Jaakko Seikkula

University of Jyväskylä | JYU · Department of Psychology

Background The open dialogue (OD) approach includes the need-adapted use of psychiatric medication in treating first-episode psychosis (FEP), but there is limited information on how psychiatric medications are actually used in OD-based services. This study aims to analyse long-term medication dispensing patterns among FEP cohort treated according t...

Open Dialogue (OD) is an integrated approach to mental health care, which has demonstrated promising outcomes in the treatment of first-episode psychosis (FEP) in Finnish Western Lapland region. However, little is known how treatment under OD is retrospectively experienced by the service users themselves. To address this, twenty participants from t...

Background Research on interpersonal synchrony has mostly focused on a single modality, and hence little is known about the connections between different types of social attunement. In this study, the relationship between sympathetic nervous system synchrony, movement synchrony, and the amount of speech were studied in couple therapy. Methods Data...

Aim: To evaluate the 10-year treatment outcomes and cost-effectiveness of adolescents' mental health treatment initiated under the social network-oriented open dialogue (OD) approach. Methods: This longitudinal register-based study included all persons who, for the first time, received psychiatric treatment in Finland during the period 1 January...

In de psychotherapie is er sprake van een groeiende belangstelling voor non-verbale synchroniciteit (onderlinge afstemming in houding of beweging). Onderzoek heeft uitgewezen dat dit fenomeen verband houdt met de therapeutische alliantie en met het resultaat van de therapie. In de context van relatietherapie is onderzoek op dit gebied nog zeer scha...

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 Dialo...

Tässä tutkimuksessa tarkasteltiin sitä, kuinka kuusi aikuista turvapaikanhakija- ja pakolaisasiakasta kuvasivat ongelmiaan terapeuttisissa keskusteluissa. Tutkimuksen kohteena ja tiedon lähteenä olivat asiakkaiden tekemät ja tulkkien suomeksi välittämät ongelmia kuvaavat ilmaukset. Terapeuttisia keskusteluita analysoimalla pyrittiin tavoittamaan en...

Nonverbal synchrony between individuals has a robust relation to the positive aspects of relationships. In psychotherapy, where talking is the cure, nonverbal synchrony has been related to a positive outcome of therapy and to a stronger therapeutic alliance between therapist and client in dyadic settings. Only a few studies have focused on nonverba...

Rationale: Open Dialogue (OD) is an approach focused on individuals’ and networks’ potentials to provide care for people experiencing a mental health crisis. In the last years, OD has been developed in several countries with promising findings. Since 2017, the ODDESSI trial has been assessing the effectiveness of a peer-supported version of OD in t...

Research on nonverbal synchrony (movement coordination) in psychotherapy has recently attracted increased attention. Nonverbal synchrony has been shown to relate to the therapeutic alliance and outcome. However, research on nonverbal synchrony in couple therapy remains scarce. In this study, we examined the therapy process of one couple in detail a...

Background: The long-term effectiveness of antipsychotic maintenance treatment after first-episode psychosis (FEP) is contested. In this real-world observational study, we examined how cumulative exposure to antipsychotics within the first 5 years from FEP was associated with the 19-year outcome. Methods: Finnish national registers were used to...

This case study adresses the multiple meanings of a moment of strong non-verbal and bodily expression within a course of psychoanalytic psychotherapy. One therapy session was video-recorded in the private practice of the therapist-researcher. In selecting important moments for qualitative analysis, two criteria were used: 1) the moment included int...

This chapter presents a couple therapy session from four different research perspectives: The verbal dialogue was analysed with the Dialogical Investigations of Happenings of Change method, the embodied reactions of each participant were analysed by examining the electrodermal activity of each participant, and nonverbal synchrony was observed betwe...

Open dialogue is based on systematic research since the very beginning of the development. In every new phase of the development and reorganization of the psychiatric organization, research was needed for both understanding the phenomenon of the therapeutic processes and detecting the outcome of the new approach. The research is “naturalistic” in t...

Investigaciones previas han encontrado patrones comunicativos específicos en parejas que lidian con la depresión, específicamente cuando la depresión está asociada con problemas conyugales. Este hecho puede conllevar a que las parejas presenten dificultades para desarrollar una comunicación colaborativa en las sesiones, lo que supone un verdadero r...

Previous investigations have found specific communication patterns in couples dealing with depression, specifically when depression concurs with conjugal conflicts. The presence of these patterns can reflect couples' difficulties in engaging in collaborative communication during their sessions, posing a real challenge for therapists. This explorato...

Phenomenology often looks at psychosis as a defined pathological state. In this paper, psychosis is not seen as a (pathological) state but as a way to respond in extreme stress. It is psychological functioning of the embodied and relational mind, and psychotic experience can be seen as one form of affective arousal among any other affects. Taken th...

Throughout the last 20 years, the human rights perspective has increasingly developed into a paradigm against which to appraise and evaluate mental health care. This article investigates to what extent the Finnish open dialogue (OD) approach both aligns with human rights and may be qualified to strengthen compliance with human rights perspectives i...

This paper presents a case study that aims to further our understanding of the relational and embodied aspects of the psychotherapy process. One psychoanalytic session is examined on multiple levels, including talk, participants’ physiological arousal and interactional attunement, ruptures in the therapeutic alliance, postural congruence and facial...

Psychosis refers to a severe mental state that often significantly affects the individual’s life course. However, it remains unclear how people with the lived experiences themselves view these phenomena, as part of their life story. In order to evaluate this personal meaning-making process, we conducted in-depth life-story interviews with 20 people...

The authors sought to study underlying processes of alliance formation, a multimethod and multimodal research procedure was developed and applied to a 6-minute episode from one couple therapy case. The participants were a couple and two male cotherapists. The interaction was analyzed at the levels of the conversational exchange, bodily postures, an...

In previous research, we found that sympathetic nervous system synchrony, measured via electrodermal activity (EDA), occurs between participants at the start of couple therapy. The aim now was to test whether this synchrony changes during the therapy process, and how any changes may be related to clients' and therapists' evaluations of the working...

Tutkimuksen tarkoituksena oli tuottaa kuvailevaa tietoa hiljaisista hetkistä ja niiden merkityksistä riidan komplisoimassa pariterapiaistunnossa. Monimenetelmäisessä tapaustutkimuksessa terapiaistunnon hiljaisia hetkiä analysoitiin havainnoimalla keskustelua ja ei-kielellistä vuorovaikutusta videoidusta terapiaistunnosta ja tarkastelemalla osallist...

Tutkimuksessa tarkastellaan sitä, kuinka kuusi aikuista turvapaikanhakija- ja pakolaisasiakasta kuvaavat kokemiaan hyödyllisiä muutoksia luonnollisissa terapeuttisissa keskusteluissa. Asiakkaiden keskustelukäynnit kriisikeskuksen työntekijöiden luona videotallennettiin. Tutkimuksen kohteena olivat asiakkaiden esittämät ja tulkkien suomeksi välittäm...

Open Dialogue (OD) is a family-oriented early intervention approach which has demonstrated good outcomes in the treatment of first-episode psychosis (FEP). Nevertheless, more evidence is needed. In this register-based cohort study the long-term outcomes of OD were evaluated through a comparison with a control group over a period of approximately 19...

This paper explores and describes the experiences of patients, family members, and professionals with the Open Dialogue approach to network meetings at a locked psychiatric hospital unit in Norway. Previous research on Open Dialogue has mostly focused on acute crises in community care contexts. In this article, we discuss the participants' experien...

The aim of the study was to investigate whether simple guided mindfulness practices in a relationship enrichment program would lead spouses to experience physiological relaxation. Skin conductance and cardiac activity were recorded from ten healthy couples (N = 20 clients) twice during 90-min relationship enrichment sessions. To assess the usefulne...

Research on human intersubjectivity has found that humans participate in a dialogue throughout their life, and that this is manifested not only via language, but also nonverbally, with the entire body. Such an understanding of human life has brought into focus some basic systemic ideas concerning the human relational mind. For Gregory Bateson, the...

The aim of this study was to examine the extent to which intimate partner violence (IPV) is discussed in couple therapy, what the participants say about it and how, and how the participants’ electrodermal activity (EDA) is activated during these discussions. We studied four couples for whom IPV was an issue in dialog with their therapists. We used...

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single-case study comprise couple therapy process video...

The subjective experiences of participants in couple therapy have been explored through Stimulated Recall Interviews (SRIs), in which both clients and therapists come individually to watch video clips of their therapy sessions. We believe SRIs offer a good resource for Practice Oriented Research (POR) by promoting meaningful, flexible interplay bet...

Open Dialogue is a family-oriented early intervention model for mental health problems developed in the health district of Western Lapland, Finland. In the present study, the aim was to describe how psychiatric services were used in Western Lapland after decades of first-episode psychosis services, and to analyze how baseline characteristics were r...

Este artículo presenta la traducción y adaptación al idioma Español del método “Investigaciones Dialógicas de Cambio” (IDC). Este método se enmarca en el enfoque dialógico y en la aproximación del Diálogo Abierto (DA) para el tratamiento psicoterapéutico. Se revisan brevemente los principales conceptos del DA que nutren el método IDC y a continuaci...

Este artículo presenta la traducción y adaptación al idioma Español del método “Investigaciones Dialógicas de Cambio” (IDC) (Seikkula, Laitila y Rober, 2012). Este método se enmarca en el enfoque dialógico y en la aproximación del Diálogo Abierto (DA) (Seikkula y Olson, 2005; Seikkula y Trimble, 2005) para el tratamiento psicoterapéutico. Se revisa...

Tässä tutkimuksessa tarkasteltiin sitä, kuinka kuusi aikuista turvapaikanhakija- ja pakolaisasiakasta kuvasivat ongelmiaan terapeuttisissa keskusteluissa. Tutkimuksen kohteena ja tiedon lähteenä olivat asiakkaiden tekemät ja tulkkien suomeksi välittämät ongelmia kuvaavat ilmaukset. Terapeuttisia keskusteluita analysoimalla pyrittiin tavoittamaan en...

The idea of meta-dialogue has evolved over the past twenty years. The study reported here focuses on meta-dialogue, analysing the importance of reflective practices for thoughtfulness and embodiment in couple therapy for psychological Intimate Partner Violence (IPV). The study also sought to determine whether, in a case of psychological IPV, reflec...

Blaming one’s partner is common in couple therapy and such moral comment often evokes affective arousal. How people attune to each other as whole embodied beings is a current focus of interest in psychotherapy research. This study contributes to the literature by looking at attunement during critical moments in therapy interaction. Responses to bla...

As part of a larger research project, this qualitative study explores sequences from six network therapy sessions. We focused on these sequences because only the therapists found them to be meaningful; the other participants did not think they were significant. The aim of this study was to explore the therapists’ inner dialogues, the degree to whic...

This study focused on a moment of weeping in one psychotherapy case. The overall aim was to explore the role of “soft prosody” in psychotherapy interaction—that is, the participants’ use of pauses, a lower volume, slower rhythms, and softer intonation than in the surrounding speech. A mixed-method, micro-analytic perspective was applied to investig...

Although there is controversy concerning indications for conjoint therapy in Intimate Partner Violence (IPV), both research and practice have come to recognize that it has some important benefits. This study analyzes issues of dominance and dialogue in a conjoint therapy for psychological IPV within a naturalistic setting, in which the spouses soug...

Currently, the most popular intervention in the problem of intimate partner violence (IPV) are shelter-based services for victims and the group program model for perpetrators. Since its establishment in the 1970s, the perpetrator group format has been adopted throughout the world, in various settings. Most services are directed at partner-violent m...

As a part of a larger research project, this qualitative study explores the interplay between an outer dialogue and participants’ inner dialogues in network therapy with adolescents in the mental healthcare system for children and adolescents. The aim of this study is to explore how the participants’ inner dialogues contribute to significant and me...

This study aims to further theoretical and clinical discussions regarding the therapy of psychosis from a dialogical perspective and to contribute to the contemporary research literature that works toward developing methods for studying the dialogical processes in therapy. Three videotaped sessions of a therapy with a heterosexual couple, in which...

The paper analyses open dialogicity in psychotherapy and juxtaposes it with education in order to find common dialogical elements in all relational practices. The core is found in unconditional respect for otherness and generating dialogical space for voices to be heard. In traditional practice, professionals are tempted to plan interventions accor...

Studies exploring the experiences of recovering from mental health difficulties show the significance of social and relational aspects. Dialogical practices operate within the realm of social relations; individual perspectives are not the primary focus of attention. The present study is part of a series of qualitative studies from southern Norway,...

Studies exploring the experiences of recovering from mental health difficulties show the significance of social and relational aspects. Dialogical practices operate within the realm of social relations; individual perspectives are not the primary focus of attention. The present study is part of a series of qualitative studies from southern Norway,...

Studies exploring the experiences of recovering from mental health difficulties show the significance of social and relational aspects. Dialogical practices operate within the realm of social relations; individual perspectives are not the primary focus of attention. The present study is part of a series of qualitative studies from southern Norway,...

This article reports an analysis of conjoint therapy for psychological intimate partner violence, treated via a dialogical approach. The article reviews current controversies surrounding this treatment modality and its outcome. The dialogical approach is presented as an appropriate method for analyzing and understanding the issue of violence, but i...

Within mental health research, the promise of exploring the lived experience of those affected is increasingly acknowledged. This research points to the significance of social aspects. The present study is part of a series of qualitative studies exploring network-oriented practices in southern Norway. The aim of this study was to explore the social...

The present study is part of a series of qualitative studies focusing on dialogic practice in southern Norway. In this article, we present a qualitative study of a network meeting focusing on the interplay between the participants' inner and outer dialogues. The network meeting is between an adolescent boy, his mother and two network therapists, th...

Abstract The article explores what professionals regard as important skills and attitudes for generating inter-agency network meetings involving intra- and interprofessonal work. More specifically, we will examine what they understand as promoting or impeding dialogue and how this is related to their professional backgrounds. The professionals part...

This qualitative study investigated talk and interaction as process factors potentially influencing outcomes in abuser group intervention. The findings showed that (a) abusers participate in group programs with considerably different degrees of motivation; (b) the interaction in abusers' various stages of change is characterized by different qualit...

Psychosis is a challenging phenomenon for professionals. In the need-adapted approach (NAA), therapy meetings constitute a deliberate effort to meet the challenges by bringing all the main parties together within a common discussion. The aims of this study are to analyze and evaluate psychiatrists' experiences of the treatment processes in psychosi...

The article describes an investigation into dialogues between native Swedish psychotherapists and refugee families. Dialogue is needed to establish the therapeutic alliance, which is ultimately important for healing, whether of individual sickness or family crisis. However the development of dialogue is hindered by cross-cultural and language barri...

This study examined Couple Therapy (CT) for depression in a naturalistic setting. It looked at the associations between the therapeutic alliance and subjective distress, and between the alliance and depression outcome. Twenty-nine depressive patients and their spouses were treated via CT. Treatments were adapted in accordance with the patient’s nee...

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient’s need. The patients’ depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The H...

The dialogical and narrative processes in couple therapy (CT) for depressions project was conducted to develop therapy for depression and to investigate the effectiveness of CT in everyday clinical practice; thus aiming at high external validity. Patients with moderate or major depression were randomized to a CT group (n = 29) and a control group (...

In Norway and many other countries, political guidelines prescribe the development of mental health strategies with both a service user's perspective and a treatment system established by the local authority. The development of new strategies frequently involves challenges regarding procedures and treatment as well as a view of knowledge and humani...

In this article, we use the intersubjective ethics of Bakhtin and Levinas and a case illustration to explore change in therapy as an ethical phenomenon. We follow Lakoff and Johnson in their emphasis on the way our conceptions of change seem permeated by metaphors. Bakhtin and Levinas both suggest through a language in which metaphors play a crucia...

Background: In the Need-Adapted approach (NAA) therapy meetings are a deliberate effort to bring all meaningful parties and views to a common discussion prior to decisions; this constitutes a challenge for psychiatrists' agency. Aims: To describe how psychiatrists see their agency in NAA. Methods: Using videos of co-research interviews, stimulated-...

In recent years, a number of family therapists have conceptualized psychotherapy as a dialogical activity. This view presents family therapy researchers with specific challenges, the most important of which is to find ways of dealing with the dialogical qualities of the multi-actor dialogues that occur, for example, in family therapeutic conversati...

As part of a larger research project on couple therapy for depression, this qualitative case study examines the nature of dialogue. Drawing on Bakhtinian concepts, the investigation shows how the conversation shifts from a monologue to dialogue. Among the findings are: first, the process of listening is integral to the transforming experience. That...

Treatment programs for intimately abusive men seek to stop and prevent partner and family violence by applying a variety of methods based on different disciplinary premises. For professionals working with this particular group of clients, the challenge is to combine therapeutic understanding and support with adequate efforts to make clients stop an...

Although various “talking cure” treatments typically constitute an important part of practices in social work and mental health services, there are few studies on the actual “talk-within-the-cure.” This qualitative study examined talk in group treatment for men who had used violence against their intimate partners. Using the method termed Dialogica...

Background: In the Need-Adapted approach decisions are made in therapy meetings with all relevant parties; this poses a professional challenge to psychiatrists.Aims: To describe psychiatrists’ inner dialogues concerning their workmates in treatment meetings.Methods: Using videos of co-research interviews, stimulated-recall interviews with eight psy...

Mental health services in a health district in Finland with a population of 72,000 were developed into a comprehensive family- and network-centered entity by giving all the psychiatric personnel training in family therapy or psychodynamic individual therapy, and by arranging a system in which all psychiatric crises were treated in a family- and net...

An open dialogue need-adapted approach was applied in Finnish Western Lapland by organizing three-year family therapy training for the entire staff, and by following the outcomes. Three inclusion periods of first-episode psychotic patients were compared. In a two-year follow-up of two consecutive periods during the 1990s (1992–3 and 1994–7) it was...

After birth the first thing we learn is becoming a participant in dialogue. We are born in relations and those relations become our structure. Intersubjectivity is the basis of human experience and dialogue the way we live it. In this paper the dilemma of looking at dialogue as either a way of life or a therapeutic method is described. The backgrou...

A multi-professional co-operation in preventing and treating domestic violence started in Jyväskylä, Finland, in 1995. The basic aim of this co-operation is to inform and educate different agencies to recognize violence against women and children, and organize and offer services for them. It consists of separate programmes for victims, women and ch...

The aim of this article is to explore the challenges connected to the transformation and emergence of professional identity in transdisciplinary multi-agency network meetings and the use of Open Dialogue. The empirical findings have been taken from a clinical project in southern Norway concerning multi-agency network meetings with persons between 1...

Parents who came with their child to Child and Adolescent Psychiatry (CAP) for the first time were interviewed 1–2weeks afterwards in the presence of the child and the therapists. In a grounded theory analysis they revealed uncertainty about their role in the first meeting as well as of future planning. What had been important to them were aspects...

This study aimed at a collaborative evaluation of therapeutic processes, through interviews in which both therapists and clients were present. The co-research interviews (Andersen, 1997) were conducted with 28 therapists and their clients after termination of dialogically-focused couple therapy in the context of psychiatric outpatient care. The cli...

The first meeting in psychotherapeutic and psychosocial work, has a big impact on the continuation. It is a less explored research field. Children’s “voices” tend to come in the back-ground in family therapy and other settings. In a project at CAP (Child and Adolescent Psychiatry) the children’s views were collected in interviews with parents and t...