[Psychodynamic therapy foci in inpatient psychotherapy--relations to self-assessment scales and individual therapeutic goals].
OBJECTIVE
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?


METHODS
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.


CONCLUSIONS
The clinical implications and the implications for quality management are discussed.
Schneider
Gudrun
G
Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster. schneig@mednet.uni-muenster.de
Schmitz-Moormann
Stefani
S
Bär
Olaf
O
Driesch
Georg
G
Heuft
Gereon
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003674:Defense Mechanisms; D005260:Female; D006040:Goals; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D017060:Patient Satisfaction; D010555:Personality Inventory; D011340:Problem Solving; D011575:Psychoanalytic Therapy / Q000379:methods*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017749:Total Quality Management