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Open Dialogue: An Alternative, Finnish Approach to Healing Psychosis

Open Dialogue: An Alternative, Finnish Approach to Healing Psychosis

Daniel Mackler


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In the far north of Finland, a stone's throw from the Artic Circle, a group of innovative family therapists converted the area's traditional mental health system, which once boasted poor outcomes for schizophrenia, into one that now gets the best statistical results in the world for first-break psychosis. They call their approach Open Dialogue.

Their principles, though radical in this day and age of multi-drug cocktails and involuntary hospitalization, are surprisingly simple. They meet clients in crisis immediately and often daily until the crises are resolved. They avoid hospitalization and its consequential stigma, preferring to meet in clients' homes. And, perhaps most controversially, they avoid the use of antipsychotic medication whenever possible. The also work in  groups because they view psychosis as a problem involving relationships. They include clients' families and social networks in the treatment process, and their clinicians work in teams, not as isolated, sole practitioners. Additionally, their whole approach values the voice of everyone in the process, most especially the client. And finally, they provide their services, which operate within the context of Finnish socialized medicine, for free.

Open Dialogue weaves together interviews with psychiatrists, psychologists, nurses and journalists to create a powerful vision of medication-free recovery and a hard-hitting critique of traditional psychiatry.


Daniel Mackler

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