דפ"י

Open Dialogue (OD) is an innovative method for treating acute mental crises at the client's home, which was developed in Finland in the 1980s. The dialogic treatment is offered to social networks – including family and friends from the client's organic community.

The approach responds to acute situations by empowering the networks to find their strengths and resilience to cope with the crisis and with the great uncertainty it brings with it. Open Dialogue is a trauma-informed and recovery-oriented approach, in which a stance of respect and partnership is given to the person in crisis, as well as to the additional members of their natural supportive network.

The therapeutic meeting in OD takes place at the family's/ supportive community’s home, or another location of their choice, in a multi-participant discussion circle. The treatment emphasizes a systemic view, respect, transparency, and joint decision-making in the therapeutic process. In addition to the OD team, members of the person's social network of their choice participate in the meeting. They are full partners in the recovery process and take an active part in the meetings.
In Open Dialogue, at least two team members from a variety of mental health professions who have been trained in the approach meet the family.

OD is an evidence-based approach – in a 19 year longitudinal study comparing OD treatment to standard psychiatric treatment in Finland, it was found that Open Dialogue treatment prevented the worsening of symptoms among patients. These were reflected in a decrease in the need for hospitalization and the need for disability benefits. The approach is being implemented in more than 13 countries worldwide, and its efficiency and humanity are widely acknowledged in the field of mental health.

Graduates of the annual training program in Open Dialogue, all from mental health professions, will work nationwide according to the principles of Open Dialogue and provide systemic-family intervention to those in need, at the family home.

The intervention will adhere to the principles of Open Dialogue treatment:

• Hour and a half meetings, with two OD professionals who hold the therapeutic spaceand facilitate it
• The meeting is for a social network: family/group of friends/ couple/ parents or any other relevant composition for the person seeking help. 
• Need-adapted treatment: The topics of conversation will be determined by the network, and the dialogue will help uncover  new meanings and develop new understandings and possibilities that were not available before. 
• The network will receive a service of Open Dialogue that will last up to 24 meetings as a first step. This is in order to create a psychological continuity and sufficient processing of events, from the initial stage to the connection to other supportive factors, as needed for further treatment and empowerment.
• Flexibility and mobility: The therapeutic teams will come to meet the service recipients wherever they are, even if it changes over time. Additionally, there will be an option to meet online.
  
  

The Israeli public mental health system is able to provide assistance for the margins – clinical treatment, psychiatric hospitalization, and day hospitalization – alongside a very limited number of halfway houses for mental health patients. As of today, there is a lack of services that allow a person to receive intensive treatment without separating themselves from their surroundings. In addition to the existing range of community services focused on individual treatment, there is an acute need for a service to provide support to the family and social network together with the individual.

Many of the people who were already exposed to trauma are at risk of developing PTSD – between 15-30% out of approximately 8,000 individuals. Clinical or therapeutic treatment will not be sufficient for many of them. Through our project, they will be able to receive intensive care in their natural environment. In its absence we believe that this population may end up in psychiatric hospitalization.

National trauma, to which individuals were collectively exposed, affects many social network members, and the network or family's ability to support those within it. Therefore, especially at this time, it is important to adopt an approach that gives key importance to the network's recovery as a group. This is a unique characteristic of the Open Dialogue approach, in contrast to all other approaches to crisis mental health treatment.

The graduates of ODI are already working privately with networks, accompanying acute crisis situations. Support for the project will enable ODI to establish a professional framework for the therapists and make treatment accessible through donation funding, with the hope of establishing a sustainable solution in the next phase and obtaining state funding.

These days, ODI is submitting the project for support from foundations and other interested parties both in Israel and abroad. We hope that after securing initial operational funding, we will also be able to offer the model for funding through the state health insurance funds. These will not be our first contacts with the health insurance funds regarding the services of Open Dialogue. The Ministry of Health has already recognized the need to subsidize these treatments.

We believe that this is the call of the hour, and that we will be able to convince at least one health fund to continue funding the project for its clients for a period of six months.

If you know any foundation or philanthropic source who might be interested in donating to this project, kindly introduce us via E-mail: info@opendialogue.co.il