ArticleCulture, medicine and psychiatry2026
Working in Pairs: The Dialogic Distribution of Clinical Responsibility.
Article in Culture, medicine and psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
At an innovative site of psychiatric crisis care work, dialogically trained clinicians in Berlin, Germany transformed the skills learned from the Open Dialogue approach into a means for building solidarity in the face of precarious health structures. Learning to sit with unknowing and tolerate uncertainty, at first developed as techniques to support clients in crisis, became a way by which these clinicians navigated a shifting and unsteady health insurance landscape. In the face of budgetary restrictions and increased oversight by health insurance companies, which challenged the terms of their work and ethical commitments, they supported each other by reconfiguring the terms of clinical responsibility: they dispersed the authoritative gaze most often cultivated in institutional psychiatry and risk management approaches, and developed a means for attending to the uncertainty of crisis by sharing the burden of unknowing with each other. They did this through their unwavering commitment to working in pairs.
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