Abstract
Open Dialogue is a need-adapted approach to mental health care that was originally developed in Finland. Like other need-adapted approaches, Open Dialogue aims to meet consumer’s needs and promote collaborative person-centred dialogue to support recovery. Need-adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need-adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need-adapted mental health care, using Open Dialogue as a case study
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Nurses who lose their jobs or are forced to leave the profession because of a substance use disorder, mental health problem, or chronic pain are at risk for suicide, according to a study published last week in the What really breaks your heart is the ones that lost their jobs last night, said Judy Davidson, DNP, RN, a nurse scientist at the University of California San Diego and lead author of the study, underscoring the impulsive nature of suicide. They may have been feeling chronically depressed, but from the moment that they think about suicide till they do it, is usually a very short interval.