Operationalized Psychodynamic Diagnosis and OPD-guided focal treatment

Domain I · Psychodynamic & depth psychology · Arbeitskreis OPD (OPD Task Force) · 1990 · Germany

What it is

OPD (Operationalized Psychodynamic Diagnosis) is a multiaxial psychodynamic system for diagnosis and treatment planning. It was developed from the early 1990s by the German-speaking OPD Task Force (Arbeitskreis OPD) of psychoanalysts, psychosomatic physicians and psychiatrists. It is mainly a…

Format

• OPD prescribes no fixed session count or therapy length. It has been used in long-term outpatient analytic therapy (the Heidelberg “Praxisstudie Analytische Langzeittherapie”), in inpatient psychosomatic units, and in planning shorter focal therapies. The stages below form the OPD-guided sequence;…
• Stage 1 — OPD interview (1–2 sessions, about 60–120 min in total).

Who practises it, and how they are trained or regulated

• Format: semi-structured. The interviewer moves flexibly between open psychodynamic exploration and structured inquiry. Video recording is standard in training and research.
• Section 4 therefore covers two things. It covers (a) the OPD interview, rating and planning procedures, at training level without reproducing checklists. It also covers (b) the treatment principles that OPD authors attach to foci, chiefly Grande 2007 and Rudolf's structure-related psychotherapy. Anything beyond these is marked. Reliable rating requires certified training: a basic course plus advanced video-rating…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• foci phrased in jargon, or more foci than you can track.
• staff splitting along the pattern's poles. That is itself confirmation of the focus.
• idiosyncratic reactions entering the rating. Check them in supervision or video review.
• leaving this until the very end, when time is short. Schedule a second appointment if needed.
• rigidity in avoiding every enactment. Some enactment is inevitable and useful when it is worked through.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.