-dialogue approach(II). Long-term stability of acute psychosis outcomes in advanced community care: The Western Lapland Project. Psychosis, 3, 1–13.

Seikkula, J. & Olson, M. (2003). The open dialogue approach: Its poetics and micropolitics. Family Process, 42, 403-418.

Project Team 
Douglas Ziedonis, MD, MPH 
Mary Olson, PhD 
Jaakko Seikkula, PhD 
Jonathan Delman PhD, JD, MPH 
Daniel Fisher, MD, PhD 
Kathleen Biebel, PhD
Carl Fulwiler, MD, PhD 
Eileen Small, MSW
Makenzie Tonelli, BA
Daniel Breslin, MD
Zlatina Kostova, PhD
Boris Lorberg, MD
Yanli Luo, MD, PhD

For more information on the UMMS Open Dialogue global collaboration project, please contact Eileen Small, Project Director, Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, S7-734, (p) 508-856-6472|(f) 508-856-6621.

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