Podejście terapeutyczne oparte na Otwartym Dialogu – o fenomenie skandynawskiej psychiatrii

Abstract

After twenty years of transformation of Finnish mental health care, in the late 80s and early 90s of the last century, incidence of schizophrenia in Western Lapland dropped from 35/100,000 to 7/100,000. This phenomenon is linked with Yrjo O. Alanen et al. who investigated schizophrenia treatment outcomes and psychosocial rehabilitation of people with schizophrenia. Investigators focused on an individually tailored psychotherapeutic recovery plan during patient's hospitalization, including care for patients' families. Within the "Finnish National Schizophrenia Project" the principles of the Need-Adapted Treatment were created and 50% of Finland's country gained access to mobile crisis intervention teams. Further studies were continued within "Acute PsychosisIntegrated Treatment Project" (1992-1993) which locally, in Western Lapland, proceeded into "Open Dialogue in Acute Psychosis Project" (ODAP) (1994-1997). In this approach, all important decisions regarding the patient, including hospitalization or pharmacotherapy, are discussed not only with the entire therapeutic team, but also with the patient and his family members. Two - and five-year follow-ups demonstrated high treatment efficacy as well as important cost reduction in mental health care spending. First two"Open Dialogue Method" training courses for representatives of the medical, psychological, nursing and social care have been completed in Poland in October 2014. Studies evaluating the therapeutic effectiveness of the described approach are being planned.