El díálogo abierto como procedimiento de trabajo en la psicosis aguda: su “poética” y “micropolítica”
DOI:
https://doi.org/10.33898/rdp.v16i63/64.891Palabras clave:
diálogo abierto, esquizofrenia, narrativas, conversación, equipo reflexivo, conversación terapéuticaResumen
En los últimos años se ha venido desarrollando en Finlandia un procedimiento que utiliza la red social denominado “Diálogo Abierto”. Se trata de un procedimiento psiquiátrico basado en el lenguaje, derivándose de los principios dialógicos de Bakhtin (1984) que continúa la tradición de Bateson. Se ofrecen dos niveles de análisis, el poético y el micropolítico. El poético incluye tres principios: “tolerancia de la incertidumbre”, “dialógico” y “polifonía de la red social”. En la sesión de tratamiento se muestra cómo funcionan estos principios poéticos para generar el diálogo terapéutico. El análisis micropolítico se refiere a los procedimientos de la institución que apoyan nuestra forma de trabajo y que son una parte del Tratamiento Adaptado-a-la-Necesidad finlandés. La investigación reciente muestra que el Diálogo Abierto mejora los resultados de los tratamientos usuales en jóvenes afectados por diferentes tipos de crisis psiquiátricas, como psicosis. En un seguimiento a dos años realizado a una muestra no-aleatoria de psicóticos con un solo episodio, se encontró que reducía la estancia hospitalaria a 19 días; se necesitó medicación neuroléptica en el 35% de los casos, en el 85% o no se necesitó o se utilizaron dosis bajas o no remitían los síntomas. Sólo el 23% necesitó de pensiones asistenciales.
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