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对话是对社会精神医学化的回应?开放对话方法的潜力。

Dialogue as a Response to the Psychiatrization of Society? Potentials of the Open Dialogue Approach.

作者信息

von Peter Sebastian, Bergstrøm Tomi, Nenoff-Herchenbach Irene, Hopfenbeck Mark Steven, Pocobello Raffaella, Aderhold Volkmar, Alvarez-Monjaras Mauricio, Seikkula Jaakko, Heumann Kolja

机构信息

Medical School Brandenburg, Rüdersdorf, Germany.

Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.

出版信息

Front Sociol. 2021 Dec 22;6:806437. doi: 10.3389/fsoc.2021.806437. eCollection 2021.

Abstract

In recent decades, the use of psychosocial and psychiatric care systems has increased worldwide. A recent article proposed the concept of psychiatrization as an explanatory framework, describing multiple processes responsible for the spread of psychiatric concepts and forms of treatment. This article aims to explore the potentials of the Open Dialogue (OD) approach for engaging in less psychiatrizing forms of psychosocial support. While OD may not be an all-encompassing solution to de-psychiatrization, this paper refers to previous research showing that OD has the potential to 1) limit the use of neuroleptics, 2), reduce the incidences of mental health problems and 3) decrease the use of psychiatric services. It substantiates these potentials to de-psychiatrize psychosocial support by exploring the OD's internal logic, its use of language, its processes of meaning-making, its notion of professionalism, its promotion of dialogue and how OD is set up structurally. The conclusion touches upon the dangers of co-optation, formalization and universalization of the OD approach and stresses the need for more societal, layperson competencies in dealing with psychosocial crises.

摘要

近几十年来,心理社会和精神科护理系统在全球范围内的使用有所增加。最近一篇文章提出了“精神病化”的概念作为一种解释框架,描述了导致精神病学概念和治疗形式传播的多个过程。本文旨在探讨开放对话(OD)方法在开展较少精神病化形式的心理社会支持方面的潜力。虽然开放对话可能不是去精神病化的全面解决方案,但本文参考了先前的研究,表明开放对话有潜力:1)限制抗精神病药物的使用;2)降低心理健康问题的发生率;3)减少精神科服务的使用。通过探究开放对话的内在逻辑、其语言运用、意义构建过程、专业主义观念、对对话的促进以及其结构设置方式,本文证实了开放对话在使心理社会支持去精神病化方面的这些潜力。结论涉及开放对话方法被吸纳、形式化和普遍化的风险,并强调在应对心理社会危机方面需要更多的社会大众能力。

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