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Conducting a family assessment
Published in Chambers Mary, Psychiatric and mental health nursing, 2017
Catherine Gamble, Christine Lewis, John Baker, Ruth Allen
Confidentiality is generally not broken when practices are openly shared and inclusive and all parties know how decisions have been made. Indeed, there is a growing evidence base developed in Finland that demonstrates the value of routinely including families and people’s social networks and taking an ‘Open Dialogue’ approach. In the 1980s psychiatric services in Western Lapland dealt with one of the highest incidences of schizophrenia in Europe. By using ‘Open Dialogue’ approaches, that is supporting people’s networks of family and friends as well as respecting the decision making of the individual with psychosis, they now report significantly better outcomes. For example, around 75 per cent of those experiencing psychosis have returned to work or study within 2 years and only around 20 per cent still take antipsychotic medication at 2-year follow-up.37 This Finnish alternative to traditional mental health services for people diagnosed with psychosis such as schizophrenia highlights that, with appropriate support, families and friends can bear extreme crisis situations and tolerate the uncertainty, so that in time shared meaning usually emerges, stigma reduces and thus a recovery paradigm is endorsed by those involved.
The Open Dialogue Approach
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Cathy Laver-Bradbury, Monica Roman-Morales
The ‘Anticipatory Meeting’ is a variation of the Open Dialogue that provides a clear co-ordination of the roles and responsibilities of the team members involved, including family members (Seikkula and Arnkil, 2006). The main principles of the Open Dialogue are followed in the Anticipatory Meeting with an emphasis on working collaboratively with families. One of the outcomes of this type of meeting is the reduction of anxiety in the family and the network system, as it offers a clear structure to the network, following the main hopes and wishes, regarding the concerns voiced by the family.
Personal narratives and the pursuit of purpose and possibility in psychosis: directions for developing recovery-oriented treatments
Published in Expert Review of Neurotherapeutics, 2023
Courtney N Wiesepape, John T Lysaker, Sarah E Queller, Paul H Lysaker
Other treatments which appear to have deep concern for personal narratives embedded in their structures include CHIME [14] and Open Dialogue [67]. CHIME is a framework for recovery-oriented treatments which emphasizes connection to others, hope, identity, meaning, and empowerment. These are clearly connected to the thematic issues of agency and community and the processes of actively making meaning of events as they unfold. Open dialogue is a family and community focused series of interventions which promote sharing persons’ accounts of their experience of the challenges of psychosis in ways that could uniquely promote the development of healthier narratives not just as experienced by the recovering person but also the others with whom they share their experiences. Of note, we offer these four treatments as examples to illustrate how this work can proceed and acknowledge that new treatments that focus on these aspects of narrative continue to be developed; for example, one novel intervention asks patients to produce and record documentary-like films of their experiences [68].
Recovery-Oriented Network Meetings in Mental Healthcare: A Qualitative Study
Published in Issues in Mental Health Nursing, 2022
Kim Jørgensen, Tonie Rasmussen, Morten Hansen, Kate Andreasson, Bengt Karlsson
Open dialogue has an element of involving the perspectives of users in a holistic manner, with open questions that clarify their needs and how professionals can help. This element corresponds with CHIME, which ensures that the professionals at the network meeting talk about personal recovery. Therefore, professionals should examine the needs that users have for help to feel connected to other people, with hope for the future, an identity as a person, finding meaning in daily life and feeling strong through empowerment. CHIME has been implemented in many Western countries and promotes an understanding of what users often need in their recovery process (Borg et al., 2013; Williams et al., 2012). Despite the theoretical suggestions for recovery, users understand the concept of experiences with mental health problems (Borg et al., 2013). This underpinning is important to clarify the user’s understanding of his or her need for recovery but CHIME can help to explore whether the five elements should be included in the user’s understanding.
Supported decision making for people with mental health disorders in clinical practice: a systematic review
Published in International Journal of Psychiatry in Clinical Practice, 2020
Louise Penzenstadler, Andrew Molodynski, Yasser Khazaal
Various possible models of implementation in different countries have been outlined. The representation agreement in Canada suggests appointing guardians chosen by the individual to support him or her in decision making. The PO scheme, introduced before the CRPD, offers the service of a PO, who actively engages with the individual in need of support over a long period in order to communicate the person’s decisions. The open dialogue model involves family, social network, and patient dialogue in all treatment decisions. The Soteria project, also dating well before the CRPD, encourages staff to spend more time with patients in order to support them in decision making and provide human support. AD were cited as an interesting means for patients to state their preferences for treatment when in a period of stability to be applied during times of crisis. Peer advocacy and support uses the experience of peers to support persons with mental health disorders in order to advocate for them in times of crisis. In South Australia, individuals can choose a person they trust to write “support agreements” under the Office of the Public Advocate. The facilitated decision-making approach is more intensive and not directly an SDM model, as it is used for persons who have significant disabilities and difficulties in communicating their decisions. The ASK ME approach proposes practically putting into action the SDM process, and two case examples were described.