-
摘要: 通过系统翻阅文献、书籍、相关纪实资料的方法,展现“开放式对话”作为一种精神疾病的干预模式,在芬兰北部西拉普兰地区的实践起源。阐释其对于对话哲学的独特理解以及精神疾病形成的哲学观、独特治疗理念、对于传统以药物为主导的精神疾病治疗的反思。而后,介绍其基本工作流程、七项核心原则、相关治疗效果研究、在世界其他地区的发展现状,并最终从对话哲学以及精神医学治疗等角度做出总结与展望,以期为我国精神卫生体系建设提供一定的参考。Abstract: To present "Open Dialogue" as an intervention model for mental illness originated from the northern Finnish West Laplan region, literatures, books, and relevant chronicle data were systematically reviewed. The paper illustrates a unique understanding of the philosophy of dialogue as well as the philosophies that shape mental illness, its unique treatment concepts, and the reflections on traditional drug-led treatment of mental illness. Then, it introduces the basic workflow, seven core principles, related research on therapeutic effects, the current state of development in other regions of the world. A summary and outlook are presented afterwards from the perspectives of dialogue philosophy as well as treatment of mental health system in China, to provide some reference for the construction of mental health system.
-
Keywords:
- open dialogue /
- mental disease /
- psychology
-
[1] FREEMAN A M, TRIBE R H, STOTT J, et al. Open Dialogue: A Review of the Evidence[J]. Psychiatr Serv, 2019, 70(1): 46-59. doi: 10.1176/appi.ps.201800236
[2] BERGSTRÖM T, SEIKKULA J, ALAKARE B, et al. The family-oriented open dialogue approach in the treatment of first-episode psychosis: Nineteen-year outcomes[J]. Psychiatry Res, 2018, 270: 168-175. doi: 10.1016/j.psychres.2018.09.039
[3] SEIKKULA J, AALTONEN J, ALAKARE B, et al. Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies[J]. Psychother Res, 2011, 16(2): 214-228.
[4] 赛库拉, 昂吉尔. 开放对话•期待对话: 尊重他者当下的他异性[M]. 吴菲菲, 译. 台北: 心灵工坊文化, 2016.
[5] VON PETER S, ADERHOLD V, CUBELLIS L, et al. Open Dialogue as a Human Rights-Aligned Approach[J]. Front Psychiatry, 2019, 10: 387.
[6] LEHTINEN K. Need-adapted treatment of schizophrenia: Family interventions[J]. Br J Psychiatry Suppl, 1994(23): 89-96.
[7] ANTIINEN E, KOKKOLA A. Treatment and rehabilitation of schizophrenic psychoses: The Finnish treatment model[J]. Nord J Psychiatry, 1990, 44(22): 363-372.
[8] VON PETER S, BERGSTRØM T, NENOFF-HERCHENBACH I, et al. Dialogue as a Response to the Psychiatrization of Society?: Potentials of the Open Dialogue Approach[J]. Front Sociol, 2021, 6: 806437. doi: 10.3389/fsoc.2021.806437
[9] VAN DORN A. Mental health and human rights[J]. Lancet Psychiatry, 2016, 3(12): 1108. doi: 10.1016/S2215-0366(16)30364-9
[10] 李凌江, 陆 林. 精神病学[M]. 3版. 北京: 人民卫生出版社, 2015: 257-313.
[11] SEIKKULA J. Psychosis Is Not Illness but a Survival Strategy in Severe Stress: A Proposal for an Addition to a Phenomenological Point of View[J]. Psychopathology, 2019, 52(2): 143-150. doi: 10.1159/000500162
[12] BERGSTØM T, SEIKKULA J, HOLMA J, et al. How Do People Talk Decades Later about Their Crisis that We Call Psychosis?[J]. Psychosis, 2019, 11(2): 105-115. doi: 10.1080/17522439.2019.1603320
[13] SEIKKULA J. Long-term Use of Medication is Based on Myths and Lack of Other Skills to Help People in Most Severe Crises: Commentary to the Article of Peter Goetzsche[J]. Clin Neuropsychiatry, 2021, 18(2): 109-110.
[14] BERGSTRÖM T, TASKILA J J, ALAKARE B, et al. Five-year cumulative exposure to antipsychotic medication after first-episode psychosis and its association with 19-year outcomes[J]. Schizophr Bull Open, 2020, 1(1): sgaa050. doi: 10.1093/schizbullopen/sgaa050
[15] SEIKKULA J, AALTONEN J, ALAKARE B, et al. Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies[J]. Psychother Res, 2006, 16(2): 214-228. doi: 10.1080/10503300500268490
[16] MONCRIEFF J, LEO J. A systematic review of the effects of antipsychotic drugs on brain volume[J]. Psychol Med, 2010, 40(9): 1409-1422. doi: 10.1017/S0033291709992297
[17] GØTZSCHE P C. Long-term use of benzodiazepines, stimulants and lithium is not evidence-based[J]. Clin Neuropsychiatry, 2020, 17(5): 281-283.
[18] SEIKKULA J, ALAKARE B, AALTONEN J. The comprehensive open-dialogue approach in Western Lapland: II: Long-term stability of acute psychosis outcomes in advanced community care[J]. Psychosis, 2011, 3(3): 192-204. doi: 10.1080/17522439.2011.595819
[19] GALBUSERA L, KYSELO M. The difference that makes the difference: A conceptual analysis of the open dialogue approach[J]. Psychosis, 2018, 10(1): 47-54. doi: 10.1080/17522439.2017.1397734
[20] AALTONEN J, SEIKKULA J, LEHTINEN K. The comprehensive open-dialogue approach in Western Lapland: I: The incidence of non-affective psychosis and prodromal states[J]. Psychosis, 2011, 3(3): 179-191. doi: 10.1080/17522439.2011.601750
[21] BUUS N, ONG B, EINBODENR, et al. Implementing Open Dialogue approaches: A scoping review[J]. Fam Process, 2021, 60(4): 1117-1133. doi: 10.1111/famp.12695
[22] SEIKKULA J, ALAKARE B, AALTONEN J. Open dialogue in psychosis I: An introduction and case illustration[J]. J Constr Psychol, 2001, 14(4): 247-265.
[23] ALANEN Y O. Towards a more humanistic psychiatry: Development of need-adapted treatment of schizophrenia group psychoses[J]. Psychosis, 2009, 1(2): 156-166. doi: 10.1080/17522430902795667
[24] ANDERSON H. Collaborative relationships and dialogic conversations: Ideas for a relationally responsive practice[J]. Fam Process, 2012, 51(1): 8-24. doi: 10.1111/j.1545-5300.2012.01385.x
[25] SEIKKULA J. Open dialogue integrates individual and systemic approaches in serious psychiatric crises[J]. Smith Coll Stud Soc Work, 2003, 73(2): 227-245. doi: 10.1080/00377310309517683
[26] PIIPPO J, AALTONEN J. Mental health care: Trust and mistrust in different caring contexts[J]. J Clin Nurs, 2008, 17(21): 2867-2874. doi: 10.1111/j.1365-2702.2007.02270.x
[27] HOLMESLAND A L, SEIKKULA J, HOPFENBECK M. Inter-agency work in Open Dialogue: The significance of listening and authenticity[J]. J Interprof Care, 2014, 28(5): 433-439. doi: 10.3109/13561820.2014.901939
[28] ULLAND D, ANDERSEN A J W, LARSEN I B, et al. Generating dialogical practices in mental health: Experiences from Southern Norway, 1998–2008[J]. Adm Policy Ment Health, 2014, 41(3): 410-419. doi: 10.1007/s10488-013-0479-3
[29] ROSEN K, STOKLOSA J. Finland in Boston?: Applying Open Dialogue ideals on a psychotic disorders inpatient teaching unit[J]. Psychiatr Serv, 2016, 67(12): 1283-1285. doi: 10.1176/appi.ps.201600340
[30] OLSON M, SEIKKULA J, ZIEDONIS D. The key elements of dialogic practice in open dialogue: Fidelity criteria[EB/OL]. (2014-08-20)[2022-10-09]. https://www.umassmed.edu/globalassets/psychiatry/open-dialogue/fidelityfinalaugust2014.pdf.
[31] LEHTINEN V, AALTONEN J, KOFFERT T, et al. Two-year outcome in first-episode psychosis treated according to an integrated model: Is immediate neuroleptisation always needed?[J]. Eur Psychiatry, 2000, 15(5): 312-320. doi: 10.1016/S0924-9338(00)00400-4
[32] JAUHAR S, LAWRIE S M. What is the evidence for antipsychotic medication and alternative psychosocial interventions for people with acute, non-affective psychosis?[J]. Lancet Psychiatry, 2022, 9(3): 253-260. doi: 10.1016/S2215-0366(21)00293-5
[33] BERGSTRÖM T, SEIKKULA J, ALAKARE B, et al. The 10-year treatment outcome of open dialogue-based psychiatric services for adolescents: A nationwide longitudinal register-based study[J]. Early Interv Psychiatry, 2022, 16(12): 1368-1375. doi: 10.1111/eip.13286
[34] BERGSTRÖM T, SEIKKULA J, HOLMA J, et al. Retrospective Experiences of First-episode Psychosis Treatment under Open Dialogue-based Services: A Qualitative Study[J]. Community Ment Health J, 2022, 58(5): 887-894. doi: 10.1007/s10597-021-00895-6
[35] BUUS N, MCCLOUGHEN A. Client and Family Responses to an Open Dialogue Approach in Early Intervention in Psychosis: A Prospective Qualitative Case Study[J]. Issues Mental Health Nurs, 2022, 43(4): 308-316. doi: 10.1080/01612840.2021.1986758
[36] NYMAN-SALONEN P, KYKYRI V L, TSCHACHER W, et al. Nonverbal Synchrony in Couple Therapy Linked to Clients' Well-being and the Therapeutic Alliance[J]. Front Psychol, 2021, 12: 718353. doi: 10.3389/fpsyg.2021.718353
[37] PILLING S, CLARKE K, PARKER G, et al. Open Dialogue compared to treatment as usual for adults experiencing a mental health crisis: Protocol for the ODDESSI multi-site cluster randomised controlled trial[J]. Contemp Clin Trials, 2022, 113: 106664. doi: 10.1016/j.cct.2021.106664
[38] SEIKKULA J. Becoming dialogical: Psychotherapy or a way of life?[J]. Aust N Z J Fam Ther, 2011, 32(3): 179-193. doi: 10.1375/anft.32.3.179
[39] 王永祥, 潘新宁. 对话性: 巴赫金超语言学的理论核心[J]. 当代修辞学, 2012(3): 40-46.
[40] 托多罗夫. 巴赫金对话理论及其他[M]. 蒋子华, 张 萍, 译. 天津: 百花文艺出版社, 2001: 171-230.
[41] LENNON E, HOPKINS L, EINBODEN R, et al. Organizational Change in Complex Systems: Organizational and Leadership Factors in the Introduction of Open Dialogue to Mental Health Care Services[J]. Community Ment Health J, 2022, 59(1): 95-104.
[42] 陈润滋, 吴霞民, 马 宁. 中国2009-2019年的精神卫生政策与实施[J]. 中国心理卫生杂志, 2020, 34(7): 555-560.
[43] 郭 桦, 杨 波, 谭小林. 精神分裂症社区康复模式的研究进展[J]. 神经疾病与精神卫生, 2022, 22(5): 337-341.
计量
- 文章访问数: 413
- PDF下载数: 240
- 施引文献: 0