The seed of change planted by an EXCELLENCE donor in Atlanta is now growing. The first quarterly report from the UMASS/Grady Hospital/Emory School of Medicine project team describes a strong launch of the Open Dialogue pilot. It is already spreading dialogic practices beyond the boundaries of the research project and attracting additional private funders to sustain the effort. The following is excerpted from the summary report of doctors Norquist and Cotes:
Grady Hospital is fully committed to improving and developing person-centered mental health services in Atlanta. The more our team has learned about the Open Dialogue approach, the more we are excited about its potential to change our system beyond the clinical research project. Although the initial proposal for Open Dialogue involved 20-25 families, principles from Dialogic Practice have spread and are being practiced on the inpatient unit and in some outpatient services at Grady. Even without formally beginning the trial, we have had successes with this approach, and our clinicians have been working this way. Families are more frequently involved in the treatment planning process and clinicians are engaged more with them.
A licensed mental health clinician who has been hired on the project 10 hours per week also works on the inpatient unit at Grady, and she will play a key role engaging clients who could benefit from this approach.
The Grady/Emory team has now received three trainings from Dr. Olson and the UMass team in Open Dialogue. We have had the experience of working with some individual clients in these trainings and learned a great deal from Dr. Olson’s expertise.
To date, expenses have been minimal, and Grady and Emory have provided considerable in-kind contributions. For example, Grady and Emory have supported clinicians’ participation for the first three trainings, and have also supported clinicians to participate in weekly administrative meetings about Open Dialogue.
Demonstrating the efficacy of the approach is a core endeavor of our team. Our protocol mirrors, in many ways, the study conducted at Advocates by Dr. Gordon and others, recently published in Psychiatric Services. The research and evaluation component of the project is moving forward on schedule. The proposal was sent to the Emory IRB and approved in October. The team will be analyzing measures of symptoms, functioning, health care utilization, and indicators of shared-decision making. Submission and approval to the Grady Research Oversight Committee (ROC) is the final step in administrative clearance in order to begin the study. The ROC will vote on the proposal on December 5.
The team at Grady continues to spread the word about Open Dialogue across the state of Georgia. Dr. Cotes hosted a workshop on Open Dialogue at the Georgia Department of Behavioral Health and Development Disabilities conference on October 6. Additionally, Dr. Cotes presented Open Dialogue to Augusta University Medical College of Georgia in a Grand Rounds lecture on October 27. Many in the audience were intrigued and excited to hear more about this approach.
Additionally, other private foundations have become interested in the work. The Betty and Davis Fitzgerald Foundation donated $100,000 to the project in the last few months.
We are extremely grateful for the Foundation’s support and are excited to continue this project.