Exploring Open Dialogue and autism: A qualitative client-perspective study

Mental health care for people diagnosed with autism is transforming towards recovery-oriented, person-centered network care. Within this changing landscape, the Open Dialogue approach is acknowledged as a promising approach that exemplifies this transformation. Characterized by its transparent and equitable collaboration between client, their network and mental health care professionals, the Open Dialogue approach shows promise for people diagnosed with autism but also poses potential challenges, leaving uncertainty regarding its suitability. Given these potential benefits and challenges, the present study aims to explore how clients diagnosed with autism experience the Open Dialogue approach firsthand. This qualitative study explores how 12 participants diagnosed with autism experienced the OD approach at a specialized mental health care center for autism. The study employs six in-depth interviews and two focus groups, utilizing a hybrid analysis approach that combines both inductive and deductive thematic techniques. Findings reveal that participants generally have positive experiences with the Open Dialogue approach, highlighting key elements such as connectedness, reassurance, recognition, agency, and support through collaborative interaction. However, a minority reported negative experiences linked to feelings of uncertainty and discomfort with therapist reflections. These findings suggest that people diagnosed with autism evaluate the Open Dialogue approach in a similar way to other mental health service users. Despite the potential challenges posed by Open Dialogue, our results indicate that providing Open Dialogue care may be valuable for people diagnosed with autism, as it is for other mental health service users. Further research is needed to substantiate this indication.