Open Dialogue for Psychosis: Organising Mental Health Services to Prioritise Dialogue, Relationship and Meaning

Edited By  Nick Putman & Brian Martindale Copyright Year 2021


Book Description

This highly readable book provides a comprehensive examination of the use of Open Dialogue as a treatment for psychosis. It presents the basic principles and practice of Open Dialogue, explains the training needed to practice and explores how it is being developed internationally.

Open Dialogue for Psychosis includes first-hand accounts of the process by people receiving services due to having psychotic experiences, their family members and professionals who work with them. It explains how aspects of Open Dialogue have been introduced in services around the world, its overlap with and differentiation from other psychological approaches and its potential integration with biological and pharmacological considerations. The book concludes with a substantive section on the research available and its limitations.

Open Dialogue for Psychosis will be a key text for clinicians and administrators interested in this unique approach, particularly those who recognise that services need to change for the better and are seeking guidance on how this can be achieved. It will also be suitable for people who have experienced psychosis and members of their families and networks.

Table of Contents


SECTION 1: Introducing Open Dialogue  1. What is Open Dialogue? 

2. The historical development of Open Dialogue in Western Lapland 

3. Psychosis is not an illness but a response to extreme stress – dialogue is a cure for it  

SECTION 2: Personal, family and professional experiences of Open Dialogue  Editors’ introduction 

4. Our son is ‘coming back’: a dialogical-network approach to a young adult diagnosed with schizoaffective disorder 

5. The experience of a family Open Dialogue approach – a sister and practitioner refl ect one year after discharge from services 

6. Psychotic behaviour: symptom of a (brain) disease or an attempt at adjustment? 

7. The stress of tolerating uncertainty: emails can help! 

8. Rooted in love – a journey through a dark time with a teenager and his family 

9. Open Dialogue as a point of entry to reconnect to the real world of relationships 

10. Permission to speak!  

SECTION 3: Open Dialogue training, including reflections from trainers and participants and adaptations in different settings  Editors’ introduction 

11. Introducing Open Dialogue training 

12. Reflections on the dialogical design of the three/ four-year Open Dialogue training 

13. Reflections on participating in the three-year Open Dialogue training 

14. Thirteen years of running Open Dialogue foundation training programmes 

15. Reflections from participants on an Open Dialogue foundation training 

16. Being ‘in rhythm’ with participants during dialogical training 

17. Personal refl ections on the Italian Open Dialogue training 

18. UK NHS Peer- supported Open Dialogue training  

SECTION 4: Introducing Open Dialogue in different contexts in various countries  Editors’ introduction 

19. Open Dialogue in Germany – opportunities and challenges 

20. Open Dialogue in the Italian national health service: a view from the borderland 

21. The challenges of introducing Open Dialogue into a UK Early Intervention in Psychosis Service 

22. Two Open Dialogue programmes at Advocates, Framingham, Massachusetts, USA 

23. Implementing Open Dialogue- informed practices at the counselling service of Addison County in Vermont, USA 

24. Migrant families: experiences using the Open Dialogue approach 

25. Peer workers in Open Dialogue 

26. The challenge of developing Open Dialogue in hospital settings 

27. Open Dialogue behind ‘closed doors’ (a locked ward)  

SECTION 5: Opening the dialogue with other approaches  Editors’ introduction 

28. Working with Open Dialogue within the neurobiological model – challenges and opportunities 

29. Systemic therapy and Open Dialogue 

30. Open Dialogue and cognitive behavioural therapy (CBT) 

31. Extending need- adapted interventions in a contemporary Open Dialogue service in Helsinki 

32. Interfamily therapy: application of dialogical practices in the multifamily group 

33. Psychoanalysis and Open Dialogue 

34. The affinities between therapeutic communities and Open Dialogue 

35. Open Dialogue and music therapy  

SECTION 6: Research into Open Dialogue  Editors’ introduction 

36. Research into the need- adapted treatment approach to psychosis 

37. Research from Western Lapland of Open Dialogue for psychosis 

38. Open Dialogue adherence and fidelity tools 

39. The UK ODDESSI trial 

40. Research into a Peer-supported Open Dialogue service in the UK 

41. Open Dialogue for psychosis in five Danish municipalities – results and experiences 

42. Researching whether Finnish Open Dialogue transfers to the Italian mental health system 

43. A feasibility study of adapting Open Dialogue to the US health context: the Collaborative Pathway at Advocates, Massachusetts, USA 

44. The Parachute Project NYC – the project and outcomes of the Brooklyn mobile team 

45. Open Dialogue research in Ireland 

46. Anthropological research into Open Dialogue in Berlin 

47. Openness and authenticity in the Open Dialogue approach 




Nick Putman Nick is a psychotherapist and an Open Dialogue practitioner, supervisor and trainer. He trained as a psychotherapist at the Philadelphia Association (PA) in London, living and working in therapeutic communities run by the PA and Arbours during his training. He now works in private practice and, due to a desire to see changes in the approach taken in public mental health services, established Open Dialogue UK in 2013 in order to develop trainings for staff working in such services, as well as services for families and networks.
Brian is a psychiatrist and a psychoanalyst. He is past chair of ISPS (International Society for Psychological and Social Approaches to Psychosis) and founding editor of the ISPS book series. He co-founded the European Federation of Psychoanalytic Psychotherapy (EFPP) and has represented the Western European Zone to the World Psychiatric Association. He has considerable clinical experience in early intervention in psychosis and has published and lectured widely.

Brian Martindale is a psychiatrist and psychoanalyst based in the UK. He is past Chair of the International Society for Psychological and Social Approaches to Psychosis (ISPS) and co-founder of the European Federation of Psychoanalytic Psychotherapy (EFPP).


“This is a much needed, timely book that provides the first account of the international implementation and adaptation of the Open Dialogue approach to promoting recovery among persons experiencing psychosis. Spanning theoretical, training, and research perspectives – with the welcome addition of first person accounts from providers, persons in recovery, and their loved ones – this comprehensive introduction is sure to hasten the spread of the first radically new approach to psychosis the field has seen in decades.” – Professor Larry Davidson, Yale University, USA

“Open Dialogue is one of the most optimistic developments in the care of people with mental illness in the last three decades… This book is vital in explaining what it is, what training is necessary, the experience of service users and the key research related to this approach. I recommend it to all mental health practitioners and those with lived experience.” – Adrian James, President, Royal College of Psychiatrists, UK

“This book is the most complete description available of Open Dialogue… The authors convincingly illustrate that Open Dialogue should play an essential role in any treatment for psychosis and the organisation of services. I heartily recommend this book.” – Ludi Van Bouwel, Chair, ISPS

“With this book Putman and Martindale aimed to create a comprehensive and thoughtful exploration of the Open Dialogue approach to psychosis and its wider application within mental health services – and they have delivered spectacularly… For the Family Therapy field, this book will make its mark as an excellent resource for practitioners, researchers, clinical training programmes and service commissioners.” – Monica Whyte, President, EFTA

For help in Australia

Salvation Army Care Line     1300 36 36 22

Reach Out

Headspace     Register and chat now at eheadspace, or call 1800 650 890  Headspace

Lifeline    13 11 14

Mensline Australia 1300 78 99 78 (24 hour phone counselling and referral)

Beyond Blue 1300 22 46 36

Mates in Construction: 1300 642 111

QLife        1800 184 527    Phone & Chat  3.00 pm – 12.00 pm everyday

SANE Australia help

SANE Australia Helpline  Chat –  Talk to a mental health professional (weekdays, 10 am-10 pm Australian Eastern Standard Time) 1800 187 263

Kids Help Line 1800 55 1800 (24 hour phone counselling)

Suicide Call Back Service 1300 659 467 (Professional call back service referral line operates seven days a week)

Veterans Line 1800 011 046 (after hours professional telephone crisis counselling for veterans and their families

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