Abstract
Implementation of Dialogical Sequence Analysis as a Case Formulation for the Assessment of Patients at a Community Mental Health Centre: Randomized Controlled Pilot Study
Highlights
We implemented a case formulation method, which is based on dialogical sequence analysis (DSA) in a community mental health center
Our aims were: 1) to determine how the DSA-based case formulation and the standard approach differed in terms of collaboration, especially in terms of patient and professional congruence concerning the goals and tasks of assessment; and 2) to examine whether there were any differences in the time and resources needed between the individualised and patient-focused assessment and the standard psychiatric assessment processes
The total score and all subscale Working Alliance Inventory (WAI) scores separately rated by clinicians and patients correlated significantly in the DSA group, whereas in the AAU group the only significant – albeit weaker – correlation was found in the WAI Bond subscale (Figure 3)
Summary
We implemented a case formulation method, which is based on dialogical sequence analysis (DSA) in a community mental health center. We report a randomized clinical study in which we compare DSA-based and standard psychiatric assessments. In addition to causing suffering to patients and their families, mental disorders place a burden on societies around the world. The aetiology and the pathophysiology of psychiatric illnesses are still mostly unidentified; the diagnostics of mental disorders are mainly determined (e.g. ICD-11 and DSM-5) by symptoms and as syndromes (World Health Organization 2018; American Psychiatric Association 2013). CRADDOCK and MYNORS-WALLIS (2014) state that psychiatric diagnosis is necessary and important, but the ‘diagnosis alone is insufficient in conceptualising psychopathology in any individual patient. In a quite recent editorial, MAJ (2018) suggested that the current diagnostic classifications would be complemented systematically with alternative approaches promoting the patients’ individual therapeutic management and prediction of outcome
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