Listening to Worries: A Phenomenological Inquiry Into Open Dialogue in Community Settings

Open Dialogue, a therapeutic approach from Finland, emphasizes dialogical interactions to support individuals with psychiatric conditions. While its clinical effectiveness is well-documented, its use in broader community contexts remains limited. In Japan, the Machiken Dialogue adapts Open Dialogue to address everyday concerns in local settings. This study explores participants' experiences with Machiken Dialogue and its potential to enhance social connectedness and emotional well-being.

A qualitative phenomenological analysis was conducted on 134 free-text responses from general citizens (n = 77) and healthcare, welfare, and care professionals (n = 57) who participated in sessions from 2017 to 2019. Interpretative phenomenological analysis was used to identify key experiential themes.

Citizens emphasized psychological safety, self-discovery, and the importance of silence and multiple perspectives. Self-disclosure, though challenging, fostered connection and shared understanding. Professionals reported a shift from expert roles to co-participants, experiencing both liberation and difficulty maintaining neutrality. Balancing structured facilitation with open dialogue reflected ongoing tensions between clinical norms and dialogical values.

Machiken Dialogue offers a supportive space for self-expression, reflection, and empathy, suggesting its value in strengthening community ties and emotional connectedness. Its application beyond psychiatric care shows promise in fostering reflective communication and empathy. Nonetheless, challenges around facilitation, self-disclosure, and shifting professional roles point to the need for further research on effective community-based dialogical practices.