Objectives: How do the OPD-based psychotherapy foci formulated by the therapeutic team at the patient's admission develop and how do they relate to change in symptoms and to the patient's individual therapeutic goals?
Method: After Operationalized Psychodynamic Diagnostics (OPD) in 188 psychotherapy inpatients, 2-3 clinically relevant OPD foci were chosen in joint team sessions after admission and assessed by the Heidelberg Structural Change Scale (HSCS) at the beginning and the end of inpatient psychotherapy. Patients formulated their individual therapy goals at the beginning and assessed their achievement at the end of inpatient psychotherapy and filled in self-assessment scales.
Results: At the end of therapy there was a significant mean improvement of one step on the Heidelberg Restructuring Scale for all three foci (0.9-1.2) in the sample as a whole. In approximately one-fourth of the patients we observed no change in the HSCS (25.5-27.7 %), approximately 70 % improved one to four steps towards higher awareness of, coping with or restructuring of the focus. The hypothesis of high correlations between the different measures of change could be supported only in part.
Discussion: The clinical implications and the implications for quality management are discussed.