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Free Content Open Dialogue Approach: Treatment Principles and Preliminary Results of a Two-Year Follow-Up on First Episode Schizophrenia

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As part of the Need-Adapted Finnish model, the Open Dialogue (OD) approach aims to treat psychotic patients in their home. Treatment involves the patient's social network, starts within 24 hours of initial contact, and responsibility for the entire treatment rests with the same team in inpatient and outpatient settings. The general aim is to generate dialogue to construct words for the experiences in psychotic symptoms. As part of the Finnish national Acute Psychosis Integrated Treatment multicenter (API) project, patients from the initial phase of OD (API group, n = 22) were compared historically with patients from the later phase of OD (ODAP group, Open Dialogue in Acute Psychosis, n = 23). Then, the API and ODAP groups were compared separately with schizophrenic patients (comparison group, n = 14) from another API research center who were hospitalized and received conventional treatment. Hospitalizations in the ODAP group were shorter than in the API group. However, API patients were hospitalized for fewer days, family meetings were organized more often and neuroleptic medication was used in fewer cases than in the comparison group. Also, patients in the ODAP group had fewer relapses and less residual psychotic symptoms and their employment status was better than patients in the comparison group. The OD approach, like other family therapy programs, seems to produce better outcomes than conventional treatment, given the decreased use of neuroleptic medication.
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Document Type: Journal Article

Affiliations: 1: Universities of Jyväskylä and Tromso Finland 2: Western Lapland Health District and University of Oulu Finland 3: University of jyväskylä Finland 4: STAKES, National Research and Development Center for Welfare and Health Helsinki, Finland

Publication date: 2003-01-01

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