Relationships Australia NSW, Sydney, New South Wales, Australia.
Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Fam Process. 2021 Dec;60(4):1117-1133. doi: 10.1111/famp.12695. Epub 2021 Jul 28.
Open Dialogue approaches fall broadly into the area of systemic psychotherapeutic practices. They encourage active participation of families and social networks, and emphasize genuine collaboration within highly integrated systems of health-care service delivery. These approaches are currently being implemented in a growing number of services across the globe, and in this review, we summarize and discuss insights from papers concerned with the implementation of Open Dialogue. We used a scoping review method, which included systematic literature searches and summarizing data extraction as well as consultation with eight Open Dialogue implementation stakeholders who were invited to comment on preliminary review findings and a draft paper. We included 18 studies in the review and present their content under four thematic headings: 1. Training, 2. Family and network experiences, 3. Staff members' experiences, and 4. Structural and organizational barriers and resistance to implementation. In general, the studies did not include rich descriptions of the implementation contexts, which made it difficult to draw conclusions across studies about effective implementation practices. The discussion draws on Jamous and Peloille's (Professions and professionalisation, 1970, Cambridge University Press, 109-152) concepts of "indeterminacy" and "technicality," and we argue that the indeterminacy that dominates Open Dialogue is a challenge to implementation efforts that favor specific and standardized practices. We conclude by encouraging the development of implementation initiatives that theorize Open Dialogue practices with higher levels of technicality without corrupting the fundamental spirit of the approach.
开放对话方法广泛属于系统心理治疗实践领域。它们鼓励家庭和社交网络的积极参与，并强调在高度整合的医疗服务提供系统内进行真正的协作。这些方法目前在全球越来越多的服务中得到实施，在本综述中，我们总结并讨论了与开放对话实施相关的论文的见解。我们使用了范围综述方法，包括系统文献搜索和数据提取总结，以及邀请八位开放对话实施利益相关者进行磋商，以对初步综述结果和一份草案进行评论。我们综述了 18 项研究，并根据四个主题标题介绍了它们的内容：1. 培训，2. 家庭和网络体验，3. 工作人员的经验，以及 4. 结构和组织障碍以及对实施的抵制。总体而言，这些研究没有详细描述实施背景，这使得难以从研究中得出关于有效实施实践的结论。讨论借鉴了 Jamous 和 Peloille（职业和专业化，1970，剑桥大学出版社，109-152）的“不确定性”和“技术性”概念，我们认为，主导开放对话的不确定性是对支持具体和标准化实践的实施努力的挑战。最后，我们鼓励制定实施倡议，以更高的技术性来构建开放对话实践，而不会损害该方法的基本精神。
