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- Reflective Structured Dialogue Helps Address “Wicked” Public Health Challenges
Reflective Structured Dialogue Helps Address “Wicked” Public Health Challenges
In 2022, a group of researchers from Brigham Young University conducted a study to determine the power of Reflective Structured Dialogue to address “wicked public health problems,” which they describe as “complex social and political problems with dynamic root causes that are difficult to precisely delineate and that lack definitive and objective solutions, especially across different contexts.”
Examples of wicked problems in public health include obesity, HIV transmission, and vaccines. These problems are not merely technical—they are strongly related to a host of overlapping social factors, such as educational attainment, poverty, racial and ethnic identities, as well as political polarization.
“Political polarization and conflict over social issues are indelible features of American society,” the researchers wrote. “Since the beginning of the COVID-19 pandemic in 2020, critical public health-related problems have increasingly become the focus of many of the most heated debates in legislatures, communities, and schools across the country.”
“Polarization affects public health in at least two critical ways,” they write. “First, polarization has been found to directly affect stress and anxiety, which can lead to a variety of poor health outcomes. Second, and perhaps most crucially, polarization impedes collective problem-solving and increases social divisiveness—a factor that can be considered a determinant of health—which creates new and exacerbates existing health and social problems. Thus, in order to build a foundation of understanding upon which today’s wicked public health problems can be more effectively resolved, the public health community needs evidence-based approaches for promoting dialogue and reducing polarization around controversial issues.”
Developed by Essential Partners co-founders, Reflective Structured Dialogue (RSD) is a research-based, flexible, scalable framework that equips people to interrupt dysfunctional dynamics and build relationships across differences in order to address challenges where they live, work, worship, and learn. RSD and its adaptations are today used by many leading organizations in the fields of dialogue and deliberation, conflict resolution, and de-polarization.
Using RSD in partnership with longtime EP collaborators, Living Room Conversations, the researchers conducted a series of 27 Reflective Structured Dialogues on the Brigham Young University campus. Nearly 140 students participated in dialogues on three wicked public health problems: COVID-19, mental health, and racism.
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“Structured dialogues, such as those used in this study, are more important now than ever as society becomes increasingly polarized along ideological, religious, racial, and other divides […] Reflective Structured Dialogue can serve as a useful tool in university settings and in the larger context of addressing wicked public health problems in communities.”
RSD Reduces Polarization, Improves Openness
Their findings were published in Frontiers in Public Health, a peer-reviewed research journal. “This study shows that [Reflective Structured Dialogue] is positively associated with improved polarization-related attitudes among university students,” the researchers wrote. “While not all changes were statistically significant, most survey questions showed positive changes between the pre- and post-surveys, with the biggest differences coming in questions related to outcomes of openness, tribal identity, and moral disdain. Nearly all students believed their experiences with RSD were positive, helped them understand the experiences of and feel more connected to others, and increased their empathy and compassion.
“[…] When asked to comment on their overall experiences, the open-ended responses from participants supported the quantitative findings. A representative comment from one student said, ‘I enjoyed being in a setting where people are encouraged to listen to others first without rebutting them. I usually do not talk about these kinds of topics due to being anxious about negative responses.’ Several students mentioned their desire to incorporate structured conversations into the university campus community in more permanent ways. For example, one participant wrote, ‘I believe this is important enough to be included in curriculum. I think that every BYU student should participate in such a discussion before they graduate.’
The researchers also identified the need for broader research among more diverse participants outside of a campus context, ideally with a less self-selecting group.
“Structured dialogues, such as those used in this study, are more important now than ever as society becomes increasingly polarized along ideological, religious, racial, and other divides. While this is a relatively small demonstration project in a somewhat unique context, the results are promising and lend strength to the argument that RSD can serve as a useful tool in university settings and in the larger context of addressing wicked public health problems in communities. Future projects should explore additional applications of RSD and use rigorous evaluation methods to better understand how to optimize outcomes.”
In the end, these researchers found the same consistent outcomes that Essential Partners has seen over four decades of real-world implementation, research, and field evaluations:
“Together, the quantitative data and participant comments suggest that, as in previous studies, Reflective Structured Dialogue helped participants create connections and understand different perspectives. This study also helps demonstrate how deliberative inquiry can contribute to student learning in higher education setting. These empirical findings are useful in supporting the theoretical justifications made about the value of RSD and other types of dialogue in building trust and understanding between diverse groups as a prerequisite to problem-solving. Successful consensual problem solving for wicked problems requires dialogue to create the conditions in which stakeholders with distinct interests can collaborate towards progress on solutions.”
Download the complete article from Frontiers in Public Health, a peer-reviewed research journal.
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Testimonials
Program ParticipantI read this comment from the 14th Dalai Lama: "Every change of mind is first of all a change of heart.” It seems appropriate for what we are doing.
Bayview, Michigan
Program ParticipantI felt an amazing sense of accomplishment when the Essential Partners training ended; that I'd done something important for my community and something important for me.
Massachusetts
Beth MendozaDialogue gets more results. It makes decision-making easier. It makes creating participation easier … our greatest organizational impact has been more contributions as well as more effective and efficient meetings.
Moraine Park Technical College, Wisconsin
Bill Scott, Project DirectorThere was a remarkable change in the way we were able to communicate with one another following the facilitated conversations.
Massachusetts Department of Mental Health
Lauren Barthold, Philosophy FacultyI’ve learned that it is not enough to announce my commitment to dialogue and expect students to know what I mean; I need concrete exercises to allow students to learn how to do it.
Endicott College, Massachusetts
Undergraduate StudentAs a pharmacy major, I do not receive much training on how to handle difficult or controversial conversations. I think that this training will help me not only in my duties as a resident assistant, but in discussing medications and therapies with future patients when the conversation becomes difficult.
Northeastern University, MA
Program ParticipantThis is the best adult learning experience I have had in the past five years. I wanted to learn new skills—I did!
Peter Cooke, Immigration Dialogue ParticipantThere’s a real difference to people who are coming to meetings. They say, wow this is so different. They all said how people were more on the ball, more congenial. Now people see growing the economy as a way to unify the receiving community and immigrant communities.
New Hampshire
Meirav Solomon ’20Dialogue not only teaches you how to interact and understand more deeply those around you, it also teaches you more about the world around you and yourself. I think dialogue is super important to my growth as a student, a global citizen and a human being. I have learned to listen, I have learned to speak out, I have learned how to access my stretch zone (where I feel uncomfortable speaking but not turned off) and I have learned where my limits are.
Cary Academy, NC
Undergraduate StudentEvery opinion was accepted. No one felt judged or uncomfortable talking to one another. These have been, by far, the best classroom discussions I have ever had.
Bridgewater College, Virginia
Patrick Hale, director of Multicultural and Identity ProgramsOne of the things that’s so crucial to even fostering dialogue around diversity, equity, and inclusion is creating opportunities for folks to engage in deep reflective self-awareness.
Babson College, MA
Janele Nelson, Mission DirectorIn these divisive times, Essential Partners has given my local YMCA and now the national YMCA a means to build bridges through dialogue, re-establishing foundations for constructive change to occur.
YMCA of Pierce & Kitsap Counties (WA)
Alex Lyford, Assistant Professor of StatisticsI can't possibly overstate the positive effects the Dialogic Classroom training had on the curriculum and approach to my Introduction to Data Science class. The difference in the course from a year ago and now is night and day. My lectures are now filled with meaningful discussion and discourse—often related to sensitive topics that I wouldn't have dared touching without the training. Student feedback about these discussions has been overwhelmingly positive, and there is no chance that I would have had the wherewithal or initiative to revamp the course in such a dramatic manner without the training.
Middlebury College
Amy Cottrill, Birmingham-Southern CollegeThe past few years in our country have been the most divisive and alienating in my lifetime, which can be a tremendous challenge in the classroom that aims for community, shared experience, and listening with empathy to opinions that are different from one's own. The Essential Partners workshop I attended provided invaluable tools to meet the challenges of teaching today. It helped me reimagine the classroom as a place to help students learn the essential tools of living and learning in community and interconnection, skills that are necessary in every single area of life. I have no doubt that my teaching has been dramatically reshaped in light of my introduction to structured dialogue and I feel like I have so much more to offer my students because of that.
Birmingham, AL
Misty Stoll, School Board TrusteeThe Sheridan Community has changed in the best way since the Essential Partners training. The Center for a Vital Community has been holding monthly dialogues. I’m going to facilitate the upcoming one. What’s great is that we’re attracting a much more diverse group of participants. There are always the regulars who come, but now we’re also getting conservative Republicans to come as well—politicians come, even the Sheriff comes.
Wyoming
Belle AbayaWhat is special about Essential Partners' approach is that it promotes authenticity, reduces defensiveness, increases curiosity, and boosts connectedness.
The Conflict Resolution Group Foundation, Philippines
Dr. Brooke Vuckovic, Clinical Professor of Leadership“The Dialogic Classroom is by far and away the most skillful and thoughtful professional development I have had in years as an educator.”
Kellogg School of Management
Bob Bordone, Expert and AuthorEssential Partners does the best work in the field of dialogue and communication.
Harvard Negotiation & Mediation Clinical Program, Co-Founder
Belle AbayaTogether, we married our ideas to create a dialogue model that took into consideration our young people’s particular needs, and our culture.
The Conflict Resolution Group Foundation, Philippines
Kim Davidson, OmbudsI’ve gained not only confidence but tools. The Essential Partners training was worth every penny.
Oberlin College, Ohio
Kate CellThe thing that always feels like magic to me—and I’ve used it in several meetings that I’ve had since—is how the practitioners start by setting out pacts or agreements.
Union of Concerned Scientists, Massachusetts
Undergraduate StudentI feel more comfortable participating in class and less defensive when other students disagree. And because I learned more from my fellow students about their views, I now feel less competitive with them than in other classes.
Bridgewater College, Virginia
Undergraduate StudentThe professor was able to engage every student. She encouraged them to present new ideas. Dialogue helped create an environment that really deepened the understanding of the material.
Southern Methodist University, Texas
Matthew Sandikie, Project PartnerThis has been quite different from other discussions in Liberia about peace. While many processes have been about how to reform ex-combatants, this was about how we may hold our own views but live together peacefully.
Liberia
Misty Stoll, School Board TrusteeI ran for my local school board in 2018 and was elected. I use the skills in our meetings, whether I’m chairing the meeting or not. This makes the meetings much more productive. We don’t go over the same topics over and over again.
Wyoming
Undergraduate StudentI notice that my classmates take much more care when speaking about people who practice other religions. They make fewer assumptions, and they’re more careful with their words to make sure to avoid unintentional connotations.
Bridgewater College, Virginia
Cricket Fuller, The Christian Science MonitorThis wasn’t a policy debate [about guns]. Instead, two people whose backgrounds and views diverged in almost every way possible shared a moment of honesty that struck at the heart of the matter.
Boston, Massachusetts
Program ParticipantThis is a different tool for engagement. It’s not about you, it’s about others. It involves the art of listening and sincerely talking from the heart
Interfaith Mediation Centre, Nigeria
Program ParticipantBefore, I thought all dialogue that does not culminate in solution was considered equivalent to failure. Now I see that dialogue is a stage complete in itself.
Burundi
Undergraduate StudentIt’s nice to talk about things that we encounter all the time but rarely get talked about. This made me hopeful that there are people who are willing to talk about serious issues.
Dartmouth College, New Hampshire
Anjali Bal, Associate Professor of MarketingWe talked about where we are in the world right now, so we talked quite a bit about polarization. Essential Partners showed how these conversations are becoming more taxing and challenging because of that polarization. These were some first steps in terms of how we can start to have those conversations.
Babson College, MA
Undergraduate StudentWe tackled really difficult topics and this helped everyone know each other and understand each person's individual perspective. Over the course of the semester, I became much more comfortable engaging with my classmates—specifically because of the peer dialogue groups.
Bridgewater College, Virginia
Undergraduate StudentDuring one dialogue, as we were reading The Joy Luck Club, we were asked to discuss our relationship to America. There were students who grew up in the United States and also those who hadn’t—and I was surprised to hear that everyone had equally complex relationships with the topic.
I appreciated being able to hear and express the full depth of our own context before delving into a discussion about first-generation immigrants.
Gordon College, Massachusetts
Program ParticipantI am now open to new views and can moderate my impulse to debate or persuade others of different views
Montana
Megan DeFranzaHere safe space was created for pastors and church leaders to wrestle with topics like evolution which are all too often “off limits” or believed to be antagonistic to the faith.
Gordon College, Massachusetts
Karen Ramirez, Director of the CU Engage ProgramWe get more requests [for campus dialogue] than we could ever respond to.… I’m proud that our work on campus is actually kind of unusual, because it doesn’t support just one population. It supports everyone—students, staff, faculty, graduate students. I don’t know if there are other University of Colorado projects going on that hit all of our campus population.
University of Colorado, Boulder
Louise O’Kane, Community Places[Essential Partners’] technique is used to explore contentious or divisive issues. So looking at renewable energy we thought this was an ideal opportunity to explore all the complexities of that issue. I found it a really useful method, and although this is the first time we’ve used it I am sure we’ll be using it again.
Northern Ireland, UK
Rebekah Shrestha, SVPEssential Partners has played a catalytic role in our ability to facilitate dialogue time and time again, and we could not have done this work without them.
Belfer Center for Innovation & Social Impact and Office of Strategic Planning, 92NY
Andrew Wulf, PrincipalThe community dialogue was instrumental in helping us create a new policy around class rank. Though a controversial topic in the community, the dialogue EP helped us run ensured all voices were heard and valued. Regardless of how people felt with the final result, one parent summed it up best for us, ‘sometimes the process is more important than the outcome’.
Newburyport High School
Cricket Fuller, The Christian Science MonitorThis wasn’t a policy debate [about guns]. Instead, two people whose backgrounds and views diverged in almost every way possible shared a moment of honesty that struck at the heart of the matter.
Boston, Massachusetts
Dr. Jill DeTemple, Religious Studies FacultyAfter using this approach in my classroom, I am now more willing, and more able, to engage students in meaningful conversations about potentially contentious issues. Whereas I used to nod toward things like homosexuality in religious life, interfaith marriage, or the role of government in reproduction, now I build these conversations into the class so students can learn to speak about their experiences, and so they learn to listen and learn from those with whom they might disagree.
Southern Methodist University, Texas
Douglas Stone, Sheila Heen, and Bruce PattonWe owe a debt of gratitude to Laura Chasin and her collaborators at Essential Partners… From them, we have learned about the transformative power of telling one’s story and speaking to the heart of the matter.
Difficult Conversations
Romeo McCauley, Project PartnerI learned that I can build relationships, that I can be connected to anybody who I want to be connected to, no matter how difficult it is
Liberia
Belle AbayaAuthentic conversations will lead people to reflect on their own thinking and transform their perspectives to include that of others.
The Conflict Resolution Group Foundation, Philippines
Veronique Cavaillier, Director of Eastern Trade CouncilI think Essential Partners' training should be mandatory in every legislature. I think it should be a requirement.
The Council of State Governments
Undergraduate StudentI have learned how to not be offended and to be better prepared to receive other people's communication. You don't have to agree, but you can respect the other person.
Randolph College (VA)
Anjali Bal, Associate Professor of MarketingOne of the things that we talked about was the ability to hear another person’s point of view, even if our minds aren’t changed. We have to remember that any sort of movement is movement. If we don’t acknowledge small movement, then we just stay on two different sides, and it’s all black and white, and we don’t hear each other.
Babson College, MA
Anne Hopkins Gross, Dean of StudentsThe Essential Partners workshop was a way of building up our ability to talk about more difficult issues, such as poverty and GLBTQ safe spaces. It was really the foundational entrée into those more challenging issues of race, ethnicity, sexuality, and gender. People walked away feeling much more confident about having difficult conversations.
Southern Vermont College, VT
Imam Sani IsahThrough this training, we will have more people in the stream of work that we do and become better equipped with the know-how, skills and techniques. But most important, together we will sow a seed that will germinate and become a source of the antidote to terrorism, fanaticism, bigotry and extremism.
Nigeria
Undergraduate StudentI learned a lot about myself from others’ perspectives—it was comforting to hear similar values and ideas expressed, yet really eye-opening and intriguing to hear very different philosophies.
Dartmouth College, New Hampshire
Undergraduate StudentI have never heard people talk so openly about race, especially in a class setting. Everyone was respectful and honest at the same time. The dialogue structure helped me learn about my peers and helped me feel more comfortable than I ever have about discussing controversial issues.
Gordon College, Massachusetts
Undergraduate StudentI started to trust everyone in the class—I felt heard and I felt that people wanted to listen. As a result, I wasn’t afraid to let my past come out and let people learn from what I have been through.
Bridgewater College, Virginia
Undergraduate StudentI notice that my classmates take much more care when speaking about people who practice other religions. They make fewer assumptions, and they’re more careful with their words to make sure to avoid unintentional connotations.
Bridgewater College, Virginia
Undergraduate StudentAt the beginning of the semester, there was not much participation in class. But by the end, almost everyone had something constructive to add every day.
Bridgewater College, Virginia
Megan DeFranzaThere is a need not only for safe space within our churches but for our church leaders who often feel alone, or who may feel their job could be at risk if they engage in controversial conversations. How are they to make safe spaces in their own congregations for healthy dialogue if they rarely experience safe space to do the same?
Gordon College, Massachusetts
Etionette Nshirmirimana, Burundian Master TrainerI realized that by using the “dialogue” approach, people could talk of what is deep in their heart, especially things that have harmed them.
Burundi
Janet Lansberry, Weissman Center Assistant DirectorThis was probably the most profound workshop that we ever brought to campus. It offered a really unique foundation in personal insight.
Mount Holyoke College, MA
Program ParticipantThe highlight for me was the interconnectedness of the participants’ views, mutual respect, and range of experiences within the group
Montana
James Rucker, Faculty MemberIt is really different than it was before. The Essential Partners process has given me the power to be heard and be seen. It’s unreal.
Randolph College (VA)
Nicki Glasser, Policy CoordinatorWhat surprised me was how much you could transform a relationship during a three-hour conversation.
Transformation Center, Massachusetts
Undergraduate StudentDialogue challenged us to think more deeply about the class topics. Talking about our own thoughts and experiences in relation to the topic also challenged us to think about our own views and articulate them more clearly.
Gordon College, Massachusetts
Janet Harris, Winthrop Rockefeller InstituteThe learning we received from Essential Partners has helped us open up space for people to have difficult conversations in a different way. The more we do this, the more we realize that dialogue has to be a part of all our work.
Arkansas
Etionette Nshirmirimana, Burundian Master TrainerI realized that by using the “dialogue” approach, people could talk of what is deep in their heart, especially things that have harmed them.
Burundi
Bob Bordone, Expert and AuthorEssential Partners does the best work in the field of dialogue and communication.
Harvard Negotiation & Mediation Clinical Program, Co-Founder
Program ParticipantI did not anticipate having as many concrete takeaways as I do. I feel there is an immense practical application.
Seth Karamage, MediatorI am amazed at what came out—the way people shared their stories. This is not like a role-play; it really touched me.
Interfaith Mediation Centre, Nigeria
Anjali Bal, Associate Professor of MarketingOne of the things that we talked about was the ability to hear another person’s point of view, even if our minds aren’t changed. We have to remember that any sort of movement is movement. If we don’t acknowledge small movement, then we just stay on two different sides, and it’s all black and white, and we don’t hear each other.
Babson College, MA
Program ParticipantI did not anticipate having as many concrete takeaways as I do. I feel there is an immense practical application.
Kim Davidson, OmbudsI’ve gained not only confidence but tools. The Essential Partners training was worth every penny.
Oberlin College, Ohio
Katie Shear, Civic Engagement CoordinatorUsing what we learned from Essential Partners, staff were able to model effective and respectful communication for students. A next step would be for us to help students employ some of these methods themselves. The staff not only gained skills in communication but also left feeling supported by each other in the work that we do.
Southern Vermont College, VT
Windor DorkoAs a former rebel, I really believe that if we had known about dialogue, perhaps we would not have had a civil war.
Liberia
Elizabeth Zehl, Undergraduate StudentEssential Partners' process gives people the space to be intellectually curious and to engage with others on important issues in a way that also benefits their own understanding of what they believe.
Randolph College (VA)
Undergraduate StudentThe most significant thing for me was learning how to ask for more information rather than trying to persuade a person to think differently. I also learned helpful dialogue tips, which are more effective during difficult conversations. If I encounter a difficult dialogue with any of my residents, I plan on using the techniques I learned in this workshop to facilitate those talks.
Northeastern University, MA
Nicki Glasser, Policy CoordinatorWhat surprised me was how much you could transform a relationship during a three-hour conversation.
Transformation Center, Massachusetts
Teresa Grettano, Associate Professor and Director of the First-Year Writing programFacilitated dialogue creates a classroom atmosphere in which exploring uncomfortable issues and asking difficult questions is an expected part of the process, and it allows students space to engage each other without fear of the vitriol common in our public discourse.
University of Scranton (PA)
Program ParticipantThis is the best adult learning experience I have had in the past five years. I wanted to learn new skills—I did!
Linda Gryczan, MediatorInstead of demonizing and dehumanizing the other, we built a deeper connection. The fact that we disagree matters much less. It matters much more that we are neighbors in this community.
Montana Mediation Association
Program ParticipantI felt an amazing sense of accomplishment when the Essential Partners training ended; that I'd done something important for my community and something important for me.
Massachusetts
Program ParticipantThis is a new idea, so many people speaking from their hearts. People can come together...if people can understand, they can change their hearts; then this can bring about more change.
Interfaith Mediation Centre, Nigeria
Undergraduate StudentI learned to expect the best of my classmates, even when we don’t agree. I can’t write off their opinions anymore, despite our disagreements.
Bridgewater College, Virginia