Open Dialogue adopted in Vermont, USA

Leading the project is Dr. Sandra Steingard, the Howard Center’s medical director of mental health and substance abuse services. For much of her 30-year career, Steingard largely accepted the mainstream thinking of the American psychiatric community — that antipsychotic medications are a critical tool in treating people who are delusional or hearing voices.

Last summer, Steingard traveled to Finland for preliminary training in Open Dialogue. Patient outcomes in that country are almost exactly opposite of those in the United States: After five years, about 80 percent of patients are fully recovered from their first-episode psychoses and are back at work. In Finland, where antipsychotic drugs aren’t prescribed as much as in the U.S., only one in five patients require any maintenance meds — or those taken continuously — at all.“They’re not really seeing schizophrenia in Finland. They’re seeing the same number of people coming in with acute psychosis,” Steingard says, “but people are getting better.”

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