Professional practices put to the test of Open Dialogue

A case study in two public psychiatry services in Marseille

Bibliographic Data

ID22203347
AuthorsAndréa Mestre (United States Department of Justice), Julien Grard (Ceres), Camille Grégoire (United States Department of Justice), Hugo Panabières (United States Department of Justice), Aurélie Tinland (0000-0002-8168-930X, Ceres), Pascal Auquier (0000-0003-3496-1996, Ceres), Saphir Desvignes (0009-0005-3265-8776, Ceres, corresponding author)
Year2026
Volume13
Pages102796
Publication date2026-06-01
Open AccessYes
TypeARTICLE
VenueSocial Sciences & Humanities Open (JOURNAL)
Journal identifiersISSN: 2590-2911 • E-ISSN: 2590-2911
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssaho.2026.102796
OpenAlexW7160277126
LanguageEN
References cited26

This qualitative study examines the introduction of the Open Dialogue (OD) approach in two public psychiatry services in Marseille; both already engaged in recovery-oriented practices. The investigation is based on a multiple case study combining observation, individual and group interviews, and an iterative thematic analysis. It explores how OD does—or does not—transform the professional norms of those who practice it. Findings show that the implementation of OD did not result in a uniform transformation of practices. Instead, its appropriation was partial, heterogeneous, and shaped by organizational constraints, professional trajectories, and collective dynamics. While OD retained strong ethical legitimacy, it was frequently held at a distance through workarounds, selective uses, and implicit resistance—particularly around reflective dialogues, which challenged established professional roles and authority. At the same time, OD functioned as an authorizing framework for some practitioners, legitimizing relational stances, uncertainty, and emotional engagement previously difficult to sustain. Rather than a model to be implemented with fidelity, OD operated as a revelatory device that made visible the normative tensions structuring professional practice. Its implementation highlights both the fragility of recovery-oriented transformations and their potential to initiate incremental reconfigurations of professional authority, relational norms, and ways of working under specific organizational conditions. • This article presents the first empirical study of Open Dialogue in France. • Professionals experience vulnerability and exposure while engaging in dialogical practice. • Reflective dialogues destabilize professional ethos and norms of control. • Open Dialogue reveals normative tensions that ordinarily go unquestioned

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Open DOIOpen Access