Open Dialogue: Frequently Asked Questions

Open Dialogue is an approach to working with people and their families experiencing psychosocial distress. Interest in Open Dialogue in Australia has been growing recently, raising questions about its adaption and implementation to local contexts. This article is an attempt to answer some of the frequently asked questions we have encountered in training and discussions about Open Dialogue. We attempt to provide responses to questions of how Open Dialogue is different to what is done already, how it fits with current approaches, how you know if you are doing it, whether it is passive or just about doing reflections, issues about including the social network, and concerns about the evidence base. This article aims to present a variety of viewpoints in relation to these questions and to hopefully further discussions on how Open Dialogue can be implemented and adapted to Australian health care and social care contexts.     

Coping With Stress as an LGBTQ+ Health Care Professional

Lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority (LGBTQ+) health care providers face both general work-related stresses and working in heteronormative settings with ill-informed or hostile coworkers and patients, yet there has been little study of whether the coping strategies are specific to LGBTQ+ stress. We analyzed qualitative data from 277 health care professionals. Sources of stress included religiously and politically conservative coworkers, coworker/patient lack of knowledge, stresses of being closeted, and concerns about being out to patients. Consequences of being out as LGBTQ+ included lack of promotions, gossip, refusals of tenure, and anti-LGBTQ+ comments and behaviors in the workplace. Respondents showed mostly positive coping strategies to deal with stress, including becoming educators/advocates and self-care activities. Self-care options were common in rural areas with few LGBTQ+ social resources. Negative coping strategies were reported by 18% of respondents. The study highlights the extra burden of stress on LGBTQ+ health care providers.     

Knox meets Cox: Adapting epidemiological space-time statistics to demographic studies

Many important questions and theories in demography focus on changes over time, and on how those changes differ over geographic and social space. Space-time analysis has always been important in studying fertility transitions, for example. However, demographers have seldom used formal statistical methods to describe and analyze time series of maps. One formal method, used widely in epidemiology, criminology, and public health, is Knox’s space-time interaction test. In this article, we discuss the potential of the Knox test in demographic research and note some possible pitfalls. We demonstrate how to use familiar proportional hazards models to adapt the Knox test for demographic applications. These adaptations allow for nonrepeatable events and for the incorporation of structural variables that change in space and time. We apply the modified test to data on the onset of fertility decline in Brazil over 1960–2000 and show how the modified method can produce maps indicating where and when diffusion effects seem strongest, net of covariate effects.     

Land-use and environmental pressures resulting from current and future bioenergy crop expansion: A review

Recent energy and climate policies, particularly in the developed world, have increased demand for bioenergy² as an alternative, which has led to both direct and indirect land-use changes and an array of environmental and socio-economic concerns. A comprehensive understanding of the land-use dynamics of bioenergy crop production is essential for the development of sustainable bioenergy and land-use policies. In this paper, we review the patterns and dynamics of land-use change associated with bioenergy crops (hereafter referred to as ’bioenergy-driven land-use change’). The review focuses on four regions as the most prominent locations in which these patterns and changes occur: Brazil; Indonesia and Malaysia; the United States of America (U.S.A.); and the European Union (EU). The review confirms that bioenergy-driven land-use change has affected and will impact most severely on the ’land- and resource-abundant’ developing regions, such as Brazil, where economic development takes priority over sustainable land-use policies, and the enforcement capability is limited. Opportunities for more effective policy are available through the development of international climate change policy (e.g. REDD under the UNFCCC), and certification criteria for sustainable bioenergy products (e.g. EU RED). However, bioenergy produced from no and/or less land-using feedstocks (e.g. wastes and residues), and their associated technologies must be given higher priority to minimise bioenergy-driven land-use change and its negative impacts.     

Competing values, tensions and trade-offs in management of nuclear power plants

The specific goal of the study is to look how tensions, competing values and trade-offs manifest in the management of nuclear power plants. Second goal is to inspect how existing frameworks, such as Competing Values Framework, can be used to model the tensions. Empirical data consists of thirty interviews that were conducted as part of a NKS study on safety culture in the Nordic nuclear branch. Eight trade-offs are identified based on a grounded theory based analysis of the interview data. The competing values and potential tensions involved in the trade-offs are discussed.     

Psychosocial Well-Being of Young People Who Participated in a Support Group Following the Loss of a Parent to Cancer

Despite the evidence of unmet support needs among young people who have lost a parent to cancer, only a few support group initiatives have been reported. This observational prospective study explored the psychosocial well-being of young people who participated in support groups at a Swedish specialist palliative care setting. On three occasions, 29 participants, aged 16–28 years, answered questionnaires covering characteristics of the participants, circumstances of the losses, psychosocial well-being of the young people, and their own assessment of the support groups. The support groups attracted mostly young women who were often unprepared for the loss. The living arrangements differed between younger and older participants; however, the loss-related variables did not differ. Significant positive changes were found regarding a sense of meaning in their future life and life satisfaction. The helpfulness of the group was assessed as high/very high and the group brought a valuable fellowship with others in a similar situation. Universality and beneficial interactions were reported and strengthened psychosocial well-being developed over time. This change, according to the young people themselves, may be attributed to the group support. The findings are useful for planning interventions to support young people in bereavement in order to enhance their psychosocial well-being.     

Gender roles,HIV risk behaviors,and perceptions of using female condoms among college students

The purpose of this study was to examine relationships between gender roles and HIV risk behavior, and perceptions and acceptance of the female condom among college students (n = 410). It was hypothesized that high hyperfeminine females and high hypermasculine males – those adhering to traditional gender roles – would engage in more HIV risk behaviors, including alcohol and drug use and various sexual practices, than those with lower hyperfemininity and hypermasculinity. It was also hypothesized that higher hyperfeminine females as well as higher hypermasculine males would perceive the female condom more negatively and would be less likely to view the female condom as a viable form of protection in the future. It was also hypothesized that high hyperfeminine females and high hypermasculine males would not accept the female condom as an alternative form of protection. Implications for prevention interventions are discussed.     

Concretizing the Concept of Social Stress

The concept of social stress, as adapted from Selye’s work on biology, is insufficient to explain psychological functioning. To be useful, social stress must include enduring social practices characteristic of particular social systems that violate socially generated as well as biological needs. Some of these stressful events are gender role, poverty, and societal practices such as extreme competition, individualism, and materialism.     

Passion,Intimacy, and Commitment in Casual Sexual Relationships in a Canadian Sample of Emerging Adults

Research on casual sexual relationships (CSRs) among emerging adults is prevalent, yet our empirical and theoretical knowledge of relationship processes involved in these relationships is limited. The present study’s objective was to compare four CSR partner types (acquaintance, friend, non-dating partner, ex-romantic partner) on passion, intimacy, and commitment, the components of Sternberg’s triangular theory of love. A total of 441 Canadians aged 18–25 years who were not in a romantic relationship, and who reported having had more than one sexual contact with their last CSR partner, completed an online survey. Across all partner types, passion was highest, followed by intimacy and commitment. Levels of passion, intimacy, and commitment generally increased with partner familiarity. However, CSR partner type differences on the three components were partially explained by CSR components (i.e., frequency of sexual activity, frequency of social activity, whether partners saw each other with the main goal of having sex, sexual exclusivity agreement, and hopes about the relationship). Results are consistent with CSRs’ emphasis on sexuality, and, to a lesser extent, emotions. However, they challenge the mainstream and scientific conflation of CSRs with an absence of emotional bond, commitment, or love.