Manual for Diagnosis and Treatment Planning
From the Foreword:"Both systems [DSM-IV and ICD-10], however, in their effort to simplify and thus facilitate communication and research have reduced the richness and clinically appropriate level of diagnosis in psychiatry. On the other extreme, some psychoanalytic clinicians have decried all classification systems..."The Operationalized Psychodynamic Diagnosis...is a major effort to bridge the gap between descriptive clarity and precision, on the one hand, and clinical sophistication and appropriate individualized differentiation, on the other."It is a diagnostic system that successfully attempts a synthesis between descriptive and dynamic features, and respects the interaction between biological, psychodynamic, and psychosocial determinants of illness."OPD will be an important stimulus for resuscitating the restrictive and reductionist systems presently in vogue."The OPD-2 is warmly recommended to all professionals in the mental health field."Otto F. Kernberg and John F. ClarkinDoody's Listings and Reviews of Your Books, published online June 2008, reviewed by Brett C. Plyler, M.D.(Northwestern Memorial Hospital)This is the second edition of a book on the Operationalized Psychodynamic Diagnosis system established by a task force in Germany in 1992. The first edition was published in 1996.The purpose is to update and revise the original publication from a diagnostic tool to an instrument for treatment planning.The book is written for therapists from analysts to psychiatrists who are interested in a psychodynamic classification system for patients.This is the result of the work of a task force with the mandate to create a psychodynamic classification system similar to ICD10 or DSM IV that could be used among therapists. The first edition focused primarily on providing a multi-axial, descriptive set for diagnostic purposes. This second edition changes in a number of ways: more focus on therapeutic processes; attempts to take into account a patient's strengths; better interface between axes; and improved to help determine therapeutic foci. The book begins with the theoretical ideas behind the system, then moves on to discuss both the operationalization and manualization of each axis in particular. A thorough section describes how to interview within the system and includes an extensive case example. The last sections deal with treatment planning, measurement of change, and different checklists for its application. This is a complex and interesting text. I wasn't aware of this movement to operationalize psychodynamic diagnoses and I think it shows promise. The book is thoroughly detailed and gives readers a good understanding of how the system works. However, it takes extensive training (60 hours or so) to learn the format for clinical practice. The case examples are excellent and clearlyillustrate how this classification system could benefit a therapist. There is also a forensic subsection for those interested. I'm not sure how far this movement will spread, but I would recommend the book for any therapist interested in psychodynamic classification systems.PsycCRITIQUES, Vol. 53, issue 45, November 2008, reviewed by Dolores McCarthy & Franziska Hoffmann:Translated from German, Operationalized Psychodynamic Diagnosis OPD-2:Manual of Diagnosis and Treatment Planning offers a sehr gut, in fact, an excellent alternative to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; 4th ed., text rev.; American Psychiatric Association, 2000), Psychodynamic Diagnostic Manual (PDM; Alliance of Psychoanalytic Organizations, 2006), International Statistical Classification of Diseases and Related Health Problems (ICD-10; 10th ed.; World Health Organization, 1992), and other psychiatric classification systems. This review is written from the perspectives of an American university professor with colleagues in Heidelberg (where the book was written) and of a German from Berlin as a
Foreword by Otto F. Kernberg and John F. Clarkin; Preface; OPD Task Force; 1. Theoretical Background; 1.1 From OPD-1 to OPD-2; 1.2 Aims of the OPD Task Force; 1.3 The Concept of the Operationalized Psychodynamic Diagnosis (OPD); 1.4 Fundamental Considerations on a Multiaxial Diagnosis; 1.5 On the Operationalization of Psychoanalytic Constructs; 1.6 Past Approaches of Operationalization of Psychodynamic Constructs; 1.7 Limits of the OPD; 2. Experiences and Empirical Findings with OPD-1; 2.1 Quality Criteria of OPD-1; 2.2 Axis I: "Experience of Illness and Prerequisites for Treatment"; 2.3 Axis II: "Interpersonal Relations"; 2.4 Axis III: "Conflict"; 2.5 Axis IV: "Structure"; 2.6 Conclusion; 3. Operationalization of the Axes According to OPD-2; 3.1 Axis I - Experience of Illness and Prerequisites for Treatment; 3.2 Axis II - Interpersonal Relations; 3.3 Axis III - Conflict; 3.4 Axis IV - Structure; 3.5 Axis V - Mental and Psychosomatic Disorders; 3.6 Conceptual Cross-References and Interactions Between the Axes; 4. Manualization of the Axes According to OPD-2; 4.1 Axis I - Experience of Illness and Prerequisites for Treatment; 4.2 Axis II - Interpersonal Relations; 4.3 Axis III - Conflict; 4.4 Axis IV - Structure; 5. The OPD Interview; 5.1 The Theory of the Psychodynamic Interview; 5.2 Carrying out the OPD Interview; 6. Case Example: "Driven out from Paradise"; 6.1 Interview Vignette; 6.2 Case Evaluation and Documentation; 6.3 Comments on the Evaluation; 7. Focus Selection and Treatment Planning; 7.1 Establishing the Indication for Treatment on the Basis of OPD Axis I; 7.2 Determination of Foci on the Basis of OPD Axes II-IV; 7.3 Principles of Focus Selection; 7.4 Component Parts of the Foci; 7.5 Treatment Planning and Therapeutic Aims; 7.6 Peculiarities of the Psychodynamic Work on Dysfunctional Relationship Patterns; 7.7 Concluding Remarks; 8. Change Measurement with OPD; 8.1 OPD and Change Measurement: Basic Considerations; 8.2 Model of an OPD-based Change Measurement; 8.3 Reliability and Validity; 8.4 Clinical Application; 9. Areas of Application and Quality Assurance; 9.1 Quality Assurance in Psychotherapy and the Law; 9.2 Quality Assurance in Psychodynamic Psychotherapies (QPP); 9.3 OPD in the Expert Assessment Procedure of the German Psychotherapy Guidelines; 9.4 OPD in Inpatient Treatment in Psychosomatic-Psychotherapeutic Hospitals; 9.5 OPD in the Psychosomatic Rehabilitation Treatment; 9.6 Training, Continuing Education, and Post-Graduate Study; 9.7 OPD and Expert Opinion; 10. Continuing Education and Post-Graduate Study (with a List of Addresses); 11. References; 12. Addresses of Authors; 13. Tools for Working with OPD; 13.1 Axis I - Forensic Module; 13.2 Axis II; 13.3 OPD-2 Conflict Checklist; 13.4 The OPD-2 Structure Checklist; 1.1 Cognitive ability: Self-perception; 13.5 Heidelberg Structural Change Scale; 13.6 Interview Tools; 13.7 Operationalized Psychodynamic Diagnosis (OPD-2) Data Evaluation Forms; 13.8 Data Evaluation Sheet Forensic Module; 13.9 Data Evaluation Sheet Focus Selection; 14. Additional Modules; 14.1 The GAF (Global Assessment of Functioning) Scale; 14.2 EQ-5D; 14.3 List of Defence Mechanisms.