The open dialogue approach for early psychotic stages. The return of family therapy in mental health Departments

Author/s Marco Bernardini
Publishing Year 2018 Issue 2018/1
Language Italian Pages 14 P. 49-62 File size 141 KB
DOI 10.3280/PSOB2018-001004
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The author, after a synthetic premise addressing the major experiences in the relational-systemic area in the early psychotic stages, deepens the therapeutic approach of public mental health services in Finland. These experiences, which began at the end of the sixties with Alanen, took a new impetus and achieved excellent clinical results in the context of the clinical intervention, thanks to the work coordinated by Seikkula, in Lapland. This work focused on the individual with psychotic onset, his family and social context which prove to be emotionally significant. The Open Dialogue Approach is then enhanced compared to the trial that has been launched in Italy through several DSMs.

Keywords: Open Dialogue Approach; Family Therapy; Reflecting Team; Self-Healing Tautology.

  1. Aaltonen J., Seikkula J., Lehtinen K. (2011) “The Comprehensive Open Dialogue Approach in Western Lapland: I. The incidence of non-affective psychosis and prodromal states”, Psychosis: Psychological, Social and Integrative Approaches, 3, 3: 179-191. DOI: 10.1080/17522439.2011.60175
  2. Alanen Y.O., Lehtinen K., Räkköläinen V., Aaltonen J. (1991) “Need-adapted treatment of new schizophrenic patients: experiences and results of the Turku Project”, Acta Psychiatr. Scand., 83(5): 363-72
  3. Andersen T. (1991) The reflecting team: dialogues and dialogues about the dialogues, Norton, New York
  4. Balter M. (2014) “Talking Back to Madness. As the search for genes and new drugs for schizophrenia stalls, psychotherapies are getting new attention”, Science, 343: 1190-1193.
  5. Bateson G. (1972) Steps to an Ecology of Mind. Collected Essays in Anthropology, Psychiatry, Evolution and Epistemology, Ballentine Books, New York
  6. Bateson G. (1979) Mind and Nature. A necessary Unity, Dutton, New York
  7. Bertrando P. (2006) “The evolution of family interventions for schizophrenia. A tribute to Gianfranco Cecchin”, Family Therapy,
  8. Boszormenyi-Nagy I., Spark G.M. (1973) Invisible loyalties. Reciprocità in intergenerational family therapy, Harper & Row, New York
  9. Jauhar S., McKenna P.J., Radua J., Fung E., Salvador R., Laws K.R. (2014) “Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias”, Br. J. Psychiatry, 204(1): 20-9.
  10. Lynch D., Laws K.R., McKenna P.J. (2010) “Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials”, Psychol Med., 40(1): 9-24. DOI: 10.1017/S003329170900590
  11. Matthew J. Page et al. (2012) “Empirical Evidence of Study Design Biases in Randomized Trials: Systematic Review of Meta-Epidemiological Studies”, PLoS One, 11(7): e0159267. Published online 2016.
  12. Grant P.M., Huh G.A., Perivoliotis D., Stoler N.M., Beck A.T. (2012) “Randomized Trial to Evaluate the Efficacy of Cognitive Therapy for Low-Functioning Patients With Schizophrenia”, Arch. Gen. Psychiatry, 69(2): 121-127.
  13. Morrison A.P., Turkington D., Pyle M., Spencer H., Brabban A., Dunn G., et al. (2014) “Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: a single-blind randomised controlled trial”, Lancet, 383: 1395-1403. DOI: 10.1016/S0140-6736(13)62246-
  14. Pezzano R.L. (2017) “L’esperienza del ‘dialogo aperto’ nel Dipartimento di Salute Mentale di Catania 4 e Caltagirone Palagonia1”, Eco Mente, 40(1): 52-60. DOI: 10.1712/2742.2795
  15. Onnis L. (2008) “L’ottica della complessità. Sviluppi e prospettive dell’orientamento sistemico”, in Petrini P., Zucconi A., La relazione che cura, Alpes Italia, Roma
  16. Onnis L. (2017) Teatri di Famiglia. La parola e la scena in terapia familiare, Bollati Boringhieri, Torino
  17. Onnis L., Galluzzo W. (1994) “La psicoterapia sistemica e I suoi attuali sviluppi nella teoria e nella pratica”, in Onnis L., Galluzzo W., La terapia relazionale e i suoi contesti, NIS, Roma
  18. Romano G., Rossi M.C. (2014) Il “dialogo aperto” un approccio innovativo nel trattamento delle crisi psichiatriche d’esordio – definizione e valutazione degli strumenti operativi ed organizzativi per la trasferibilità del “dialogo aperto” nei DSM italiani. Consultabile all’indirizzo web
  19. Rosenbaum B., Harder S., Knudsen P., Køster A., Lindhardt A., Lajer M., Valbak K., Winther G. (2012) “Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis: two-year outcome”, Psychiatry, 75(4): 331-41.
  20. Seikkula J. (2007) “Networks on networks: initiating international cooperation for the treatment of psychosis”, in Anderson H., Jensen J. (eds), Innovations in the Reflecting Process, Karnac, London and New York, pp. 125-37
  21. Seikkula J. (2008) “Inner and outer voices in the present moment of family 3. And network therapy”, J. Fam. Ther., 30: 478-91
  22. Seikkula J. (2014) (a cura di Chiara Tarantino) Il dialogo aperto. L’approccio finlandese alle gravi crisi psichiatriche, Giovanni Fioriti, Roma
  23. 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. DOI: 10.1080/17522439.2011.59581
  24. Seikkula J., Laitila A., Rober P. (2011) “Making sense of Multi-Actor dialogues in family therapy and network meetings”, J. Marital Fam. Ther., 38: 667-87.
  25. Seikkula J., Olson M. (2003) “The open dialogue approach to acute psychosis: Its poetics and micropolitics”, Family Process, 42: 403-418.
  26. Seikkula J., Trimbe D. (2005) “Healing elements of therapeutic conversation: dialogue as on embodiment of love”, Fam. Process, 44: 461-75
  27. Turner D.T., van der Gaag M., Karyotaki E., Cuijpers P. (2014) “Psychological interventions for psychosis: a meta-analysis of comparative outcome studies”, Am. J. Psychiatry, 171(5): 523-38.
  28. van der Gaag M. et al. (2012) “Cognitive Behavioral Therapy for Subjects at Ultrahigh Risk for Developing Psychosis: A Randomized Controlled Clinical Trial”, Schizophr. Bull., 38(6): 1180-1188.
  29. Wykes T., Huddy V., Cellard C., McGurk S.R., Czobor P. (2011) “A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes”, Am. J. Psychiatry, 168(5): 472-85.

Marco Bernardini, L’Open Dialogue Approach agli esordi psicotici. Il gradito ritorno della terapia familiare nei Dipartimenti di salute mentale in "PSICOBIETTIVO" 1/2018, pp 49-62, DOI: 10.3280/PSOB2018-001004