Our Practice: Dialogical Therapy

Dialogical Therapy

Our practice, Dialogical Therapy, focuses on treating individuals, couples, families and groups. We are experienced with LGBTQ populations, young adults, couples, family members of those with addictions, those with addictions themselves, those caring for dying or ill family members, and those experiencing loss/grief/dying themselves. We have specialized training in working with families and social networks surrounding a person in crisis, with what some sometimes call psychosis.

We practice dialogically, which portends that every position in a family or in a couple has a voice and a perspective that is both important and unique from all the others. Allowing and hearing all the voices is a tenet of dialogical practice. Conversations that emerge in therapy are infinite in possibility. Humans are relational beings and our engagement with the world is in endless motion. In dialogic practice, the mystery and awe of each person’s creative way of problem-solving and each dynamic relationship within their particular social and/or family network is held. Dialogical therapists allow lots of space, silence, and reflection in sessions, intuiting the natural inner intelligence and capacity of each relationship and person to find their way. We carefully witness, listen, and actively attend to a family’s or social network’s style. We reflect the client’s goals, focusing on strengths, helping elicit and facilitate dialogue around current, immediate needs.

Alita is an educator and trainer of psychotherapists in Open Dialogue, the public mental health model for treating psychosis and other crises which has been studied and practiced in Western Lapland, Finland since the 1980s. Open Dialogue is (1) inclusive (i.e., client-/family-/social network-centered,) (2) collaborative (i.e., multiple professionals are present at sessions), (3) flexible and mobile (i.e., sessions vary in length and frequency adapted to the person and their extended support system), and (4) a community-based model for mental health care. Philosophically, we treat people, not diagnoses. I envision Open Dialogue becoming standard practice as its evidence basis is robust, it is extremely cost-effective for societies, and it is humanistic and socially just. Many countries are adapting Open Dialogue to the way psychiatry is practiced. Currently, it is an emerging practice in the U.S. for families and early psychosis.

Fletcher is a psychiatrist, teacher, author, and researcher with interests including mood disorders, anxiety (such as post-traumatic stress), learning difficulties (such as attention-deficit), and sleep disorders. His other experiences include past medical doctor for the Tacoma Mountain Rescue Unit, past Medical Quality Assurance Chair for St. Joseph’s Hospital, and primary investigator for several studies in his field that yielded new treatments. He enjoys writing (poetry and prose), climbing, skiing, and general horsing around with family and friends.