Competing Responsibilities and the Distribution of Outcome through Dialogic Practice

Crisis intervention teams in Berlin, Germany use a form of dialogic practice - a therapeutic approach based on the relational meaning of language - to develop an alternative means of negotiating risk and evaluating "outcome" in psychiatric experience. These clinicians bring familial networks into the process of crisis management, revealing meaningful "outcomes" regarding crisis care to be tethered to local concepts of chronicity and responsibility. To conceive of outcome in this context requires attention beyond the individual, and instead the consideration of a distributed outcome, in which living with risk, and its consequences, is bound to the collective experience of the network.