A Psychodynamic Guide for Essential Treatment Planning

Frank Trimboli
University of Texas Southwestern Medical Center at Dallas
Kenneth L. Farr
University of Texas at Arlington

Abstract

This article presents a model for conceptualizing psychopathology designed to assist practitioners in evaluating patients and applying effective treatment plans. The model describes psychopathology as a function of two major dimensions consistent with psychoanalytic diagnostic principles. These dimensions are 1) level of ego organization, and 2) character style. In addition to the two major dimensions, two adjunctive variables are discussed which augment treatment planning through 1) evaluation of the individual's current level of adaptive functioning, and 2) confirmation of the diagnostic conceptualization and treatment approach by evaluation of the primary dynamic or conflict. These two major dimensions and two adjunctive variables are examined in relation to theoretical description of psychological functioning and procedures for assessment, and treatment considerations, respectively. We contend that a patient's level of ego organization and character style dictate the most fundamental goals of treatment. Level of adaptive functioning augments the pursuit of these goals by suggesting specific treatment considerations and approaches, while confirmation of the patient's primary dynamic or conflict helps to validate the diagnostic conceptualization and treatment approach. Key guidelines for the treatment of prototypical disorders are presented.

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Frank Trimboli, Ph.D., Department of Psychiatry, Division of Psychology, University of Texas Southwestern Medical Center at Dallas and private practice, Dallas, Texas;

Kenneth L. Farr, Ph.D., Student Health Services and Department of Psychology, University of Texas at Arlington, and private practice, Arlington, Texas. Member of Dallas Society for Psychoanalytic Psychology.

Requests for articles may be e-mailed to the authors.

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