Introduction to Mentalization-Based Approaches for Parents, Children, Youths, and Families.

Family members mentalize when they try to understand each other's behavior on the basis of intentional mental states. This article aims to introduce and briefly describe how the concept of mentalization can provide a useful framework for clinicians to understand psychopathology of children, youths, and families. The authors further outline how mentalization-based techniques and interventions can be applied to build epistemic trust and to reestablish mentalizing in families by presenting clinical vignettes of initial sessions from various clinical settings in the United Kingdom and Germany. The article concludes with a brief summary about the current evidence for mentalization-based interventions with children, adolescents, and families and provides an outlook for future clinical and research work.

[Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy]. / Mentalisierungsbasierte Therapie bei Adoleszenten mit Borderline-Persönlichkeitsstörung ­ Konzept und Wirksamkeit.

Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.

The use of mentalization-based treatment for adolescents (MBT-A) with a young woman with mixed personality disorder and tendencies to self-harm.

This article explores the psychological profile and treatment of young people who present clinically with features of borderline and avoidant personality disorder, along with vulnerable narcissistic traits. Self-harm in these youngsters is often used to regulate internal storms. It is argued that the adolescent phase of development is a trigger point for collapse in these vulnerable young people. In therapy, these patients are difficult to connect with emotionally and treatment can be fraught with strong countertransference reactions. A case study is used to illustrate the use of mentalization-based treatment for adolescents for such individuals.

Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial.

OBJECTIVE: We examined whether mentalization-based treatment for adolescents (MBT-A) is more effective than treatment as usual (TAU) for adolescents who self-harm. METHOD: A total of 80 adolescents (85% female) consecutively presenting to mental health services with self-harm and comorbid depression were randomly allocated to either MBT-A or TAU. Adolescents were assessed for self-harm, risk-taking and mood at baseline and at 3-monthly intervals until 12 months. Their attachment style, mentalization ability and borderline personality disorder (BPD) features were also assessed at baseline and at the end of the 12-month treatment. RESULTS: MBT-A was more effective than TAU in reducing self-harm and depression. This superiority was explained by improved mentalization and reduced attachment avoidance and reflected improvement in emergent BPD symptoms and traits. CONCLUSIONS: MBT-A may be an effective intervention to reduce self-harm in adolescents.