Beyond polyphony: Open Dialogue in a Women’s Shelter in Australia as a possibility for supporting violence‐informed practice

UNSTRUCTURED Abstract Patient-centred medicine (PCM) involves looking at more than just a disease and how to treat it. It has evolved from the realisation that all patients are different physiologically, psychologically, emotionally, and socially, and it therefore encompasses all of these domains in its application. The mainstay of this approach is the promotion of a mutual relationship between patient and doctor that involves creating a secure environment to allow for open dialogue. By learning to listen to patients, and exploring other causes of disease other than physiological ones, doctors are able to provide a holistic approach to treatment. Patients are also actively encouraged to participate in the decision making process by adding their ideas, concerns and expectations. This negotiation allows for flexibility and individualisation of each treatment plan that is tailored to suit each individual patient. In essence, PCM encourages concordance: the agreement between doctor and patient on how to proceed towards a common goal. It is therefore important to teach medical students about PCM as early on in their medical education as possible. This will give them time to hone skills in communication so that they can better understand and explore their patient’s circumstances as well be aware of other domains that may require support. But how can medical schools effectively teach their students PCM? Here we suggest the use of expert patients as a beneficial method for promoting PCM in medical school curriculums as students have the opportunity to gain first hand knowledge of what a patient with a specific disease actually feels, what impact it has on their lives and those around them, and what support they find lacking or useful. Encourage medical curriculums to incorporate expert patients as a resource of information to teach future doctors abotu patient-centred medicine and its holistic objectives.

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Towards a systemic-dialogical model of therapy

Human Systems: Therapy, Culture and Attachments ◽

10.1177/26344041211003853 ◽

2021 ◽

pp. 263440412110038

Author(s):

Paolo Bertrando ◽

Claudia Lini

Keyword(s):

The World ◽

Open Dialogue ◽

The Difference ◽

Systemic Understanding ◽

Case Supervision ◽

Model Of Practice

Bakhtin-inspired ideas that led to the emergence of dialogic therapies are usually considered as incompatible with other, more traditional models. This article presents a possible integration of dialogical ideas, with their acceptance of uncertainty and disorder, within a systemic understanding, where the emergence of systemic patterns is recognised. Through a comparison with the open dialogue approach, the article aims at clarifying the difference between a pure dialogical and a systemic-dialogical perspective, that is seen as more fitting with the contextual complexity of the world of today. The model of practice is illustrated by a case supervision example.

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The Terminal: A tale of virtue

Nursing Ethics ◽

10.1177/0969733007071358 ◽

2007 ◽

Vol 14 (1) ◽

pp. 54-61 ◽

Cited By ~ 3

Author(s):

Wendy Austin

Keyword(s):

New York ◽

Virtue Ethics ◽

Flight Attendant ◽

Open Dialogue

The movie, The terminal, is used to illustrate Mac Intyre's description of virtue ethics. The terminal is a mythical tale about a traveler, Viktor Navorski, who is stranded by circumstances in a New York airport. Viktor is a person who, without a strict reliance on duty or rules, has developed the disposition to act well despite variation in his circumstances. His character is revealed in contrast to that of three other characters: a cleaner, a flight attendant and the airport manager. Stories like this one may be a good way to open dialogue among clinicians about being virtuous as a practitioner. Such dialogue may make striving to be virtuous an acceptable goal for practitioners and less like an idealistic, pseudo-goal for those aiming for sainthood.

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