A comparative study of a mentalization-based versus a psychodynamic group therapy session

Abstract

Aims: The purpose of this study was to explore how mentalization-based group therapy (MBT-G) for patients with borderline personality disorder may be both different and similar to a more traditional psychodynamic group psychotherapy approach. Material and methods: The study is a comparative case-study examining a supposedly representative clinical example of MBT-G and a supposedly representative clinical example of a psychodynamic group (PDG). Both groups were composed mainly of patients with borderline personality disorder. The study used a mixed methodological approach with quantitative research methods, including MBT-G Adherence and Quality Scale and Reflective Functioning Scale (RF-scale), and qualitative content analysis. Results: 1) The MBT-G therapists focused consistently on mental states and emotions. This was reflected both in a significantly higher intervention frequency, and in a higher proportion of theoretically assumed mentalizing-promoting interventions. 2) We observed an increase in mentalizing (defined as RF) among some patients in the MBT-G group. In the PDG session, RF development were less systematic, and had lesser impact. 3) Interventions with ‘demand’ characteristics might play an important role in developing a mentalizing group discourse. 4) In both groups, therapists and patients actively structured the sessions, but the MBT-G session more explicitly engaged in ‘meta’ discussions about it, i.e. discussing whether a topic should or should not be put on the agenda. Conclusion: Despite similarities between the approaches, differences in choice of therapeutic focus and consistency suggest that the two methods engage patients in different therapy processes. The results warrant studies that include more sessions in order to validate or falsify the resulting hypotheses.