Operationalized psychodynamic diagnosis in childhood and adolescence (OPD-CA): Changes across psychodynamic child and adolescent therapy

Abstract

Psychodynamic therapies are effective in reducing mental health symptoms. However, little is known in terms of changes in the core psychodynamic concepts, like the structural level, interpersonal relatedness, and intrapsychic conflicts. The current study focused on these psychodynamic concepts – measured with the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA) – over the course of therapy and its relation to therapy outcome. Additionally, the OPD-CA axis treatment prerequisites was tested as a predictor of outcome. Therapists assessed the OPD-CA as well as the level of psychosocial impairment of 146 patients (aged M = 12.7 years, 62% female) at the beginning and end of therapy as part of a larger study on the effectiveness of psychodynamic psychotherapy. Structural level, interpersonal relations, and conflicts improved significantly over the course of therapy. Positive outcome was predicted by communicative abilities, positive self-relatedness and a high conflict level at the beginning of therapy as well as the improvement of these variables during therapy. Among the treatment prerequisites, only the subjective level of psychosocial impairment and the intrapsychic resources were predictive of outcome. Psychodynamic psychotherapy for children and adolescents may improve central psychodynamic concepts like structural level, interpersonal relations, and conflicts.

Keywords:

• Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA)
• children
• psychodynamic diagnostic
• sensitivity to change

Acknowledgements

We thank the therapists, the patients, and their parents for their contribution to the study.

Disclosure statement

The authors declare that they have no competing interests. The Vereinigung analytischer Kinder- und Jugendlichen-Psychotherapeuten (VaKJP) funded the study but had no influence on either the design of the study and collection, analysis, and interpretation of data or in writing the manuscript.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not publicly available.

Additional information

Funding

Vereinigung analytischer Kinder- und Jugendlichen-Psychotherapeuten (VaKJP)