In the last decade, many first-episode psychosis programs have been developed in the United States and elsewhere. First-episode psychosis typically affects adolescents and young adults. These programs, therefore, emphasize early intervention to alter long-term consequences and address specific needs of the affected population. Open Dialogue, which has shown promise in Finnish studies, is one such program that is gaining popularity outside of Finland. The program emphasizes active involvement of family and collaborative decision making. The three studies in this dissertation elucidate how Open Dialogue can contribute to current treatment options and describe considerations in adaptation and implementation of Open Dialogue in the United States. The Promoting Action on Research Implementation in Health Services (PARiHS) framework describing the role of evidence, context, and facilitation in successful implementation provides the theoretical basis for these studies. Study One is a systematic scoping review of the literature describing first-episode psychosis programs. Study Two is a qualitative study of stakeholder experiences in a pilot study of the Open Dialogue model in the United States. It examines perceived usefulness, contextual support, and factors facilitating participation. Study Three examines organizational characteristics that supported implementation at the agency where the program was piloted in the United States. The scoping review of first-episode psychosis programs indicates a need for further research regarding their long-term benefits, optimal duration and intensity, and critical components. Family intervention appears to be beneficial, suggesting that the Open Dialogue approach to family support might be a valuable addition warranting further investigation. Stakeholders involved in the Open Dialogue pilot identified several unique and beneficial features of the approach, focusing particularly on the value of family involvement, transparency, respectfulness, and collaborative nature of the approach. The compatibility of the Open Dialogue model with agency values, strong leadership support and vision, alongside organizational capacity to deliver the services emerge as critical factors in successful implementation of the model in the pilot study. As per the PARiHS framework, contextual factors, particularly funding of this model of services in the United States healthcare environment are key determinants to address for the future implementation of Open Dialogue in the United States. / 2019-12-31T00:00:00Z

Visame pasaulyje vis plačiau toleruojamos antišeimiškos vertybės. Jaučiama taip pat ir moralinio reliatyvizmo įtaka, teigianti, kad nėra vienos privalomos etinės ar moralinės tiesos, ir skelbianti tariamą laisvę, iš tiesų tik atskiriančią žmogų nuo žmogaus. Tokioje situacijoje šiandieninė Katalikų Bažnyčia aktyviai vykdo teologines bei pastoracines paieškas, siekdama įveikti vis didėjantį tarpusavio susvetimėjimą ir individualizmą šeimoje bei dabartinę šeimos krizę, besireiškiančią plintančia kohabitacija bei skyrybomis. Katalikiškoji teologija akcentuoja Dievo trinitarinį gyvenimą esant tinkamiausiu santuokos pirmavaizdžiu. Šeima yra unikali būtent savo panašumu į Dievo paveikslą ir tam tikra prasme yra apreiškimas, nurodantis, koks turėtų būti žmonių santykis su Dievu ir vienas kitu. Savo meilės bendryste vyras ir moteris santuokoje atspindi Trivienio Dievo paveikslą. Žmogus sukurtas pagal Dievo paveikslą turi asmeninį Dievo kvietimą meilės dialogui, bendrystei. Dialogo, pokalbio, komunikacijos matmuo yra esminė žmogaus tiesa. Žmogus save suvokia tik akistatoje su kitu. Santuokos kaip dialogo supratimas reiškia kokybiškai naują sutuoktinių buvimą kartu - buvimą santykyje, dialoge su nuostata girdėti suprasti, dalintis ir atleisti. Būti žmogumi reiškia būti pašauktam tarpasmeninei žmogiškai bendrystei, kurios pavyzdys matomas Trejybės Asmenų bendrystėje, kur visų tarpasmeninių santykių pamatas - buvimas dovana. Sutuoktiniai realizuoja šį pašaukimą meilei per santuoką. ... [toliau žr. visą tekstą] / This bachelor paper studies the positive experience of the retreat movement “Encounters hof Spouses”. This movement aims at reconciliation of families where spouses have relationship problems. This movement encourages openness and dialogue between spouses which is based on discovering the image and likeness of God in the human person. The paper therefore, stresses the role of understanding both oneself and the other person as having natural dignity and worth due to the image and likeness of God. This understanding leads to an open dialogue between spouses which brings confidence, trust and new unity. The methodology of the research was participant observation. The spouses shared their experience by talking and analyzing the positive changes in their relationships. The paper aims at the theological anthropological generalization of this help to families and provides some recommendations of how to apply this experience more widely. Thus , the paper is relevant and important for today’s society and Christian communities. The first part of the paper discusses the theological aspects of the human person and marriage in God’s plan for this world as seen from the documents of the Catholic Church. It deals with the Christian idea of the family as a reflection of the Trinitarian Union and as a vocation for divine love, as well as complete self-giving. It also analyzes marriage as a sacrament. The second part of the paper is devoted to the phenomenon of the dialogue as the basic... [to full text]