Open Dialogue is alive and well in Massachusetts. Since 2011, when Advocates was the first recipient of funding support from the Foundation for Excellence in Mental Health Care, Advocates has been providing Open Dialogue services in two programs based in Framingham, Massachusetts.
Advocates is a full-service, not for profit provider of services and supports to people with psychiatric conditions, developmental and other cognitive disabilities, substance use conditions, and other life challenges, offering residential supports, outpatient and emergency services, among other supports, all dedicated to the idea that everyone, regardless of diagnosis or disability, can live a full, challenging and rewarding life of their own design, given the right supports.
With the initial support from the Foundation for Excellence in Mental Health Care, and with additional support, particularly from the Department of Mental Health, Advocates was able to train 35 staff members at the preeminent training site for Open Dialogue in the US, the Institute for Dialogic Practice under the direction of Dr. Mary Olson, currently affiliated with Yale University.
We then launched two programs – one for young people experiencing early episode psychosis, called The Collaborative Pathway; the other for people receiving services from the Department of Mental Health, whose difficulties had become or were at risk for becoming more chronic, called Open Dialogue in Behavioral Health Services. With support from the Cummings Foundation, and ongoing support from the Department of Mental Health, both programs have been delivering Open Dialogue Services for nearly ten years.
Read MoreOn July 2 and 3, 2019, I was privileged to attend the first meeting of the HOPEnDialogue International Research Collaborative in Rome. I attended as a representative of the Board of the Foundation for Excellence in Mental Health Care, along with the Foundation’s President and CEO, Gina Nikkel, and the Foundation’s new Chief Philanthropy Officer, Kevin Aspegren.
The meeting was hosted by the leaders of the project, Raffaella Pocobello and Giuseppe Salamina, and brought together forty representatives from 12 countries, first in an open forum to discuss the goals and overarching strategy of the project, and a second day for the 20 international members of the Advisory Council to address more focused challenges, such as site selection requirements; inclusion/exclusion criteria; training; fidelity; and outcomes.
Read MoreSeveral years ago, a person whom I was serving as a psychiatrist changed my life. This man had been a participant for some years in the services of the non-profit where I work, Advocates in Framingham, Massachusetts.
He had spent years going in and out of hospitals, for what doctors called bipolar disorder, but what he himself experienced as periods of great spiritual elation (which clinically looked like mania) alternating with what he described as “spiritual hibernation” (which looked like severe depression).
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The Collaborative Pathway is a replication and adaptation of Open Dialogue at Advocates, Inc., the human services agency in Framingham, Massachusetts, where I serve as Medical Director. Last week, our team (Chris Gordon, Vasudha Gidugu, Sally Rogers, John DeRonck, and Doug Ziedonis) published an article in the Best Practices column of the journal Psychiatric Services, describing the program and our results from the first cohort of young people and families experiencing a psychotic crisis.
This is the first published adaptation of Open Dialogue in the U.S. and represents the culmination of several years of planning, training and direct service. None of it would have been possible without generous initial funding from the Foundation for Excellence in Mental Health Care.
We provided our services to 16 young people and families over a period of one year. Most have continued to receive services after the study period, so we have more substantial follow-up data than was published in this initial paper. It’s hard to draw many conclusions about Open Dialogue from such a small sample, but I would like to share some of the promising lessons we’ve learned along the way:
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