A randomized control trial of re-designed and shorter research informed consent forms to improve comprehension.

Open Dialogue (OD) is a network-oriented approach to mental health care that integrates both service organization and a dialogical method for clinical practice (Razzaque & Stockmann, ). It emerged through bottom-up service development in the southwestern Finnish Lapland. In the early 1980 s, clinicians at the local psychiatric facility, Keropudas Hospital, began applying psychoanalytically informed psychotherapy and systemic family therapy in the treatment of psychosis. However, these predefined therapeutic frameworks were soon found to be too rigid and objectifying to respond effectively to the diverse and complex needs of individuals referred to public psychiatric services (Seikkula & Olson, ). Influenced by the need-adapted approach (Alanen, )—which emphasizes tailoring care to the evolving needs of individuals and their social networks—staff began organizing network treatment meetings involving all those affected by a given crisis. Drawing on collaborative (Anderson & Goolishian, ) and reflective therapeutic traditions (Andersen, ), these meetings avoided predetermined agendas and interventions. Instead, they focused on amplifying the voices of all participants. This shift encouraged professionals to move away from expert-driven models towards polyphonic dialogues that seemed to improve outcomes (Seikkula & Olson, ); the dialogical stance not only helped generate new meanings and shared understanding around difficult situations, but also reduced psychological distress by legitimizing diverse perspectives. Rather than pathologizing or defending experiences, participants engaged in joint reflection within their social contexts. The orientation toward shared meaning-making allowed for a more nuanced understanding of mental health crises and enabled care to be flexibly tailored on a case-by-case basis. These developments led staff at Keropudas Hospital to formalize a region-wide model that promoted dialogism in all clinical encounters (Seikkula & Olson, ). This effort was supported by the Länsi-Pohja Hospital District, established in the late 1980 s, which brought the region’s mental health units under the same organizational structure (Haarakangas, ).