Do People with Psychotic Symptoms Receiving Need-Adapted and Open-Dialogue Treatment Experience Improvement?

Purpose: People experiencing acute or severe psychosis in the United States do not typically have access to alternatives to standard practice.  To provide people with psychotic symptoms meaningful choices in treatment, alternative approaches should be evaluated for potential integration into the mental health service system.  The need-adapted and open-dialogue approaches are psychotherapeutically focused interventions for psychosis that were developed in Finland. If these treatments are found to be effective, they could potentially be used in the US. Method: This narrative review uses systematic and transparent methods to locate and synthesize findings from treatment, quasi-treatment, and pre-treatment outcome studies of the need-adapted and open-dialogue approaches.  Results: A total of 112 potentially relevant studies were identified for this review using electronic searches and reference harvesting.  Of those, 7 met the review’s inclusion criteria.  These studies revealed that the open-dialogue and need-adapted treatments had outcomes that were equivalent or superior to those of standard care.  Discussion: More research is needed on these promising modalities before they are routinely incorporated into US practice.