Improving Mental Health Care by Centering Peers in Open Dialogue

A new study calls for rethinking Open Dialogue practices by placing peer practitioners at the heart of therapeutic work.

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New research published in Frontiers in Psychology highlights the critical role of peer support specialists in successfully implementing dialogical-based mental health care.

Originating in Finland, Open Dialogue has shown long-term success in reducing hospitalization, medication use, and chronicity in psychiatric care. The authors argue that meaningful implementation requires peer involvement from the outset and offers a practical framework that centers lived experience as vital to therapeutic engagement, systemic change, and sustainable practice.

At the heart of this approach is a commitment to dialogue as a relational stance that invites openness, uncertainty, and mutual transformation. As Intentional Peer Support founder Shery Mead puts it:

“In real dialogue, we are able to step back from our truth and be very deeply open to the truth of the other person while also holding onto our own. When this type of dialogue occurs, both of us have the potential to see, hear and know things in ways that neither of us could have come to alone.”

The authors of the study echo this sentiment, writing:

“The uncertain and sometimes risky process of dialogue may create a space in which new and alternative meanings emerge, ones which may return to people opportunities for reclaiming voice and agency.”

The study, authored by Charlotte Hendy, Jerry Tew, and Sarah Carr, seeks to clarify how peer practitioners contribute uniquely and essentially to the practice of Open Dialogue. While peers are often seen as “add-ons” to a primarily clinical team, the authors argue that their experiential knowledge is central to dialogical integrity, relational depth, and structural change.

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