Open Dialogue is an approach to working with mental health problems that emphasises promoting dialogue between multiple perspectives within an individual person and between all the people present, including the therapists. Therapists’ own perspectives are often introduced during conversations called reflections, which present a potential source of different perspectives. Using conversation analysis we analysed 14 hours of video-recorded Open Dialogue sessions with a focus on therapists’ reflections. We noticed that therapists did not display explicit agreement with each other’s reflections. This absence of explicit agreement was displayed through a variety of verbal and non-verbal forms. Eliding agreement facilitated deference to the epistemic authority of the client, assertion of epistemic rights from second position, emphasis of a positive perspective or to voice multiple perspectives. Therapists avoided consensus and thus presented multiple perspectives to the family while also attending to issues of contingency. The implications of epistemic primacy and asymmetry connected to sequential structures in talk pose a challenge to the generation of collaborative reflective dialogues.

开放式对话是一种处理心理健康问题的方法，它强调促进个人内部多个观点之间以及包括治疗师在内的所有人之间的对话。治疗师自己的观点通常在称为反思的对话中被介绍，这代表了不同观点的潜在来源。使用对话分析，我们分析了 14 小时的视频录制的开放式对话会议，重点是治疗师的反思。我们注意到治疗师并没有对彼此的反思表现出明确的同意。这种缺乏明确同意的情况通过各种口头和非口头形式表现出来。取消协议有利于尊重客户的认知权威，从第二位主张认知权利，强调积极的观点或表达多种观点。治疗师避免达成共识，因此向家人提出了多种观点，同时也关注突发事件。